Express Scripts to launch programme aimed at limiting opioid drugs prescribed to first-time users

Express Scripts indicated that it plans to limit the number and strength of opioid medications that it will allow doctors to prescribe to patients who are first-time users. The move, which is slated to take effect at the start of next month, stems from a year-long pilot programme introduced by the pharmacy benefit manager in 2016 to help curb patients' dependency on opioids and the risk of addiction.

According to Snezana Mahon, Express Scripts' vice president of clinical product development, analysis of 106 000 patients in the pilot programme showed that hospitalisations and emergency room visits were cut by 38 percent and 40 percent, respectively, compared with a control group. 

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Under the programme, prescriptions for new opioid users will be limited to seven days even if doctors request longer periods. The initiative will also require first-time users to be prescribed short-acting drugs. Moreover, dosages will be limited, with Express Scripts planning to work to prevent situations in which patients may try to collect multiple opioid prescriptions from different doctors. However, the programme will not apply to patients in hospice or palliative care, or to those suffering from cancer.

Commenting on the news, Patrice Harris, who chairs the American Medical Association's (AMA) opioids task force, noted that doctors have already taken steps to reduce opioid prescriptions, which she said have declined 17 percent in recent years. "We want to be pro-active in making sure the alternatives are available, versus a sort of blunt, one-size-fits-all-all approach regarding the number of prescriptions," Harris remarked, adding that "the AMA's take has always been that the decision about a specific treatment alternative is best left to the physician and their patient." 

CVS Caremark previously unveiled a similar programme that limits opioids to a 10-day supply and restricts the dosage.

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