Express Scripts to limit opioids for first time users: 4 things to know

Express Scripts — the nation's largest pharmacy benefit manager — will begin limiting the potency and number of opioid painkillers prescribed to first-time users, according to a report from CBS News and the Associated Press.

Here are four things to know.

1. The initiative stems from a pilot program Express Scripts launched in 2016 to reduce the risk of patients developing opioid addiction. The program includes a seven-day limit on opioid prescriptions for first time users. An analysis of 106,000 patients enrolled in the pilot program revealed a 38 percent reduction in hospitalizations and a 40 percent reduction in emergency room visits when compared with a control group. 

2. The program also bars physicians from prescribing long-acting (higher potency) opioids to first-time users and aims to prevent patients from "physician shopping" to obtain multiple opioid prescriptions.  

"A lot of times physicians are prescribing these drugs blindly," said Snezana Mahon, PharmD, vice president of clinical product development for Express Scripts, according to CBS/AP report. "They don't know that a patient may be going to see multiple prescribers … [some physicians] are actually appreciative and saying, 'Thank you, I didn't know this was happening.'"

3. American Medical Association officials have spoken out against the program, arguing physicians are already working to address the opioid crisis. Patrice Harris, MD, an Atlanta psychiatrist and chair of the AMA's Opioids Task Force, said physicians have reduced opioid prescriptions by 17 percent over the last couple of years with the aid of alternative forms of pain management like physical therapy.

"We want to be proactive in making sure the alternatives are available, versus a sort of blunt, one-size-fits-all-all approach regarding the number of prescriptions," said Dr. Harris, according to the CBS/AP report. "The AMA's take has always been that the decision about a specific treatment alternative is best left to the physician and their patient."

4. Express Scripts plans to implement the program nationally Sept. 1. Competitor CVS Caremark already has a similar program in place.

To read the full CBS/AP report, click here

More articles on opioids: 
Michigan governor creates state panel to address opioid crisis 
CDC: Drug overdose deaths among adolescents highest for opioids 
The most cost effective way to treat opioid dependence in the ED

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