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We aimed to examine the cost and probable impact of up\u2010scaling naloxone supply to people who are prescribed opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Decision\u2010tree model. Four scenarios were compared with a baseline scenario (the current <jats:italic>status quo<\/jats:italic>): naloxone scale\u2010up between 2020 and 2030 to reach 30 or 90% coverage by 2030, among the subgroups of people prescribed either \u2265\u200950 or \u2265\u2009100\u2009mg of oral morphine equivalents (OME).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>People who are prescribed opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Possible deaths averted, costs (ambulance and naloxone distribution) and cost per life saved for different scenarios of naloxone scale\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Maintaining the <jats:italic>status quo<\/jats:italic>, there would be an estimated 7478 [uncertainty interval (UI)\u2009=\u20096868\u20138275] prescription opioid overdose deaths between 2020 and 2030, resulting in Australian dollars (A$)51.9 million (49.4, 56.0) in ambulance costs. If naloxone were scaled\u2010up to 90% of people prescribed &gt;\u200950\u2009mg OME, an estimated 657 (UI\u2009=\u2009245, 1489) deaths could be averted between 2020 and 2030 (a 20% reduction in the final year of the model compared with the no naloxone scenario), with a cost of A$43\u2009600 (20\u2009800\u2013110\u2009500) per life saved. If naloxone were scaled\u2010up to 30% of people prescribed &gt;\u200950\u2009mg OME an estimated 219 (82\u2013496) deaths could be averted with the same cost per live saved. If naloxone were restricted to those prescribed &gt;\u2009100\u2009mg OME, an estimated 130 (UI\u2009=\u200944\u2013289) deaths would be averted if scaled\u2010up to 30% or 390 (UI\u2009=\u2009131\u2013866) deaths averted if scaled\u2010up to 90%, with the cost per life saved for both scenarios A$38\u2009200 (UI\u2009=\u200912\u2009400\u201397\u2009400).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In Australia, scaling\u2010up take\u2010home naloxone by 2030 to reach 90% of people prescribed daily doses of \u2265\u200950\u2009mg of oral morphine equivalents would be cost\u2010effective and save more than 650 lives.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15727","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T19:04:00Z","timestamp":1637262240000},"page":"1009-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The cost and impact of distributing naloxone to people who are prescribed opioids to prevent opioid\u2010related deaths: findings from a modelling study"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"first","affiliation":[{"name":"Behaviours and Health Risks Burnet Institute  Melbourne VIC Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Scott","sequence":"additional","affiliation":[{"name":"Behaviours and Health Risks Burnet Institute  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Tidhar","sequence":"additional","affiliation":[{"name":"Behaviours and Health Risks Burnet Institute  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8943-2808","authenticated-orcid":false,"given":"Maria del Mar","family":"Quiroga","sequence":"additional","affiliation":[{"name":"Behaviours and Health Risks Burnet Institute  Melbourne VIC Australia"},{"name":"Melbourne Data Analytics Platform University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7013-9812","authenticated-orcid":false,"given":"Simon","family":"Lenton","sequence":"additional","affiliation":[{"name":"National Drug Research Institute Curtin University  Bentley WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dietze","sequence":"additional","affiliation":[{"name":"Behaviours and Health Risks Burnet Institute  Melbourne VIC Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston VIC Australia"},{"name":"National Drug Research Institute Curtin University  Bentley WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-019-01154-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13326"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12523"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-1-201301010-00003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.07.014"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.06.035"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4785-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13792"},{"key":"e_1_2_9_10_1","unstructured":"World Health Organization (WHO)WHO\u2010UNODC \u2018Stop Overdose Safely (S\u2010O\u2010S)\u2019 initiative 2021. 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