CVS’s Opioid Limitations — Please Note
I wanted to quickly clear something up with the recent news of CVS’s opioid limitations. In their press release about the news, they mentioned:
CVS Caremark, our pharmacy benefits manager, is enhancing our utilization management program to ensure that opioids are being prescribed and used appropriately, consistent with the Guideline for Prescribing Opioids set by the Centers for Disease Control and Prevention. This includes:
Limiting to seven days the supply of opioids dispensed for certain acute prescriptions.
Limiting the daily dosage of opioids dispensed based on the strength of the opioid.
Requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.
The important thing to note here is the first two words of that above quote, “CVS Caremark.” This will be CVS Caremark that is implementing these restrictions (along with the entire CVS enterprise) not just CVS Pharmacy. The difference between CVS Caremark and CVS Pharmacy is a little confusing but there is a difference. Briefly, CVS Caremark is a pharmacy benefits manager (PBM) and they handle prescription claims for a lot of prescription insurance plans. In contrast, CVS Pharmacy is the physical location where you can pick up your medications. So, why is this important? Well, if your insurance plan uses CVS Caremark to process your prescription claims, you could have a prescription taken to Walgreens or some other pharmacy other than CVS and still be affected by these new restrictions. There seems to be a common misconception that this will only happen if you bring your prescriptions to a CVS Pharmacy and that is not the case.
I hope this prevents any confusion or delay in someone getting a medicine they really need. In addition, for healthcare professionals not working at a CVS Pharmacy, please understand you may have to break the news to your patients about the above changes.
Please feel free to reach out to me if you have any questions on how this might affect you.
Thanks for reading,
-Richard
—
Richard Waithe, PharmD | Richard@MedVize.com
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Original link to press release from CVS:
