Newsroom
Findings suggest cost of OTC naloxone is likely a barrier in areas with high social deprivation – emphasize importance of low- and no-cost distribution channels
RESEARCH TRIANGLE PARK, N.C. — A new study from RTI International, an independent scientific research institute, shows that over-the-counter (OTC) sales of the opioid reversal medication naloxone remain limited in areas hardest hit by opioid overdoses, despite the U.S. Food and Drug Administration’s March 2023 approval of the nasal spray for nonprescription use.
Researchers examined retail sales data from Kentucky, Massachusetts, New York and Ohio—four states with historically high opioid overdose death rates—during the first eight months of OTC naloxone availability. They found that the medication was sold in approximately 9% of stores and that sales were significantly lower in communities with high levels of social deprivation.
“Naloxone’s move to over-the-counter status was a critical step toward expanding access,” said Doris Gammon, a public health researcher and program manager at RTI and lead author of the study. “But our findings show that price and availability still limit its reach, especially in the communities that need it most.”
Based on NielsenIQ retail data from September 2023 through April 2024, the study found that the average price per naloxone kit was $45. The brand Narcan accounted for 99% of all OTC sales. Weekly sales spiked in the first two months after market entry but stabilized at lower levels through the spring.
The research team analyzed sales patterns using a Social Deprivation Index, which accounts for factors such as poverty, housing, transportation, education and employment. They found that areas with higher social deprivation indices consistently had lower OTC naloxone sales.
The findings suggest that low- or no-cost distribution channels remain vital to naloxone access, according to the research team.
The study was published in the Journal of Substance Use and Addiction Treatment (JSAT).
Learn more about RTI’s public health and well-being research
Narcan display in a grocery store (photo credit: Doris Gammon)
RTI International is an independent scientific research institute dedicated to improving the human condition. Our vision is to address the world's most critical problems with technical and science-based solutions in pursuit of a better future. Clients rely on us to answer questions that demand an objective and multidisciplinary approach—one that integrates expertise across social, statistical, data, and laboratory sciences, engineering, and other technical disciplines to solve the world’s most challenging problems.
For more information, visit www.rti.org.