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P003: Epidemiology Response Division (FY18)

P003: Percent of retail pharmacies that dispense naloxone

Current Value

72.6%

FY 2018

Definition

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Story Behind the Curve

  • New Mexico had the 12th highest drug overdose death rate in the nation in 2016. Naloxone is a safe and effective medication that reverses the effects of prescription opioids and heroin, thereby preventing opioid overdose death. 
  • The risk of opioid overdose is statewide, with the highest death rates among people aged 35-54 and in rural areas. 
  • In 2016, Senate Bill 262/House Bill 277 was signed and the naloxone Statewide Standing Order for Pharmacists was written, which allows all registered pharmacists to dispense naloxone to any person who uses an opioid or any person in a position to assist a person at risk of experiencing an opioid overdose. The state Medicaid plan was expanded to include coverage of intranasal naloxone. Pharmacies are being trained on the naloxone standing order and billing procedures. In FY17, 60.9% of retail pharmacies statewide dispensed naloxone products.
  • The Epidemiology and Response Division will continue to provide technical assistance to retail pharmacies with billing questions about naloxone. The Division is continuing a contract to provide training to pharmacies about naloxone, billing and coverage issues, and reduction of stigmas against people who request naloxone. The Division is also continuing to resolve naloxone billing and coverage issues with the Board of Pharmacy, the New Mexico Pharmacists’ Association, and third-party payers. As a result of the ongoing collaboration and partnership with retail pharmacies, data shared with NMDOH show that 54.2% of retail pharmacies dispensed naloxone in the 4th quarter. Overall for FY18, 72.6% of retail pharmacies dispensed naloxone, which exceeds the performance target.
  • The partnership with retail pharmacies will continue into FY19 and should help NMDOH achieve a greater percentage of retail pharmacies that dispense Naloxone.

Partners

  • NMDOH
  • New Mexico Board of Pharmacy
  • New Mexico Human Services Department
  • New Mexico Pharmacists’ Association
  • Local community and chain pharmacies and pharmacists
  • Local managed care organizations and insurance payers
  • Pharmacy wholesalers  
  • University of New Mexico College of Pharmacy
  • Southwest CARE Center Pharmacy

What Works

  • Removing barriers to pharmacy-based naloxone dispensing practices.
  • Implementing naloxone standing orders.
  • Training pharmacies on naloxone and the standing order.
  • Collaborating with state managed care organizations, and other insurers, to add naloxone products to their drug formularies.
  • Peer-to-peer and community engagement with stakeholders to assist NMDOH in overdose prevention efforts, such as pharmacy-based naloxone.

Strategy

  • Remove barriers to pharmacy-based naloxone dispensing practices, such as ensuring adequate pharmacy reimbursement for naloxone, removing extra training requirements for pharmacists, and working on stigma reduction.
  • Work with managed care organizations, and other insurers, to include naloxone products, and reducing restrictions on those products, on all pharmacy benefit drug formularies.
  • Conduct peer-to-peer outreach to pharmacists through large chain pharmacies, professional pharmacist associations, and the University of New Mexico College of Pharmacy.

Action Plan

  • Q1: 40%: Reach out to the district managers for all chain retail pharmacies for reporting data on naloxone sold through all types of payments.  Provide training to pharmacies regarding the naloxone standing order and billing practices.  Resolve naloxone billing and coverage issues with the Board of Pharmacy, the New Mexico Pharmacists’ Association, and third-party payers. Not met.
  • Q2: 45%: Follow-up with district managers for any chain retail pharmacies that did not report in the previous quarter.  Provide training to pharmacies regarding the naloxone standing order and billing practices.  Resolve naloxone billing and coverage issues with the Board of Pharmacy, the New Mexico Pharmacists’ Association, and third-party payers. Exceeded-Newly discovered data from Medicaid claims has allowed NMDOH to more accurately account for an even greater number of pharmacies that dispense naloxone. Met - 59.9%.
  • Q3: 50%: Conduct outreach to independent, outpatient pharmacies for reporting data on naloxone sold through all types of payments. Provide training to pharmacies regarding the naloxone standing order and billing practices.  Resolve naloxone billing and coverage issues with the Board of Pharmacy, the New Mexico Pharmacists’ Association, and third-party payers. Met.
  • Q4: 55%: Conduct outreach to pharmacies in underserved areas.  Provide training to pharmacies regarding the naloxone standing order and billing practices.  Resolve naloxone billing and coverage issues with the Board of Pharmacy, the New Mexico Pharmacists’ Association, and third-party payers. Met - 72.6%.

FY18 Annual Progress Summary

Despite not achieving anticipated results for the 1st quarter of FY18, the Prescription Drug Overdose Prevention Program (PDOPP) achieved and exceeded results for Q2, Q3 and Q4.  Overall for FY18, 72.6% of retail pharmacies dispensed naloxone, which exceeds the performance target. PDOPP has many other program activities currently operating along with this performance measure to address and lessen the overdose death rate due to opioids.  With FY18 ending and FY19 starting, PDOPP is continually engaged in many well established program activities and partnerships while establishing evidence-based new ones to effectively address the evolving drug overdose burden in New Mexico.  Pharmacies not currently providing naloxone have been surveyed and the individually encouraged to start providing naloxone.

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