Willingness-to-pay for naloxone over-the-counter and from a pharmacist

Last registered on May 30, 2024
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Pre-Trial

Trial Information

General Information

Title
Willingness-to-pay for naloxone over-the-counter and from a pharmacist
RCT ID
AEARCTR-0013657
Initial registration date
May 23, 2024

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
May 30, 2024, 3:16 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Name
David Powell
Affiliation
RAND
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Other Primary Investigator(s)

PI Name
Mireille Jacobson
PI Affiliation
University of Southern California
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Additional Trial Information

Status
In development
Start date
2024-05-23
End date
2024-10-31
Keywords
Health
Additional Keywords
harm reduction; naloxone
JEL code(s)
I12; I18
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
We will conduct a survey about opioid misuse and naloxone access in a nationally-representative sample and a sample that has previously stated that they suffer from opioid dependence. Within the survey, we will ask the respondents to provide their maximum willingness-to-pay for a two-dose kit of Narcan. Respondents will be randomized into one of two arms. In the first arm, the experiment will specify that the purchase will be made "from a pharmacist." In the second, they will be told that the purchase will be made "over-the-counter." We are interested in whether there are differences in the willingness-to-pay for naloxone based on where the naloxone is purchased from. We hypothesize that respondents will be willing to pay more to purchase naloxone over-the-counter to avoid interaction with a pharmacist and any associated stigma with this purchase.
External Link(s)

Registration Citation

Citation
Jacobson, Mireille and David Powell. 2024. "Willingness-to-pay for naloxone over-the-counter and from a pharmacist." AEA RCT Registry. May 30. https://doi.org/10.1257/rct.13657-1.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
We will randomize whether respondents are asked for their willingness to pay for a two-dose kit of Narcan (a) from a pharmacist or (b) over-the-counter.
Intervention Start Date
2024-05-23
Intervention End Date
2024-05-31

Primary Outcomes

Primary Outcomes (end points)
a) We will calculate the mean willingness-to-pay for both treatment arms and compare across them. Our full sample includes a “nationally-representative sample” and an “opioid-dependent sample.” We will use the full sample.

b) We will also present results for an opioid-dependent sample and for the rest of the sample. We will stratify based on our questions about opioid dependence.

We will use Westfall-Young to adjust for multiple comparisons for the primary outcomes since we will present results for three (overlapping) samples.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
We will repeat the main analyses but study medians.

In addition, we will make the same comparisons (means and medians) for the following stratified samples:
(1) people who know someone impacted by opioids in any of the following ways: (a) struggled with an opioid addiction, (b) needed medical attention because of an opioid addiction, (c) sought treatment for an opioid addiction, (d) had an overdose (nonfatal or fatal) (e) faced police contact, arrest, or incarceration due to an opioid addiction, or (f) believe them to be likely or very likely to overdose from opioid use;

(2) people who are personally impacted by opioid use (same reasons as above, although we can only include those who experienced a nonfatal overdose) or state that they are likely or very likely to overdose from opioid use. In each stratification, we will show the comparable results for the sample not meeting the conditions.

(3) We will also stratify by race, gender, and political affiliation.

(4) Finally, we will stratify based on the 2022 overdose death rate of the state.

Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We are conducting the survey on Bilendi. The survey randomizes respondents into one of the two arms with a 0.5 chance of each arm.
Experimental Design Details
Not available
Randomization Method
Randomization done by code running the survey in real-time.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
2000 respondents
Sample size: planned number of observations
2000
Sample size (or number of clusters) by treatment arms
1000 in each treatment arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Our full sample consist of 2000 respondents. We use alpha = 0.05 / 3 as a conservative multiple hypothesis adjustment for the power analysis since we are presenting estimates for 3 overlapping samples. If the mean willingness-to-pay for naloxone from a pharmacist is $20 and the standard deviation for both groups is $10, then with alpha=0.0166, we will be able to detect a difference of 1.448 with power=0.8. For the nationally-representative sample, we make the same assumptions but for a sample size of 1,500 respondent. We will be able to detect a difference of 1.6725 with power=0.8. For the opioid-dependent sample, we make the same assumptions but for a sample size of 500 respondent. We will be able to detect a difference of 2.9024 with power=0.8.
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
RAND Human Subjects Protection Committee
IRB Approval Date
2023-08-29
IRB Approval Number
2023-N0309
IRB Name
University of Southern California Human Research Protection Program
IRB Approval Date
2024-04-01
IRB Approval Number
UP-24-00279
Analysis Plan

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