Insurance coverage and consistent pricing is needed for over-the-counter naloxone.

With the Food and Drug Administration's approval of the first over-the-counter naloxone nasal spray in 2023, it was expected that access to naloxone nasal spray would increase and that its cost would be reduced. However, the writers of this commentary found varying insurance coverage of naloxone during purchase attempts at local pharmacies. Failure to cover naloxone can reduce access and increase risk of overdose death. We suggest federal policy implementation that requires universal insurance coverage of at least one formulation of naloxone and to utilize national opioid settlement funds to pay for naloxone nasal spray to ensure equitable access to this lifesaving medication.