CVS Health announced Thursday that it was limiting the amount and strength of prescription opioid painkillers it provides to patients taking the drugs for the first time, a step intended to help curb opioid abuse.

Through its pharmacy benefit manager, CVS Caremark, which has 90 million plan members, the company will introduce three new policies, effective in February. First, patients new to opioids will only get seven days’ worth of medication. The program will also limit daily dosages and require that immediate-release formulations of drugs be given before extended-release versions are prescribed.

Doctors can ask for exemptions for certain patients, CVS said, and employers and insurers can opt out of the program.

advertisement

CVS said the new rules will bring the company in line with prescribing guidelines issued by the Centers for Disease Control and Prevention last year. In a Health Affairs blog post, CVS officials estimated that 61 people at a company of 100,000 employees would avoid becoming addicted to opioids in a given year if those guidelines were followed. The estimate, they said, was based on commercial insurance data.

“The CDC Guideline should become the default approach to prescribing opiates, a scenario in which physicians would have to seek exceptions for those patients who need more medication or longer duration of therapy,” the officials wrote. “What is more, pharmacy benefit managers are better placed than others in the pharmacy supply chain to put this approach to the CDC Guideline into practice,” as opposed to medication wholesalers or retail pharmacists.

Newsletters

Sign up for our Morning Rounds newsletter

Please enter a valid email address.

Based on the CDC’s recommendations, CVS’s new daily dosage limit is 90 morphine milligram equivalents, or MMEs, a measure of the strength of a painkiller.

As part of the new effort, CVS Pharmacy sites will also offer enhanced counseling and education campaigns about opioid safety and addiction.

The move by CVS could fuel the debate about whether doctors, PBMs, and pharmacies are reacting too stringently to the opioid epidemic, tightening access to prescription opioids so that patients with legitimate pain problems cannot get the treatment they feel they need. Another large PBM, Express Scripts, previously announced it was planning to limit the supply and dosage of opioids for first-time patients, a move the American Medical Association warned was a “blunt, one-size-fits-all approach” that took treatment decisions away from the doctor and patient.

Increasingly, heroin and the illicit use of synthetic opioids like fentanyl are responsible for fatal opioid overdoses, but many cases of addiction begin with prescription painkillers. In some cases, people will start taking leftover medicine originally prescribed to someone else.

CVS also announced Thursday it was adding another 750 medication disposal kiosks at its pharmacies around the country, roughly doubling the number that CVS has helped open as of now.

The roots of the opioid epidemic are multifaceted, but pharmacies and PBMs have been accused of allowing painkillers to flow into communities with few limitations. Earlier this year, Cherokee Nation sued CVS and other companies, alleging they helped fuel an addiction crisis in the tribal community.

Leave a Comment

Please enter your name.
Please enter a comment.

  • I’ve been on pain meds for years and had no problems ever filling my scripts till recently. I was on MUCH stronger meds and at higher does before and choose to switch to a different med due to severe reaction to the patches. I had a wonderful pharmacist who was helpful and professional at CVS. Unfortunately she left CVS due to their new policies which she firmly disagreed with. I was informed that CVS had staff that were writing their own scripts and filling them. When they got caught is when CVS cracked down on opiate scripts….COINCIDENCE.. The new pharmacist is a real bitch. She has deliberately did not fill my non opiate scripts on purpose , just because she could. I’ve also had her not order a few of my meds that were on auto fill and I was with out those meds for over a week. She is a very angry, frustrated, mean person who takes it out on the customers and subordinates. Back to my pain meds. I have NEVER abused any med and like so many others get drug tested frequently. My pain Dr. Is so frustrated w/ these new policies also. My only hope is that these people making these policies get a chronic disease or devastating injury for which they need these meds and can’t get them due to their decision to stop addicts. And I do mean everyone, from POTUS on down. Then and only then will they realize that chronic pain sufferers are NOT ADDICTS. Addicts will always get their high while law abiding people have to literally suffer due to people who just abuse drugs. It makes me sick that addicts get their high and get praise if they “kick their habit” while the rest of us need to suffer because the chose to abuse their meds. Sorry for going on a tangent but I did not choose my disease which causes great pain while addicts chose their path in life. I have to pay for my medical care and meds on my own while drug addicts get the government to pay for rehab numerous times and then get free healthcare on top of it. How is this right. I fall into the category of making just $8.00 over the limit to get any assistance and the addicts get everything paid for. This sh** ain’t right and neither is CVS for their policies.

  • I feel the same way about CVS because of a similar issue regarding my long term opioid rx. I have been taking an opioid for over 15 years. I have never had any issues and take the legally prescribed rx responsibly. I have NOT been in a CVS store for anything in over 2 years. I encourage all chronic pain patients to do the same as CVS DOES NOT TREAT US FAIRLY

  • I have been suffering with cronic pancreatitis for 12 years, and i have been with the same doctor for 12 years. If it was not for the opioid meds my doctor prescribes for me i would be disabled. I went to the same Walmart pharmacy for 12 years with the same monthly prescription for the chronic pain with no problem. Walmart changed their rules for the meds, so i moved my business to CVS, it went fine for about three months, and now they lie to me about the price, and will not even honor the Singlecare duscounts all of the sudden. Its a shame how the folks that are living with chronic pain are being treated because of criminals and drug addicts. Where is our Federal Goverment on folks like me with years of chronic pain. Not a word, they are silent. CVS is the worst i have ever had to do business with. No more CVS, i will die before i ever darken the doors of your store again, with your employees treat me like a criminal just because i want a doctors prescripton filled.

  • i hope some one sues you all its not yours to make law my daughter is scheduled to have surgery her dr prescribed lortab 7.5 the pharmacy told her she could only get 1 wks worth .at a time she is not supposed to drive for 2 wks after the surgery you idiots dont know what your doing good dr control of narcots should not be superceded by retail pharmacies now your openning yourselves to legal consequences.

  • I’m from the Pittsburgh area, I’m visiting my grandchildren in Zionsville oh. My primary physician, dr. Thornton was kind enough to give me a prescription for my pain medication. I have arthritis in both hips and in my spine. The prescription is for Vicodin. It is dated to be filled aug. 14,2018. If there are any problems having it filled, she advised to have the pharmacy contact her. I will provide the number as needed. My question is “should I expect to encounter any problems having CVS fill the prescription. It calls for
    Vicodin
    Dosage 7.5
    Quantity 100.
    This is my 30 day or longer quantity.
    Please advise what policy is.
    Thank you for your time and trouble.
    Respectfully ,
    James R Martin
    James.martin191@comcast.net
    412-926-6307

    Sorry but I fat fingered the year. At 68 years of age, these things happen. Thank you

    • I had a similar situation. At first CVS clerk said absolutely not. We can Not fill it. I asked to see a pharmacist and asked them to ck their CVS COMPUTER SYSTEM. They could see that I had been getting my rx for pain med filled at CVS for months. Then they filled my rx. Good luck

  • I have been through all nonsurgical injections including a percutaneous discectomy. I refuse to get multiple spinal fusions at age 32 (with no promising guarantees). I have multi level herniated discs and narrowing of the spinal canals throughout the lumbar and thoracic spine. I’m in chronic pain all day and everyday.

    Without the medication, I would still be on disability, would not have went back to school to finish my Bachelors and Master’s, would not be able to do light cardio exercise, and would not be able to spend the time with my family and play with my daughter.

    They lowered my extended release coverage. Im prescribed 90 pills for 30 days. CVS has forcibly reduced it to 60 pills for 25 days (not even a full month). I have yet to see my doctor for a follow-up yet. I been on opiates and NSAIDs for 7 years. My spine progressively has worsened year by year (with MRIs to prove it).

    I’m not sure what my options are if this is the solution.

    • There are many treatment options for herniated disks. If your neurologist has not discussed the treatment options with you, then you should consider going to another neurologist. You have my sympathy if you have gone to this neurologist for an extended time, and you still don’t know what your options are.

    • Go to a different pharmacy. Preferably go to an independent pharmacy and not a “big box” store like walmart or target or krogers. Boycott CVS for everything.

  • Michelle, you said everything that’s on my mind. I see so many veterans who served this country and then disregarded by a pharmacy! They need to follow a strict protocol and then being told, I know more then your pain specialist! Drug addicted people get more compassion by this whole misdirected opioids phenomena! We are a strong nation, somehow we fail the ones who made us being able to live life! We need to do better and if only one life is lost, because of the opioid conscious pharmacy, they should be held accountable! The doctors have to go through so much red tape, it’s a disgrace to our nation! God bless the USA and help us!

Sign up for our Daily Recap newsletter

A roundup of STAT’s top stories of the day in science and medicine

Privacy Policy