The role of managed care pharmacy in coprescribing naloxone for patients with specific risk: recommendations from the AMCP Addiction Advisory Group

Abstract

SUMMARY in treatment, coverage, policies, and needs associated with providing health services to Prescription opioid misuse remains a sigpatients with substance use disorders, the nificant cause of morbidity and mortality Academy of Managed Care Pharmacy (AMCP) associated with drug overdose. Researchers, Addiction Advisory Group conducted a surgovernment agencies, public health intervey in 2019. Eighty percent of the managed ests, and professional organizations support behavioral health organizations and 47% of the benefits of naloxone coprescribing for AMCP payer members who responded to the patients on chronic opioid therapy to presurvey encouraged naloxone coprescribing in vent deaths from opioid overdose. However, patients at high risk of overdose; however, no gaps remain in the provision of naloxone organizations require coprescribing. to patients at risk. Currently, less than 1% Health plans, managed care organizaof patients who should be prescribed tions, prescribers, pharmacists, patients, and naloxone with their opioid medications others have important roles in decreasing obtain a prescription for naloxone, illustratthe morbidity and mortality associated with ing an opportunity for health care providers opioid overdose. In particular, managed care to conduct thorough risk assessments for organizations can take specific and meaning-patients taking opioids and coprescribing ful actions to implement payment policies naloxone to those at risk. that improve naloxone coprescribing for There are documented barriers to the pro-patients at risk. In this article, opportunities vision of naloxone for primary care providers, have been outlined for managed care lead-pharmacists, and patients. Managed care ership that actively support public health organizations have also created barriers. policies for naloxone coprescribing, and To better understand and evaluate trends 7 recommendations are presented.