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CVS redoubles efforts to tackle opioid abuse

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CEO Larry Merlo outlines plan to address national crisis

WOONSOCKET, R.I — CVS Health has unveiled a sweeping plan that marshals its integrated pharmacy assets to help stem the rising tide of drug misuse and abuse, namely opioid painkillers.

CVS said Thursday that its enterprisewide strategy to fight the opioid epidemic includes initiatives for safe drug disposal and utilization management of pain medications, as well as increased funding for addiction programs counseling for opioid abuse.

The company noted that its enhanced efforts come amid pressure on pharmacists, doctors, insurers and drug companies to take action to combat what has swelled into a national drug abuse crisis.

“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,” CVS Health president and chief executive officer Larry Merlo said in a statement. “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 that end, CVS Caremark plans to roll out an enhanced opioid utilization management program for all commercial, health plan, employer and Medicaid clients as of Feb. 1, 2018, unless clients choose to opt out.

CVS pharmacistThe initiative includes limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy, as well as limiting the daily dosage of opioids dispensed based on the strength of the opioid. Also, the program will require the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

With more than 9,600 CVS Pharmacy locations, CVS said it would also empower its pharmacists to educate patients about the dangers of opioids and encourage shorter prescriptions to prevent addictions.

The 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 many ways, the abuse of opiates can be seen as the leading public health emergency the United States faces today,” CVS Health chief medical officer Troyen Brennan wrote in a commentary posted today on the Health Affairs blog. “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,” he noted. “Employing principles sanctioned by the CDC is clearly necessary and prudent.”

On top of limiting opioid dispensing, CVS plans to expand its Medication Disposal for Safer Communities Program to a total of 1,550 kiosks, including 750 more disposal units at CVS Pharmacy locations nationwide, starting this fall in Florida, Massachusetts, North Carolina, Pennsylvania, South Carolina and the District of Columbia.

To date through the program, created with the Partnership for Drug-Free Kids, CVS has donated more than 800 medication disposal units to local police departments in 43 states. More than 100 metric tons of unwanted medication have been collected and discarded. in the past two years.

“Without a doubt, addressing our nation’s opioid crisis calls for a multipronged effort involving many health care stakeholders, from doctors, dentists and pharmaceutical companies to pharmacies and government officials,” Merlo added. “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.”

CVS Pharmacy medication disposal boxCVS, too, is expanding its opioid abuse prevention education by bringing its Pharmacists Teach program to a parent audience. The program connects CVS pharmacists with schools in their communities to educate 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.

Prevention efforts also include broader access to the opioid overdose antidote naloxone in 43 states and improving tools like prescription drug monitoring programs to help pharmacies and prescribers address abuse.

Meanwhile, the CVS Health Foundation has added a $2 million commitment to its prescription drug abuse initiatives to help support federally qualified community health centers to widen access to medication-assisted treatment and other recovery services. The foundation and the National Association of Community Health Centers convened a panel of experts to devise 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.

The guidelines will serve as a resource for community health centers receiving grants from the partnership to provide treatment for opioid addiction, CVS said.

CVS’ wide-ranging plan to battle drug abuse comes as the White House declared this week as Prescription Opioid and Heroin Epidemic Awareness Week. President Donald Trump recently announced plans to designate the opioid crisis as a national emergency, though the official declaration was still under a legal review as of last week. Once passed, the legislation could free up certain federal resources to tackle the nationwide problem, according to CVS.

In the last two decades, opioid prescribing rates have swelled almost threefold, from 76 million prescriptions in 1991 to about 207 million prescriptions in 2013. Such opioid prescribing volume is unique to the United States, where prescribing in 2015 was nearly four times that of Europe, CVS reported.

“Everyone has a role to play in addressing the opioid epidemic, and CVS Health is showing how the private sector can help,” commented 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.”


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