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ST. LOUIS — The nation’s largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans.

But the new program from Express Scripts is drawing criticism from the American Medical Association, the largest association of physicians and medical students in the U.S., which believes treatment plans should be left to doctors and their patients.


About 12.5 million Americans misused prescription opioids in 2015, according to the U.S. Department of Health and Human Services. More than 33,000 deaths that year were blamed on opioid overdoses.

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    • Thomas, I’ve had a hip and a knee replaced, plus plenty of arthroscopies leading up to that. About 6 surgeries involving opioids. A week supply was more than enough because I didn’t take the medication at the pace that they prescribe, creating plenty of extra. In addition, I work in a hospital and see physicians prescribe “plenty” because they don’t want to deal with somebody needing more medication in the middle of the night… convenience for them based upon their worst case senario memories. Statistically, 70% of people use less than 50% of their medication. Again, extra medication that ends up in the medicine cabinet, and from there the local high schools…. again and again.

  • Garbage in, garbage out. Well intentioned but poor policy resulting from bad data.

    According to the CDC, opioid prescriptions peaked 7 years ago, and 2/3rds of those 33,000 deaths are the result of NON-prescription opioids.

    Let’s get PBR’s, pharmacies and doctors involved when they start dispensing heroin and Chinese fentanyl. Until then, this is a solution in search of a problem.

  • And meanwhile, patients with chronic degenerative conditions that put us in pain 24/7 are basically just being told to suffer because there’s an “opiod epidemic”.. I’m sorry, but as a person who sometimes goes days without sleep because I’m in so much pain, and who can barely hobble to the bathroom and back some days, I’m not feeling very sympathetic to a bunch of junkies overdosing..

  • While Express Scripts is to be commended for good intentions in an atttempt to be part of the solution to opioid addiction, they unfortunately have thrown the baby out with the bath water. Opioids have useful and legitimate roles in pain control. When a patient is discharged from a surgical hospital stay, a week’s worth of potential painkillers is inadequate. This PBM is inadvertently trading one problem for another. When a person is writhing in pain with no practical way to get a timely refill, that is no time to tell them their sacrifice has theoretical value in mitigating an entirely different public health issue.

    • Absolutely. Yes, doctor’s should be careful and aware but ultimately they and their patients are the ones who should be making these decisions, and putting these barriers in the way doesn’t address a large part of the root cause of the problem and just creates additional costs and barriers for those in need

    • Yes, opioids have useful and essential roles in pain control for post operative care. But often a week supply is more than adequate. Rather than prescribing for the high quantity user and creating excess medication for those that need less, lets approach it the other way around. Prescribe for the low quantity user and address those that need more when and if that time arises. Excess proactive prescribing has been the root of the supply chain that has filled this country’s medicine cabinets…. the first “non-medical” supply source for too many. As a society we do a poor job of managing this product in our home. Lock it up when in use, and get rid of the excess as soon as possible after the need if fulfilled. Zero Left in the medicine cabinet.

    • I don’t know how far along eScripts have progressed, but getting a Schedule II (hydrocodone, oxycodone) filled was a hassle with paper only scripts, and then pharmacies treating you like a criminal if you had a high quantity script. How does someone determine 1 week is enough after post-operative surgery? Do you know how many different kinds of surgeries there are and whether one week is enough? Having your gall bladder removed is not the same as a c-section, knee replacement, etc.

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