Industry awaits opioid crisis policy response
The industry response to the opioid epidemic has been far-reaching and proactive, but the retail pharmacy world currently awaits legislative action that can help retain access to chronic pain treatments for patients that need it, while curbing the potential for abuse by those that do not.
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This story is part of a special report in DSN’s February issue.[/caption]
In an October letter to President Donald Trump and Administration agencies, the National Association of Chain Drug Stores highlighted legislative fixes that could help with the opioid crisis. Principle among them is mandating electronic prescribing of controlled substances, with few exceptions. The organization noted that even though such states as New York have seen a 70% drop in the number of lost or stolen prescriptions after implementing a new prescribing law, nationwide, e-prescribing is done at a rate of 14%. E-prescribing is something retailers have been keen on, as well.
“We’ve been very supportive of e-prescribing efforts because we do believe it can help reduce the risk of diversion by having paper copies out in circulation,” said Rick Gates, who Walgreens recently promoted to senior vice president of pharmacy and health care. “We’re big advocates because we get direct communication from the prescribers, and obviously it helps from an abuse standpoint.”
Complementing a need for secure transmission of patient prescriptions in NACDS’ policy goals is reducing the supply that is given to first-time recipients of an opioid. The CDC has found that the average supply per opioid prescription has increased from 13.3 days to 18.1 days per prescription between 2006 and 2016. NACDS has called for a bill that would limit first-time acute pain fills to a seven-day supply.
In the absence of a legislative mandate, companies with the capacity to do so have begun taking steps of their own to limit the amount of opioids dispensed. Positioned as it is with an in-house pharmacy benefits manager, CVS Health on Feb. 1 rolled out opioid utilization management tools for CVS Caremark clients, which includes limiting certain acute pain prescriptions for seven days, as well as limiting daily dosage of dispensed opioids based on strength and requiring the primary use of immediate-release formulations.
“Common sense tells us that overprescribing increases the risk of addiction for the patient, but also for family members when there are extra pills left in the house,” CVS Health president and CEO Larry Merlo wrote in a Health Affairs op-ed in July.
NACDS recently has seen progress from the government on one of its goals for ensuring patients with legitimate need to conveniently access their treatment. The proposed rule for contract year 2019 from the Centers for Medicare and Medicaid Services allows pharmacies with multiple locations, sharing real-time electronic data, can be treated as a single pharmacy under 2016 legislation. The move “will help ensure legitimate beneficiary access to needed prescriptions without compromising the integrity of [Medicare Part D] and its goal to combat abuse and diversion,” NACDS' letter said.
Moving forward, NACDS and partner organizations said that they want to continue to be a part of how the government addresses the crisis. On Feb. 2, the National Conference of Pharmaceutical Organizations — which includes NACDS as a member — called for an opportunity to meet with Trump and other Administration officials to discuss how to address the issue.
“This NCPO statement and request for a meeting with the administration reflects pharmacy’s consistent engagement as a working partner to help address the opioid abuse epidemic, and that of our partner organizations. Pharmacy continues to take seriously its role as part of the solution, and as an ongoing collaborator with enforcement and health agencies,” NACDS president and CEO Steve Anderson said. “Pharmacy has significant insights about the complexity of this issue given the role of pharmacists on the front lines of healthcare every day, and we are committed to working proactively with NCPO members and with all levels and branches of government for the safety of our families and communities.”
[caption id="attachment_581522" align="alignleft" width="196"]
This story is part of a special report in DSN’s February issue.[/caption]In an October letter to President Donald Trump and Administration agencies, the National Association of Chain Drug Stores highlighted legislative fixes that could help with the opioid crisis. Principle among them is mandating electronic prescribing of controlled substances, with few exceptions. The organization noted that even though such states as New York have seen a 70% drop in the number of lost or stolen prescriptions after implementing a new prescribing law, nationwide, e-prescribing is done at a rate of 14%. E-prescribing is something retailers have been keen on, as well.
“We’ve been very supportive of e-prescribing efforts because we do believe it can help reduce the risk of diversion by having paper copies out in circulation,” said Rick Gates, who Walgreens recently promoted to senior vice president of pharmacy and health care. “We’re big advocates because we get direct communication from the prescribers, and obviously it helps from an abuse standpoint.”
Complementing a need for secure transmission of patient prescriptions in NACDS’ policy goals is reducing the supply that is given to first-time recipients of an opioid. The CDC has found that the average supply per opioid prescription has increased from 13.3 days to 18.1 days per prescription between 2006 and 2016. NACDS has called for a bill that would limit first-time acute pain fills to a seven-day supply.
In the absence of a legislative mandate, companies with the capacity to do so have begun taking steps of their own to limit the amount of opioids dispensed. Positioned as it is with an in-house pharmacy benefits manager, CVS Health on Feb. 1 rolled out opioid utilization management tools for CVS Caremark clients, which includes limiting certain acute pain prescriptions for seven days, as well as limiting daily dosage of dispensed opioids based on strength and requiring the primary use of immediate-release formulations.
“Common sense tells us that overprescribing increases the risk of addiction for the patient, but also for family members when there are extra pills left in the house,” CVS Health president and CEO Larry Merlo wrote in a Health Affairs op-ed in July.
NACDS recently has seen progress from the government on one of its goals for ensuring patients with legitimate need to conveniently access their treatment. The proposed rule for contract year 2019 from the Centers for Medicare and Medicaid Services allows pharmacies with multiple locations, sharing real-time electronic data, can be treated as a single pharmacy under 2016 legislation. The move “will help ensure legitimate beneficiary access to needed prescriptions without compromising the integrity of [Medicare Part D] and its goal to combat abuse and diversion,” NACDS' letter said.
Moving forward, NACDS and partner organizations said that they want to continue to be a part of how the government addresses the crisis. On Feb. 2, the National Conference of Pharmaceutical Organizations — which includes NACDS as a member — called for an opportunity to meet with Trump and other Administration officials to discuss how to address the issue.
“This NCPO statement and request for a meeting with the administration reflects pharmacy’s consistent engagement as a working partner to help address the opioid abuse epidemic, and that of our partner organizations. Pharmacy continues to take seriously its role as part of the solution, and as an ongoing collaborator with enforcement and health agencies,” NACDS president and CEO Steve Anderson said. “Pharmacy has significant insights about the complexity of this issue given the role of pharmacists on the front lines of healthcare every day, and we are committed to working proactively with NCPO members and with all levels and branches of government for the safety of our families and communities.”