CVS Health, the Rhode Island-based drug retailer, plans to become the first major pharmacy chain to restrict the number of opioids a customer can obtain with a new prescription. It is one of several measures CVS announced recently, intended to combat the national opioid abuse epidemic.
Beginning in February, CVS will use its pharmacy benefit manager, CVS Caremark, to enforce the new policies.
They include limiting new opioid prescriptions to seven-day supplies; limiting daily dosages based on opioids’ strengths; and reducing the dispensing of stronger and long-release opioids.
CVS will require the use of immediate-release opioids before extended-release opioids are dispensed. The Centers for Disease Control and Prevention (CDC) recommends this action when starting therapy for chronic pain.
About 90 million consumers use CVS Caremark to manage their prescriptions.
“Prescribing doctors are generally the ones responsible for limiting their patients’ access to opioids,” CVS said in a statement. “CVS hopes to leverage its national presence and platform to help steer patients away from misusing prescription drugs.”
None of these policies can be put into place, however, without speaking to the patient’s physician, before changing a prescription. a doctor before the prescription is modified. Doctors can request exemptions for certain patients, and both employers and insurers can opt out of the program.
CVS says that when a pharmacist gets a new prescription that doesn’t meet the new guidelines, they will then call the doctor to have them modify the prescription voluntarily. CVS pharmacies already call doctors when a prescription isn’t covered, the company said.
CVS said the new rules are meant to follow the prescribing guidelines issued by the Centers for Disease Control and Prevention last year.
“These limits are imposed by the prescription drug benefit plan offered by CVS Caremark,” CVS Health spokesperson Erin Britt told Thewhim.com. “So, for a CVS Caremark member, their prescription drug coverage would only cover a 7-day supply of opioids for certain, acute conditions.
“If the prescription is not in line with utilization management requirements, the pharmacy can call the provider to adjust the prescription or submit a request for an exception.
The policy does not impact prescriptions filled for CVS Pharmacy retail customers who are not members of the CVS Caremark pharmacy benefits management program.
Under the plan, CVS pharmacy locations will also strengthen counseling for patients filling an opioid prescription with a robust safe opioid use education program highlighting opioid safety and the dangers of addiction.
The effort will educate patients about the Guideline for opioid prescribing published by the Centers for Disease Control and Prevention (CDC), which advises using the lowest effective dose for the shortest duration possible.
Also, CVS pharmacists will educate patients on the risk of dependence and addiction tied to duration of opioid use, the importance of keeping medications secure in the home and methods of proper disposal of unused medication, the company says.
In addition to limiting opioid dispensing, CVS Health is expanding its Medication Disposal for Safer Communities Program to a total of 1,550 kiosks.
It will add 750 additional disposal units in CVS pharmacies across the country beginning this fall, with locations in Florida, Massachusetts, North Carolina, Pennsylvania, South Carolina and the District of Columbia.
In the last two decades, opioid prescribing rates have increased nearly three-fold, from 76 million prescriptions in 1991 to approximately 207 million prescriptions in 2013. In 2015, opiate prescribing in the U.S. was nearly four times what it was in Europe.