Federal Policy
GAO Finds Broad Medicare, Medicaid Coverage of Overdose Reversal Drugs
GAO reports that all Medicare Part D and Medicaid enrollees had coverage of some form of naloxone in 2025 and 2024, respectively, while coverage of nalmefene, a newer and longer-acting overdose reversal medication, was less common. Part D out-of-pocket costs ranged from $3 to $10 median copays for generic naloxone injections up to 25 to 35 percent coinsurance for brand high-dose naloxone and nalmefene nasal sprays. Among four selected state Medicaid programs GAO reviewed, two had no copays and two had copays under $5. GAO analyzed 2025 Part D data and 2024 Medicaid drug reimbursement data from all 50 states and DC, and interviewed four plan sponsors and four state Medicaid programs about coverage and cost factors.
Why it mattersState Medicaid agencies and Part D plan sponsors may use the findings to benchmark their own cost-sharing and coverage policies for opioid overdose reversal medications against peers.