VS 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.


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.


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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.

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  • I am a victim of this war on pain killers I have many issues and see a pain specialist recently I had a total knee replacement complicated no infected and the pharmacy is dictating to my dr of 18 years what I can/can’t have when your pain specialist and Surgon say “They” won’t allow this or that tying their hands to giving proper treatment to their patients something is way out of balance and who are “they” anyway. “They have not examined me nor looked at my medical history. Patients are not dying of overdose or selling their meds. patients are killing themselves because they’re not getting the medical care they been getting from their doctors for many years. Treatment that is working without incident. This has nothing to do with opiate drugs this has to do with disrupted care. who is it that we/patients have to start appeal to/ suing?
    My drs say “they” just don’t care.
    how many people have to die before those In charge realize “They” made a big mistake. ultimately who is responsible ??

  • Bruce, it is “crystal clear” to me and the majority of the people having this discussion this morning that you have been living “under a rock” for quite sometime. Obviously you don’t have a clue the difference between “physical dependency “ and being “an addict” after suffering for years (in most cases) from chronic pain that is so debilitating that there are no words to accurately describe it, through NO fault of the person suffering from this condition. My husband and myself are model, tax paying citizens and have been for many years. If you can’t see “the light before the storm” regarding this situation , which is just beginning , then I don’t know what I (or anyone else ) can tell you as far as what you are facing when very innocent and like I stated before “model citizens” of this United States of America for which I am extremely proud to be a part of are unfortunately going to have to accept and be responsible for the horrible consequences that these changes will cause. The difference between “physical dependency “ and an “addict” are so completely different just like if you or God forbid your child, parents, sibling or a good friend suffers from being a diabetic and is “physically dependent “ on insulin. You need to open your eyes and open them quickly. God bless and God help you.

  • Doctors can ask CVS for exemptions for certain patients?
    Please read that statement a few times, absorb, and get back to me.
    This country has lost its mind and corporations have far, far, far too much control over our daily lives. Mind you, it was not the doctors who got people addicted, but the pharmaceutical corporations who pushed and continued to develop these drugs. But now a doctor, with all of their years of education and training, can ask CVS for an exemption for certain patients. Yeah ok. Everything is fine here, kids. No worries.

    • Lisa,

      They havent lost their sick minds. They always have a plan in place that benefits them monetarily or otherwise; with no regards to collateral damage along the way. Were controlled by them, the insurance companys, Big Pharma and comfort care has become a thing of the past for us. In most of the states they also deny you death with dignity; even though the majority of the people support it. In Calif. it was a law and then they appeal it. We are left with a choice of suffering or commit suicide. We can only hope that there day is coming but it wont. Their health care is far superior to ours and they wont have to deal with the ineffective generic medication that they push on us thats loaded with binders and fillers. This country is run by self absorbed, entitled individuals who have access and choice to the best of everything when it comes to their healthcare. Im dealing with advanced cancer and I feel completely hopeless as Im sure others do. If there isnt; there should be a special place in hell for all of them.

  • This policy is foolish and dangerous. It is the duty of the medical community to eliminate human suffering, not contribute to it. A new patient could easily overdose on seven days of medication if they choose to do so. Nothing in life is black and white only grey, sadly
    these policies are just creating a PR stunt.

    • I wholeheartedly agree with you. I have scleroderma, raynaud’s, and degenerative disk disease. I also have an autoimmune blood clotting disorder and gastrointestinal problems which prevent me from taking any NSAID medications. Two years ago I developed a very large ulcer on the inside of my right ankle. After going through a year and a half of different wound care procedures it is now 8 inches by 4 inches and the pain is excrutiating. I have been getting a series of skin grafts and all the sudden Caremark is cutting me off and requiring me to pay in full for my Hydrocodone prescription? I have used this medicine responsibly for over 5 years. Not because I wanted to but because without it I am in so much pain that I can not function without it. No alternatives are available for me. It is totally unfair to cut patients who already are dependent on this medicine off with any warning because of the actions of those who use it for recreational purposes.

    • I totally agree. As a health care professional I have watched with growing concern over the past 30 years physician and patient slowly start losing control of the medical situation of an individual to health insurance and other groups that have no business making medical decisions. At one point the doctor and not the health insurance companies made the diagnosis and prescribed the medications. No longer.From setting the amount of time a doctor can spend with each patient to what and how much can be prescribed the health insurance companies have taken over.

    • The majority of the comments here are right on target with regards to the state of our health care! I have had years of chronic pain and recently been unable to get a modest prescription. I am experiencing level 9 pain daily. Inexcusable!!!! My quality of life has been seriously reduced and I struggle to find the help that I need.

  • The American people are being deceived; while the people with power boast about the fact that they have cut back opioid use and are saving lives. The truth is they have been disrupting and destroying the quality of life and ignoring the fact that no alternative treatments are being offered and paid for.

    Please sign the petition. Here is a direct link: https://paintreatmentdirectory.com/advocacy/

  • If I understand this right, the pharmacy has more knowledge regarding the patients heath then the physician? Everything is so strict already and most veterans go to a pain management specialist. I like to talk to a veteran or severely disabled person, what are they going to do next? They follow the law and last time I checked, doctors are already cautioned about giving pain medications out. Did CVS go to medical school? Too much soda, too much carbs, too much of everything and the abuser will find a way to get it, while our men and women who served this country can’t get somewhat relief to live a better life. This country is in trouble and I know it’s coming. What a disgrace treating human beings like that. Walk in their shoes and then let’s talk. High profile celebrities died and now the average disabled citizen has to pay the price. Food control, gun control, medical care control, what’s next? No more driving, cars do too much damage and the list goes on!

  • All this started with prohibition and the war against drugs. People are still becoming alcoholics and drug addicts. Just like marijuana they say it leads to worst drugs. Tell that to all the states that have legalized it. CVS is way out of line. Part of our government operates from the sell of drugs. The issue here is that the pharmaceuticals are not willing to share their profits. There are those that follow the instructions on the pain bottle and some don’t. Just like having a bottle of alcohol, you know what will happen if you drink it all. DUIs have skyrocketed. Next is your addiction to your cell phone. This has cause many deaths while not paying attention to traffic. How about those that are obese? Those will just go and buy it somewhere thinking is ok, but end up dying. They can also turn to the corner guy and buy illegal drugs?

  • I just picked up my refill of 10/325 that I have been taking for years and the pharmacist told me they are going to cally doctor to tell him to put me on something different cause that is there new policy. They are deciding how to treat me and threatened that the DEA would come after my doctor of he doesn’t comply.

    • That’s BS about DEA coming after doctor. First of all the CDC guidelines are just that guidelines not laws. The doctor may have chronic pain patients that require more than the 90 MME that the guidelines state for new prescriptions. Many chronic pain patients require more than that and the DEA knows that. People often throw around the initials DEA as a scrare tactic. Go to another pharmacy. Independent pharmacies are better than the “big box” stores like CVS and Walmart and Krogers, etc. The independent pharmacies have knowledgable professional pharmacists that know the law and know what they are doing. The “big box” stores often have non-professional people making up the rules at Corporate offices that do not understand the rules. Don’t be scared by the person at the counter at CVS. They are usually not professioal pharmacists. The pharmacists are the corporate pill counters in the back. They are not allowed to deal with the patient professionally.

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