AG Jepsen Leads Bipartisan Letter Urging PBMs to Implement Opioid Mitigation Programs

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Press Realease Header of the Attorney General of Connecticut

10/19/2017

AG Jepsen Leads Bipartisan Letter Urging PBMs to Implement Opioid Mitigation Programs

Attorney General George Jepsen today led a bipartisan group of attorneys general from across the country in letters to 15 health care companies that provide pharmacy benefit management (PBM) services encouraging the companies to implement programs to mitigate prescription opioid abuse.

The attorneys general also sent a letter to the president and CEO of CVS Health Corporation applauding the company's recent program that automatically enrolled all commercial, health plan, employer and Medicaid clients in an opioid abuse mitigation program.

"All of us – law enforcement, first responders, policymakers, healthcare providers, individuals and families – have an important role to play in addressing this epidemic," said Attorney General Jepsen. "I commend CVS for taking steps to reduce prescription opioid abuse, a contributing factor in the opioid crisis that has impacted Connecticut and communities across the country. Today, my colleagues and I are strongly urging other PBMs to take similar steps and join with us all in action help stop opioid abuse."

In their letters to the PBMs, the attorneys general asked that the companies adopt similar measures as CVS, including 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. The CVS program's requirements are similar to the opioid prescribing guidelines recently issued by the Centers for Disease Control and Prevention (CDC).

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
• WellDyneRx

"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 opioid epidemic is the most pressing public health crisis our country faces," the attorneys general wrote. "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 CDC, opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999. The Connecticut Office of the Chief Medical Examiner is projecting that more than 1,000 people will die of opioid-related overdoses in Connecticut in 2017.

In addition to Attorney General Jepsen, those joining one or both of today's letters include attorneys general from Alabama, Arizona, Delaware, Georgia, Indiana, Iowa, Louisiana, Maine, Michigan, Montana, New Hampshire, Rhode Island, South Carolina, Utah, Virginia, West Virginia, the District of Columbia and the U.S. Virgin Islands.

Assistant Attorneys General Jeremy Pearlman, Ann-Marie DeGraffenreidt, Michael Wertheimer, John Wright and Lorrie Adeyemi, head of the Consumer Protection Department, are assisting the Attorney General with this matter.

Please click here to view these letters.