As the opioid crisis escalates, CVS has announced measures its pharmaceutical program is taking to combat the epidemic.
CVS Caremark, the pharmacy benefits manager of the giant retailer, has instituted a three-plank plan for opioid prescriptions that would:
- Limit to seven days supplies dispensed for acute prescriptions for those who have not previously used opioids.
- Limit daily dosage based on the opioid’s strength.
- Require use of immediate-release opioids before extended-release opioids are dispensed. The Centers for Disease Control and Prevention (CDC) recommends this action when starting therapy for chronic pain.
Opioid use and abuse have increased significantly in the past several years. A BlueCross BlueShield study found a nearly 500 percent increase from 2010 to 2016 in the diagnoses for opioid use disorder.
A recent collaborative investigation by the New York Times and ProPublica cited experts who say that part of the problem is that many insurers have restricted coverage for chronic pain to opioid drugs because they are much less expensive than safer alternatives.
According to CDC guidelines, clinicians are advised to “evaluate risk factors for opioid-related harms” and should “incorporate into the management plan strategies to mitigate risk.” Specifically, they "should evaluate benefits and harms with patients within one to four weeks of starting opioid therapy for chronic pain or dose escalation,” to be reevaluated every three months.