CVS does battle with our opioid problem
Thursday, September 28, 2017
The company that banned cigarette sales from its stores in 2014 is planning to take on the opioid epidemic. Last week, CVS announced their intentions to tighten their policies and expand programs related to narcotic prescribing and dispensing.
"Today we are announcing an expansion of our enterprise initiatives to fight the opioid abuse epidemic that leverages CVS Pharmacy's national presence with the capabilities of CVS Caremark, which manages medications for nearly 90 million plan members," according to Larry Merlo, president and CEO of CVS Health.
Our national problem with opioid addiction, overdose and abuse is no secret. Opiates cause about 1,000 emergency department visits every day in the U.S. In 2015, more than 20,000 deaths were related to these prescription pain relievers. Today, 2 million Americans have a diagnosed substance abuse disorder involving opioids. Doctors wrote more than 200 million opioid prescriptions in 2013 — an amount three times higher than two decades ago.
But what exactly is CVS going to do about it?
1) They will leverage the power of their PBM, Caremark, which currently manages approximately 90 million American lives. They will limit new-start opioid prescriptions to seven days for patients and under certain conditions. They will reject claims for opioids that exceed a certain dosing threshold (the exact nature of that limit is undisclosed). Finally, they will prevent the dispensing of long-acting opioids in certain circumstances unless short-acting opioids are tried.
2) CVS pharmacists will be required to provide additional counseling to patients related to opioid prescriptions. The counseling will include information regarding the dangers of addiction and the importance of taking only the lowest needed dose for the shortest duration possible. They will also remind patients about the importance of keeping their prescription opioid medication secure in a locked container to prevent theft or diversion.
3) CVS will also expand the number of drug-disposal kiosks that are available for patients to safely remove unwanted or unneeded opioids from their homes. The total number of such units will expand to 1,550 and will include 750 more units inside CVS pharmacies nationwide.
4) The company, through the CVS Health Foundation, will add $2 million in funding to support efforts of federally-qualified community health centers involved in treating patients with addiction disorders. Tom Van Coverden, president and CEO of the National Association of Community Health Centers (NACHC) said, "We are proud of our long-standing relationship with the CVS Health Foundation to help reduce health disparities among medically underserved populations."
5) Finally, CVS will expand the focus of their Pharmacists Teach program. This program, which has historically connected CVS pharmacists and local schools to educate teens about drug abuse, will now include a parent-focused educational campaign.
With all of the bad press circulating about our national opioid problem, CVS is probably being wise to proactively develop programs that address the issue. Merlo clearly wants the U.S. government to know CVS is doing its share.
"With a presence in nearly 10,000 communities across the country, we see firsthand the impact of the alarming and rapidly growing epidemic of opioid addiction and misuse," he said.
But some are concerned that the new strategy might limit access of patients to an adequate opioid dose to manage their pain. According to Dr. Patrice Harris, chairwoman of the American Medical Association's opioid task force, "one-size-fits-all limits, such as blanket prior authorization protocols, may cause delays in care that could severely harm patients."
As a pharmacist, I'm fully aware of the excessive volume of opioid prescriptions being dispensed today. I'm proud of the fact that pharmacy has been on the front line of making legislative changes to help curb narcotic abuse.
It is, however, disappointing that the PBM and pharmacy industry seem to be doing more than the medical, social services or law enforcement communities to address the problem. We need a team effort.
As a nation, we have more data about our opioid problem than ever before. We know exactly who prescribed, filled and dispensed each and every controlled substance that is legally obtained within our borders. But information alone won't help if we don't change.
Tougher restrictions are needed for patients seeing multiple prescribers, including emergency departments, to obtain narcotics. We need accountability for doctors whose prescribing habits are outside the boundaries. And we need better incentives for patients to cut back on their own opioid doses in exchange for other methods to manage pain.
I applaud CVS for their efforts, so long as they provide the staffing support to carry out their plan. Small steps like this will help win battles. But we need more cooperation from the rest of our society if we hope to win the war.
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