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October 20, 2017

Miller Joins Bipartisan Attorneys General Group in Urging Pharmacy Benefit Managers to Adopt Opioid Mitigation Programs

Attorneys general urge companies to adopt policies in line with CDC opioid prescribing guideline

DES MOINES – Attorney General Tom Miller today joined a bipartisan group of attorneys general in asking 15 health care companies that provide pharmacy benefit management (PBM) services to implement programs to mitigate prescription opioid abuse.

In letters to the PBMs, the attorneys general asked the companies to adopt measures similar to those that CVS announced in September, which are based on the Centers for Disease Control and Prevention (CDC) opioid prescribing guideline issued in March. The measures include limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to the therapy, limiting the daily dosage of opioids dispensed based on the strength of the opioid, and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

"While there are no doubt additional measures that pharmacy benefit managers could take to combat prescription opioid abuse, we believe over-prescribing of opioids could be curtailed by the implementation of a CVS-type program," the attorneys general wrote.

The multistate PBM letters were sent to Argus Health Systems Inc., Benecard Servies LLC, Envision Pharmaceutical Services LLC, Envolve Health, Express Scripts Inc., Humana Inc., Magellan Rx Management, MedImpact Healthcare Systems Inc., Navitus Health Solutions LLC, OptumRX Inc., PerformRx, Prime Therapeutics Inc., ProCare Rx, RxAdvance, and WellDyneRx.

The attorneys general also sent a letter to the president and CEO of CVS Health Corporation applauding the company's recent commitment mitigate opioid prescription abuse.

"The opioid epidemic is the most pressing public health crisis our country faces," the attorneys general wrote to the PBMs and CVS. "It affects every state and has a devastating impact on communities – tearing apart families and stretching the budgets of local law enforcement and first responders as they do the difficult work on the front lines. For our part, attorneys general are pooling resources and coordinating across party lines to address the crisis."

Opioids, both prescription and illicit, are now the main driver of drug overdose deaths nationwide. According to the CDC, opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999.

Last year in Iowa, according to the Iowa Department of Public Health, 180 people died of opioid-related causes and health care facilities admitted 2,274 patients for opioid treatment. Since 2005, opioid-related treatment admissions statewide have more than tripled.

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