A Pilot Study to Increase Take-up of Overdose Reversal Drugs
Last registered on March 31, 2020

Pre-Trial

Trial Information
General Information
Title
A Pilot Study to Increase Take-up of Overdose Reversal Drugs
RCT ID
AEARCTR-0005333
Initial registration date
March 31, 2020
Last updated
March 31, 2020 7:27 PM EDT
Location(s)

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Primary Investigator
Affiliation
USC
Other Primary Investigator(s)
PI Affiliation
RAND
Additional Trial Information
Status
In development
Start date
2020-04-23
End date
2021-01-07
Secondary IDs
Abstract
Despite widespread public attention to the opioid epidemic and numerous policies to prevent opioid misuse, overdose deaths in the United States increased 16 percent per annum between 2014 and 2017. Public health authorities consider naloxone, a prescription opioid-overdose reversal drug, a key strategy to stemming the tide of overdose deaths and recommend dispensing the medication along with high-dose opioid prescriptions. Nonetheless, naloxone take-up remains low. In collaboration with an online pharmacy platform licensed to dispense naloxone in many states, we will use an online advertising campaign to pilot test approaches to increasing naloxone purchases. Randomizing advertisements across counties, we will measure how traffic to the pharmacy site and naloxone purchases respond to purchase price and information content, including how salient the ads make stigma. We will also consider the impact of advertising more generally. This pilot will be used to scale up to a study that sheds light on both the price elasticity of demand for naloxone and potential non-price barriers to take-up.
External Link(s)
Registration Citation
Citation
Jacobson, Mireille and David Powell. 2020. "A Pilot Study to Increase Take-up of Overdose Reversal Drugs." AEA RCT Registry. March 31. https://doi.org/10.1257/rct.5333-1.1.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
In partnership with an online naloxone distributor, we will test the importance of price and information (including stigma) in deterring access to naloxone. More specifically, we will implement randomized experiments (via Google Ads) for multiple concurrent interventions related to price, and information. We will monitor ad exposure (or impressions), clicks or traffic driven to the exchange site by different types of advertisements, and subsequent purchases. Google Analytics will also be used to track clicks and purchases made from counties that are randomized to receive no ads.
Intervention Start Date
2020-04-23
Intervention End Date
2020-12-10
Primary Outcomes
Primary Outcomes (end points)
naloxone doses purchases
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
ad impressions; ad clicks; website visits; revenue
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
We will run concurrent experiments through the Google Adwords platform to randomize ads that address information gaps and/or stigma issues that may be barriers to the take-up of naloxone. We exclude counties in which the online naloxone distributor is not selling naloxone (as of March 31, 2020).

Randomization will occur at the county level. We will also randomly allocate counties to a control arm that receives no advertising from us. Across our treatment conditions, we will further randomize the advertised (and thereby offered) price of naloxone. In the end, we have 5 approximately equally-sized groups of counties.

Using 2018 overdose data, we constructed the opioid overdose rate for each county as well as indicators for each quintile of the opioid overdose distribution. To improve balance on these metrics, we re-randomized until all 5 experimental arms were within 0.5 opioid overdoses per 100,000 of each other and the distributions were similar as well (for each quintile, no arm is more than 10 percentage points larger than any other arm).
Experimental Design Details
Not available
Randomization Method
In office by computer
Randomization Unit
county
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
2354 counties
Sample size: planned number of observations
4500 clicks
Sample size (or number of clusters) by treatment arms
1500 clicks per treatment condition
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
At present, we have proposed 1500 clicks per treatment condition, divided within each condition by prices of $20 and $110. These choices were chosen with the budget constraint in mind. Across the two price points of $110 and $20, we will have 2250 clicks. Assuming a baseline conversion rate of just 5%, 2250 clicks with the $20 coupon would allow us to detect an increase in purchases of 1.8 percentage points or 36%.
Supporting Documents and Materials
Documents
Document Name
IRB - Not Human Subjects
Document Type
other
Document Description
USC IRB determined that this protocol is not human subjects.
File
IRB - Not Human Subjects

MD5: ec5ccfe319b54a1f9c2fd41edf5ab142

SHA1: b1e3706f5d82f067430920a3773c19c3d959cd41

Uploaded At: January 21, 2020

IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
University of Southern California
IRB Approval Date
2019-12-20
IRB Approval Number
HS-19-00953: Deemed not human subjects
Analysis Plan

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