GAO Report on Opioid Overdose Reversal Medications, Medicare and Medicaid Enrollees Generally Had Coverage in Selected Recent Years

The Government Accountability Office looked at coverage for opioid overdose reversal medications for Medicare and Medicaid enrollees in recent years. The analysis showed that both Medicaid and Medicare covered some form of naloxone in 2025 and 2024. Coverage for nalmefene was less common among enrollees.

Opioid Reversal Medication Coverage

Naloxone and nalmefene are available as injections, nasal sprays, generic, and brand versions. Low-dose naloxone nasal sprays became available for over-the-counter use in 2023. Federal data showed that all enrollees of Medicare Part D had coverage of some form of naloxone in 2025 and 2024. Coverage for nalmefene was less common. Out-of-pocket costs varied based on the drug formulation and status. Generic naloxone injections had median copays ranging from a $3 to $10. High-dose brand medications had median coinsurance ranging from 25 to 35 percent.

Why GAO Looked Into It

GAO reviewed the coverage and costs of opioid overdose reversal medications for enrollees of federal health programs. This review addressed concerns about access because newer over the counter versions faced issues with insurance coverage. GAO analyzed Centers for Medicare & Medicaid Services Part D data for 2025 and Medicaid drug reimbursement data for all 50 states and the District of Columbia for 2024. The GAO examined the percentage of Part D enrollees with coverage and the number of state Medicaid programs with coverage. GAO also looked at median copays or coinsurance for Part D enrollees and copays for four selected state Medicaid programs.

GAO made no recommendations in this report.

The full report, Opioid Overdose Reversal Medications: Medicare and Medicaid Enrollees Generally Had Coverage in Selected Recent Years, is on GAO’s site, publicly released Nov 09, 2026.