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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  • My pain management doctor writes a 90 day RX Ultram generic (Tramadol). Listed as a Schedule 4 (IV) Drug.
    Honestly I don’t understand the new laws. I find info on US Gov & then each state has their laws! My doctor has never once done me wrong has written my Tramadol RX. She said it was law. I find after several hours of research Narcotic, controlled drug RX must be sent electronically. Of course some cases it’s possible. (I’m not going to tell her she’s wrong or write! She’s a great doctor) I don’t think half the people running this bus 🚌 knows what they are doing. Other half are filling their wallets! I’m not a pill junky. I rarely take the max daily dose. The RX is written as my doctor thinks I need it. So if I take 6 a day it’s my business!!! I started with Fibro 1998 & now many other health diseases. That’s the only narcotic, wasn’t narcotic till 2015!? I use Herbal Remedies & Essential Oils & other natural remedies. Anything to take less poison. Try to eat good clean food. …. CVS I have put with you since you took over my beloved Target Pharmarcy so long ago. I’ve put up with you for my convince. I hate mail order. (Hell I don’t even know if mail order will ship a junky drug) I don’t like going to little stores like Walgreens & Riteaid. I like to get it all done in one place. No amount of money will I do Walmart Pharm! CVS you locked me out of your App months ago & I can’t control my RX. Your CS reps are no help!
    I get my 90 Day RX (that was on hold) filled. Hubby picks up. He doesn’t argue with them. No use! (That CVS previously Target, Rude, Bipolar, No It All, etc! Only one pharmacists I will have a conversation with. She is the nicest person. Knows what she is doing!)
    Comes in with 30 Day RX. I’m thinking ok, new laws!
    I can’t sleep so I’m spinning my wheels searching online. Trying to find this in the new Opiod Laws Effective 2018! I can’t find anything. I find 7 days if you have surgery. Blah Blah, basically if your doc says your need more pills you can get them!
    CVS this it! Last straw! Sure I can get my RX once a month. That’s not the point. Nobody controls me! Especially some corporation! I love God, Self, Family & Country! I do what’s right & treat everyone with kindness doesn’t mean I’m going be run over! Some corporation isn’t going to make decisions about my health care. Yet you let your employees be exempt from this rule!
    I know this is very long. I do apologize. I know the opioid controversy has affected many people. I’ve seen bad side of Narcotics. I have tried to stay neutral because I know what pain feels like. I have never had a problem until now & I’m HOT! I can’t imagine what others have been through.
    CVS Hope door hits you in the $$$$

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