Access to naloxone at community pharmacies under the Massachusetts statewide standing order.

Objective: This study aimed to evaluate access to, and barriers to accessing, naloxone at community pharmacies throughout Massachusetts following implementation of new legislation that requires all community pharmacies to maintain a sufficient supply for dispensing under a statewide standing order.

Design: From September 2018 through January 2019, we conducted a cross-sectional telephone-based survey of Massachusetts pharmacies by having an interviewer pose as a customer seeking naloxone.

Setting And Participants: Community pharmacies were identified from a list of all actively licensed pharmacies provided by the Massachusetts Department of Public Health and one-half were randomly selected for inclusion. Pharmacies that were permanently closed, duplicated on the list, or closed to the general public were excluded from analysis.

Outcome Measures: Rates of stocked naloxone, perceived need for identification or prescription, and pricing.

Results: Of the 524 pharmacies surveyed, 97.7% (n = 512) reported routinely stocking naloxone. Of those, 90.4% (n = 463) had naloxone in stock on the day of contact. Most pharmacies with naloxone in stock did not require a prescription (96.1%; n = 445); at these pharmacies, personal identification was required by 38.9% (n = 180). The average out-of-pocket naloxone nasal spray price was $128.34 ± $40.75.

Conclusion: Nearly all Massachusetts community pharmacies routinely stock naloxone as required by state law; however, barriers remain regarding perceived need for identification and high out-of-pocket costs.