Patients' Willingness to Pay for Naloxone: A National Cross-Sectional Survey of Prescription Opioid Users with Chronic Pain in the US.

BACKGROUND:Millions of US people have been heavily affected by opioids. In March 2023, the FDA approved naloxone as an OTC medication. This has allowed more access to patients at high risk of opioid overdose. However, the patient's willingness to pay for naloxone at the pharmacy counter has not been assessed. OBJECTIVES:To characterize factors associated with the willingness to pay for naloxone among the patient group. METHODS:A cross-sectional Qualtrics online panel survey instrument was developed. This survey was distributed to patients in the US, aged ≥18, with any chronic pain and taking opioids. The survey included demographics, and clinical characteristics (pain assessment, opioid use, and knowledge of naloxone. Also, willingness to pay was assessed using a 7-point Likert scale ranging from strongly disagree to strongly agree. An ordinal logistic regression model was used to examine demographic and clinical characteristics. RESULTS:549 subjects completed the survey (women: [53.01%], White or Caucasian (83.61%), age: mean [SD]: 44 [13]). Women were associated with less willingness to pay (adjusted odds ratio [aOR], 0.685; 95% confidence interval (CI), 0.478-0.983; p= 0.0403). Compared to the high household income group (≥ $150,000), low household income ≤ $25,000 (aOR, 0.326; 95% CI, 0.160- 0.662; p=0.0020) or income between $25,000-74,999 (aOR, 0.369; 95% CI, 0.207-0.657; p=0.0007) was associated with less likelihood of willing to pay. Patients with a prior diagnosis of obstructive sleep apnea were associated with a higher likelihood of willingness to pay (adjusted odds ratio [aOR], 1.685; 95% CI, 1.138-2.496; p=0.0092). Each unit increase in pain was also associated with a higher likelihood of willingness to pay (aOR, 1.247; 95% CI 1.139-1.365; p< 0.0001) CONCLUSIONS: Demographics and clinical factors were associated with willingness to pay for naloxone. This study's findings are useful in the development of interventions to address pharmacy-based naloxone distribution programs.