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

Authors

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

Document Type

Article

Publication Date

11-18-2025

Comments

This article is the author's final published version in Western Journal of Emergency Medicine, Volume 26, Issue 6, November 2025, Pages 1605-1610.

The published version is available at https://doi.org/10.5811/westjem.47387. Copyright © London et al.

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.

Recommended Citation

London, Kory S.; Patel, Sejal; Lockstein, Drew; Rashid, Jamal; Goodstein, Dennis; Pacitti, Richard; Warrick-Stone, TaReva; Randolph, Frederick; Cherney, Alan; Alexander, Karen; and Reed, Megan, "Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System" (2025). Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers. Paper 56.
https://jdc.jefferson.edu/ppcbfp/56

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English