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’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
    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

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

  • 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!

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