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.


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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  • So now we’re going to have pharmacists and insurance companies influencing and overriding what our trained and licensed physicians are allowed to prescribe for those of us who have to live with chronic pain? My physician knows me, has personally examined me, and seen my MRI scans. My insurance company doesn’t know me or give a damn about anything but their bottom line.

    What we’re going to see here, is The Law of Unintended Consequences: People with chronic pain who are seen as nothing more than “Not MY Problem” by those who can’t tell the difference between legitimate pain sufferers and dope addicts, will be left with three choices… live in constant pain, become new customers for drug pushers, or suicide victims. Some of them will end up as new felons and thrown in prison. Some of them will probably die from overdoses of illegal drugs taken without the benefit of a doctor’s supervision, and some of them will sadly decide that life just isn’t worth living anymore. None of this folly is going to decrease the number of deaths from the dreaded “opioid monster”.

    Most drug-related deaths are caused by people chasing that next high, and doing it illegally… they’re NOT by long term chronic pain sufferers under a doctor’s care, who have never demonstrated an inability to use their drugs responsibly and as intended. I’m 70 years old, and I wrecked my back decades ago. I’ve been taking “opioids” for the last 8 years, and never once have I used them to get “high”. Never once, have I taken more than I was supposed to. These are supposed to be my “Golden Years”. What a joke THAT is! Thanks a lot, junkies…

  • Brilliant! More knee jerk reaction that will not do a damn thing but affect legitimate patients negatively. I hope they are ready to pay the much higher costs of any new super drugs that are sure to come out as everyone tries to cash in. IDIOTS! Lance, Phila. Pa.

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