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.

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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 don’t use CVS anymore or Walgreens simply because they aren’t Dr’s. Unless I come to you for advice all I need you to do is fill my prescription. You only make it harder on people in pain to get their medicine. If you’re selling it what does holding it up mean?

  • CVS has NO business overriding what a trained physician who has personally examined a patient, determines that that patient needs. How is that logical? How is it even lawful? Is CVS licensed to practice medicine on a patient they haven’t even examined? It’s highly questionable whether this practice is even legal. BTW, Target pharmacies are now owned by CVS as well. I get my prescriptions filled by Sav-On, and have never had to put up the asinine overreach tactics that CVS has decided to adopt.

    I urge EVERYONE to BOYCOTT ALL CVS STORES! I wouldn’t buy a Band-Aid from Larry Merlo’s CVS pharmacies!

  • CVS punishes people who have real pain. Everyone is treated like a drug addict. I have never used drugs or alcohol in my life. The employees have kind of gone over board on this policy and are mean and treat you like a criminal it’s horrific and degrading. After 30 years I will never go into another CVS pharmacy ever after being treated the way me and my surgeon have. Following rules I do not kind; however, the pharmacist treated my doctor and surgeons like she was God. They know the rules and regulations. In talking about my issue I am not the only one in my town. Furthermore with all the regulations it only punishes the non addicted pain patient as the death rates from heroin and fentanyl have increased not decreased.

  • I picked up script today at Wallgreens. I get my oxycodone an independent pharmacy recetly; like their generic better. I havent had a problem filling the oxy at either place but Im a cancer patient. I dont consider my pain more important than anyone.

    Anyhow, I ask at Wallgreens about their policy on the opiods for chronic pain patients, etc. I wanted to know the right answer before I commented here. They do have the 7 day limitation but they will call the Doctor and if she instructs them to fill the script as written, they will honor her decision and override. I care about everyone dealing with this. Have you tried Wallgreens. I think Wallmart is doing same now. Hope it helps.

    • I dont think I was clear on my last sentence. I think Wallmart is placing the same restrictions as CVS.

  • Celeste: Good for you, and you’re not alone. CVS recently sent me an “invitation” to shop there for some “special deals”, having obtained my name and address from my Medicare provider. I wanted to return it to them with a note telling them what I think of them playing doctor, but decided against it because (1), they don’t care; and (2), they’re not worth the cost of a stamp to send it.

    • This is the reason I no longer use CVS. I’m a person that suffers from chronic pain, and I do not appreciate being treated like a criminal over the medications I need to live a somewhat normal existence. I’m not five years old and I do not need CVS to treat me as such. Unfortunately I had to use them this month and was given one week of my prescription. I can go back every week as punishment for being sick? Maybe they should pick on people abusing illigal drugs instead? It’s just a thought… As for me I’m only reminded of why I left CVS in the first place and I won’t be using them again in the future!

  • My family and I will never get another prescription filled at CVS. As difficult as it is these days to get pain medicine, CVS has taken it upon themselves to add even more restrictions, forcing people in pain to forfeit legal and legitimate meds prescribed by their own qualified and knowledgeable physicians. Who do they think they are? They actually refused to fill my husband’s hydrocodone 5mg prescription of 28 pills (which would have lasted him approx 4 weeks) saying they would only allow him to have 7 days of tablets. My husband, who is suffering from severe pain, having very high inflammation levels in his body, was given 5 mg vicodin – one tablet every 12 hours as needed. He has had vicodin before and takes them sparingly. But the CVS pharmacy assistant informed me that my husband would have to forfeit the 3 weeks of pills, since they have decided he should only have one week of pills. CVS DECIDED THIS! The girl crisply told me that this was a corporate decision and CVS would not allow my husband to have what his doctor prescribed, due to their war on opoids. I immediately demanded the prescription back and took it to Walgreens, where it was filled immediately without any questions. I called back CVS to get the name of the pharmacist, in order to write a letter, and also informed them that after 30 years of shopping there, I was done. I am never going back there for any prescriptions. I am also warning all friends and family not to get any pain medicine there because once you accept only a week’s worth, you cannot get the remainder. It is forfeited to CVS.

    • I have severe nerve damage from Guillain Barre Syndrome in 1997.
      I have been under the same physician’s care since then and have been prescribed 50mcg fentanyl for over 15 years now. I have never had an overdose nor am I taking any other medications, legal or illegal, that would cause me to be at risk for an overdose. The pharmacist said my kidneys might not metabolize the medication as it always has. She then told my autistic son to watch out for me to stop breathing! I can’t tell you how upset he was after hearing that and what it took to calm him down!
      My physician knows me well and is highly qualified to determine my medical needs without a pharmacist playing doctor. However, CVS recently refused to dispense my monthly prescription that they have filled for 15 years now unless first:
      1. They had a diagnosis.
      2. They forced me to purchase Narcan along with my usual prescription.
      I will never again go to CVS for my prescriptions. It is none of their business what my medical diagnosis is. How can I be sure that my privacy is protected under the HIPPA law if every pharmacy personnel has access to my diagnosis? This is an invasion of my privacy and harassment.

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