Overview

• Published in JAMA Internal Medicine on Sept. 15, 2025, the RAND analysis tracks retail activity from September 2023 through late September 2024.
• Sales peaked in the first month of availability then settled at 11 to 15 units per million residents every two weeks, with a brief uptick in August 2024.
• Even at peak, retail volumes reached only about 7.5% of prescription sales, indicating limited consumer uptake.
• The average shelf price was nearly $45 for a two-pack, and the national retail average over the study period was 396 units per million residents.
• State-by-state variation was considerable, with Western states higher, and the authors suggest testing insurance coverage for OTC purchases and more visible store placement to boost access.