Increasing Naloxone Access and Prescribing for Patients on High-Dose Opioids From a Managed Care Pharmacy Health Plan Perspective.

This article focuses on efforts by Baylor Scott & White Health Plan (BSWHP) to increase naloxone prescribing among members taking high-dose opioids, defined as exceeding 90 morphine milligram equivalents (MME) per day, to reduce opioid overdose risk. Through a multi-pronged approach—including removing naloxone copays, provider and pharmacist education, case management referrals, and implementation of a best practice alert (BPA) in the electronic medical record—naloxone prescribing rates among high-dose opioid users increased from 6.87% in June 2019 to 41.18% by May 2023, while the proportion of members exceeding 90 MME per day decreased. The study highlights challenges such as communication barriers and limitations in claims data but supports that system-wide interventions can improve naloxone access in a commercially insured population. Future directions include expanding targeting criteria to lower opioid dosages and further evaluating the impact of electronic health record alerts.