Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System.

Authors

• Kory S London
• Sejal Patel
• Drew Lockstein
• Jamal Rashid
• Dennis Goodstein
• Richard Pacitti
• TaReva Warrick-Stone
• Frederick Randolph
• Alan Cherney
• Karen Alexander
• Megan Reed

Publication/Presentation Date

11-18-2025

Abstract

INTRODUCTION: Take-home naloxone (THN) programs in emergency departments (ED) can reduce opioid overdose deaths by providing naloxone directly to at-risk patients before discharge. However, sustainable models that integrate reimbursement and workflow alignment remain limited.

METHODS: A reimbursable ED-led THN program was developed across a large regional health system. The program used electronic health record (EHR)-integrated ordering, on-site kit dispensing, and third-party insurance billing when available. Kits were stocked in automated medication dispensing systems and supplemented by city-provided stock for uninsured patients. Pilot outcomes included kits dispensed and reimbursement rates across eight participating EDs.

RESULTS: A total of 2,520 naloxone kits were dispensed across eight EDs between January 2019-December 2024, with a total of 6,551 encounters with decision support prompting naloxone ordering (31.6% of eligible). The proportion of kits reimbursed by insurance rose from 46% in 2019 to 95% by 2025. In total, 89.9% of kits were reimbursed either by insurance or public supply (the rest paid by the hospital system). Kit distribution grew from 99 in 2019 to 702 in 2024, reflecting expanded site participation, improved workflows, and greater staff engagement.

CONCLUSION: A reimbursable ED-led naloxone program can increase access to life-saving medication for patients at risk of opioid overdose. Integrating take-home naloxone distribution into EHR workflows, leveraging insurance billing, and partnering with public health agencies offers a sustainable, low-barrier model that other health systems can adopt.

Volume

26

Issue

6

First Page

1605

Last Page

1610

ISSN

1936-9018

Published In/Presented At

London, K. S., Patel, S., Lockstein, D., Rashid, J., Goodstein, D., Pacitti, R., Warrick-Stone, T., Randolph, F., Cherney, A., Alexander, K., & Reed, M. (2025). Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System. The western journal of emergency medicine, 26(6), 1605–1610. https://doi.org/10.5811/westjem.47387

Disciplines

Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences

PubMedID

41380066

Department(s)

Department of Pharmacy

Document Type

Article