Beginning in February 2018, CVS Pharmacy will limit the dose of opioid pain medication and restrict new prescriptions for acute pain to a 7-day supply, which adheres to the Centers for Disease Control and Prevention’s guidelines for prescribing opioids. This limit involves capping daily low-dosages and requires patients to receive versions of the medication that give pain-relief for a short period of time rather than a long duration. However, pharma companies seem to be following in the pharmacy’s footsteps as well.
According to the CVS plan, for a patient to receive an opioid prescription for longer than seven days, the patient would need to complete a pre-authorization for the medication — obtained after the pharmacy benefit manager consults with the prescribing doctor — and will have to pay for them out of pocket. The plan also includes in-store pharmacy training and awareness programs on opioid safety and addiction prevention, along with 750 in-store medical disposal units.
While the seven-day quantity limit on opioid prescriptions is intended for CVS Caremark’s PBM clients and applies only to prescriptions written for acute conditions, such as a minor surgery or dental procedure, CVS is not the first — and will not the be last — to place limitations on opioid prescriptions. Earlier this week during a meeting of President Trump’s opioid commission, the Pharmaceutical Research and Manufacturers of America announced support to limit the supply of opioids to seven days for acute pain management. PhRMA is a trade organization representing more than three dozen pharma companies, including AstraZeneca, Bayer, Allergan, Bristol-Myer Squibb, Eli Lilly, Johnson & Johnson, Merck, Pfizer, Teva, Novartis, GlaxoSmithKline, and Purdue Pharma.
In August, OptumRx announced the initial results of its Opioid Risk Management program, which is also reducing opioid use. The program places maximum fill limits on opioid therapy regardless of whether the patient is new to opioids or a chronic user. Results include:
- 82 percent decrease in prescriptions above the CDC guideline recommended dose of 50 mg morphine equivalent dose (MED) per day for first-fill acute prescriptions;
- 65 percent decrease in prescriptions for first-fill acute opioid treatment written above the maximum seven-day supply;
- 68 percent decrease in prescriptions for current chronic opioid utilizers issues for >90 mg MED; and
- 14 percent reduction in average dose across all opioid prescriptions.