MMA Looks to Clarify PBM’s New Opioid Policies

Over the past several weeks, the MMA has sent letters to pharmacy benefit managers (PBMs) requesting information on each company’s new opioid policies. 

Specifically, the letters, signed by MMA President George Schoephoerster, MD, requested information on the following:  
•    The Advanced Opioid ManagementSM solution that Express Scripts released in June 2017
•    The OptumRx Opioid Risk Management Program that Optum launched on July 1, 2017
•    The “Controlled Substance Management Program” that Prime Therapeutics LLC launched on July 17, 2017
•    The opioid utilization management policy that CVS Caremark will begin to roll out on Feb. 1, 2018, for all of its commercial, health plan, employer and Medicaid clients.

“The MMA takes very seriously the significant personal and public health consequences associated with the use, abuse, and diversion of opioids, and we have worked to provide education to physicians on appropriate opioid prescribing,” says the letter. “At the same time, the MMA is committed to ensuring that access to opioid therapy remains available for appropriate patients. With the changing landscape of opioid prescribing, it is critical that physicians understand the policies and guidelines being enacted, and how these changes will affect their patients who receive opioid treatment.”

So far, the MMA has heard from CVS Caremark. The MMA will be sharing more details with members about the policies and the differences among the various programs.