All studies reviewed concluded that community distribution of naloxone was cost effective, based on the willingness-to-pay threshold considered; all but one fell under the standard threshold of $US50,000 (year 2020 values).

The cost effectiveness of community distribution of naloxone increases with greater bystander willingness to intervene and/or higher rates of opioid overdose in the community.

The findings from this review demonstrate that, in many settings, most notably high-income countries, community distribution of naloxone for lay administration is a worthwhile investment that can and should be implemented.