Only one-third of Philadelphia pharmacies carry naloxone nasal spray and many pharmacies require a physician's prescription, according to a study published in JAMA Network Open.

Jenny S. Guadamuz, from the University of Illinois at Chicago, and colleagues conducted a survey study of all pharmacies in Philadelphia to examine the availability and cost of naloxone nasal spray.

Overall, 418 of 454 eligible pharmacies were surveyed. The researchers found that 34.2 percent of pharmacies had naloxone nasal spray in stock; 61.5 percent of these pharmacies indicated that it was available without prescription. Significant differences were identified in naloxone availability by pharmacy type and neighborhood characteristics. Compared with independent stores, in chain stores, naloxone was more likely to be in stock (45.9 versus 27.8 percent) and available without a prescription (80.6 versus 42.2 percent). In planning districts with very elevated rates of opioid overdose death versus those with lower rates, naloxone was less likely to be available (31.1 versus 38.5 percent). Among pharmacies offering naloxone without a prescription, the median out-of-pocket cost was $145; independent pharmacies and planning districts with elevated rates of opioid overdose death had the greatest costs.

"Our findings suggest that policies that discourage pharmacies from imposing unnecessary dispensing restrictions, including individual prescription or age requirements, are also critical in these neighborhoods, as are efforts that address the high cost of naloxone," the authors write.

One author disclosed financial ties to the medical technology and health care industries.

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