CVS Pharmacies making changes to combat opioid abuse

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(CVS) — ► CVS Pharmacy expanding drug disposal collection program to 1,550 units with addition of kiosks at 750 retail pharmacies nationwide, adding to 800 units previously donated to law enforcement

► CVS Caremark enhancing opioid utilization management aligned with CDC Guideline for PBM clients and members, complementing measures already in place

► CVS Health Foundation adding $2 million commitment to previous investments in mitigating prescription drug abuse with support for Community Health Centers providing medication-assisted treatment and other addiction recovery services

CVS Health (NYSE: CVS) announced today that, as part of the company’s broad commitment to fighting the national opioid abuse epidemic, it is enhancing its enterprise-wide initiatives supporting safe drug disposal, utilization management of pain medications and funding for treatment and recovery programs.

“As America’s front door to health care 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,” said Larry J. Merlo, President and CEO, CVS Health. “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.”

To support this goal, CVS Caremark will roll out an enhanced opioid utilization management approach for all commercial, health plan, employer and Medicaid clients as of February 1, 2018 unless the client chooses to opt out. This program will include limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy; limiting the daily dosage of opioids dispensed based on the strength of the opioid; and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

CVS Pharmacy locations will also strengthen counseling for patients filling an opioid prescription with a robust safe opioid use education program highlighting opioid safety and the dangers of addiction. This clinical program will educate patients about the Guideline for opioid prescribing published by the Centers for Disease Control and Prevention (CDC), which advises using the lowest effective dose for the shortest duration possible. Pharmacists will counsel patients about the risk of dependence and addiction tied to duration of opioid use, the importance of keeping medications secure in the home and methods of proper disposal of unused medication.

In the last two decades, opioid prescribing rates have increased nearly three-fold, from 76 million prescriptions in 1991 to approximately 207 million prescriptions in 2013. This remarkable volume of opioid prescribing is unique to the United States, where prescribing in 2015 was nearly four times what it was in Europe.

“Without a doubt, addressing our nation’s opioid crisis calls for a multipronged effort involving many health care stakeholders,” Merlo added, “from doctors, dentists and pharmaceutical companies to pharmacies and government officials. With this expansion of our industry-leading initiatives, we are further strengthening our commitment to help providers and patients balance the need for these powerful medications with the risk of abuse and misuse.”

“The misuse and abuse of opioids is a public health crisis we have to work together to solve,” said Dr. Gary Roberts, president of the American Dental Association. “As prescribers of opioid pain medications, dentists can help keep these drugs from becoming a source of harm for patients, and the American Dental Association (ADA) is absolutely committed to working with our fellow health organizations to promote the appropriate use and disposal of controlled substances. The ADA will do everything we can to help end this national emergency.”

In a commentary published today on the Health Affairs Blog, CVS Health Chief Medical Officer Troyen A. Brennan, M.D., M.P.H., wrote, “In many ways, the abuse of opiates can be seen as the leading public health emergency the United States faces today…In light of the human suffering and financial costs caused by the current epidemic, a thoughtful, responsible, evidence-based treatment of pain is a service we must provide to our patients. Employing principles sanctioned by the CDC is clearly necessary and prudent.”

In addition to limiting opioid dispensing, CVS Health today announced that it will be expanding its Medication Disposal for Safer Communities Program to a total of 1,550 kiosks, including 750 additional disposal units in CVS Pharmacy across the country beginning with locations in Florida, Massachusetts, North Carolina, Pennsylvania, South Carolina and the District of Columbia this fall.

“Everyone has a role to play in addressing the opioid epidemic, and CVS Health is showing how the private sector can help,” said Richard Baum, Acting Director of National Drug Control Policy. “Making sure people can safely dispose of unwanted medications is a key part of preventing opioid misuse and abuse, and CVS Health has taken this important step which will support the health of communities across the country.”

To date, through this program, created with the Partnership for Drug-Free Kids, CVS Health has previously donated more than 800 medication disposal units to local police departments in 43 states. More than 100 metric tons of unwanted medication, that could otherwise have been diverted, misused or abused, have been collected and safely disposed of through this program in the past two years.

“CVS Health has long partnered with us to help prevent and address prescription drug abuse and we understand the depth of the company’s commitment and the breadth of their ability to respond,” said Fred Muench, PhD, President and CEO of the Partnership for Drug-Free Kids. “We strongly support their work to limit the quantity of opioids dispensed to patients, consistent with the Guideline set by the CDC, and their work to educate patients, teens and parents about the dangers of opioid misuse.”

The CVS Health Foundation has also added a $2 million commitment to its previous investments in mitigating prescription drug abuse with support for Federally-qualified community health centers to increase access to medication-assisted treatment and other recovery services. Together, the CVS Health Foundation and National Association of Community Health Centers (NACHC) convened a panel of experts to develop a protocol of best practices for community health centers on provider prescribing guidelines, medication-assisted treatment, behavioral health and collaboration with other community organizations to treat and prevent prescription drug abuse among at-risk patients. These guidelines will serve as a resource for community health centers receiving grants from this partnership to provide treatment for opioid addiction. This initiative expands the CVS Health Foundation’s ongoing funding of programs to reduce prescription drug abuse.

“We are proud of our long-standing relationship with the CVS Health Foundation to help reduce health disparities among medically underserved populations,” said Tom Van Coverden, President and CEO, National Association of Community Health Centers. “Community health centers have the unique ability to leverage their care teams, health information technology systems and quality infrastructure to support drug abuse control in their communities. Through the Innovative Approaches for Prescription Drug Abuse Management and Prevention program, we hope to build capacity for providing integrated behavioral health services in communities with high incidence of substance use and abuse with the goal of implementing innovative, collaborative, and community‐based models that result in safe prescribing practices, care coordination, strengthened partnerships and non-judgmental environments for all patients.”

CVS Health is also expanding its commitment to opioid abuse prevention education by bringing its Pharmacists Teach program to a parent audience. The Pharmacists Teach program has been part of the company’s ongoing commitment to prevent and address prescription drug abuse in the communities it serves. The program connects CVS Pharmacists with schools in their communities to provide a unique perspective to students about the dangers of prescription drug abuse. To date, the program has focused on teens and has educated more than 295,000 students about prescription drug abuse.

In addition to the company’s ongoing focus on prevention, CVS Health has also worked to expand access to the opioid-overdose reversal medication naloxone in 43 states and has advocated for improving tools like Prescription Drug Monitoring Programs, which help pharmacies and prescribers prevent abuse.