Opioid Program Results

Josh Bindl  •   August 9, 2018

What are you doing about opioids?

By now, we are all aware of the addictive nature of opioid medications. What’s unfortunate is how long it has taken society to act. At our 2015 and 2016 annual meetings, National CooperativeRx educated members and partners about opioids, their addictive nature and how they impact the workforce. Today, opioids are one of the most common topics members and prospects want to discuss.

One of the perks for members of the Cooperative is we have a team dedicated to evaluating the programs developed by our pharmacy benefit manager (PBM). After careful evaluation, we recommend for or against PBM programs — or even modify or supplement them.

In the Fall of 2017, CVS/caremark released new utilization management criteria to address the overuse of opioids. The goals of the program align with the Center for Disease Control guidelines and include:

  • Appropriate utilization
  • Access to overdose treatment
  • Access to counseling and support
  • Safe disposal

Those in need of opioids for pain management will still get them. To ensure this, there are necessary exceptions for cancer-related pain and for those receiving end-of-life palliative care.

For CVS clients adopting this new program, 94.3% of new opioid prescriptions have been for a supply of seven days or less, compared to 80% for those not in the program. CVS reports 30 million of their 90 million lives have adopted the program.

The Cooperative has recommended this program to all members and 90% of our members have adopted the program. These groups represent approximately 230,000 of our 285,000 participants. During its short time in place, we have witnessed a 10.5% reduction in opioids dispensed. At the current pace, the program is expected to save over $1 million annually for our participating groups. More importantly, this is a big step towards preventing people from experiencing the negative consequences of addiction.

These results cannot all be attributed to recent educational efforts and CVS’s new utilization management criteria. Much is being done nationwide to address the opioid crisis, such as new state and federal efforts to track and control the overuse of opioids.

At National CooperativeRx, our team takes great pride in the fact that our recommendations are made with our members’ best interests in mind. Recommending limits on a highly addictive drug such as opioids gives us the peace of mind of knowing we’re having a real impact on a nationwide health crisis.