Opioid Crisis: VI Attorney General Joins Stateside Counterparts In Letter Urging Pharmacies To Implement Mitigation Programs

Attorney General Claude Earl Walker has joined with 17 of his counterparts 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, V.I. Department of Justice Public Media Officer Corliss Smithen announced Sunday.

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.

Although the territory has not experienced the opioid epidemic, Mr. Walker strongly believes that taking a proactive approach may help to stymie a potential opioid crisis.

“So far, the Virgin Islands has not been hit by this epidemic,” he said. “But we have to proactive and need not wait for it to come before we take action because a number of states are being ravaged by it. I recently spoke to the attorney general of Connecticut, George Jepsen, one of the primary sponsors of the letter, and he revealed to me that the New England states have been hit particularly hard by the opioid epidemic.

“For instance, New Hampshire has perhaps the highest rate of opioid deaths, per capita, in the nation. Therefore, this voluntary practice instituted by CVS should be commended as it puts people above profit and is a model for all other pharmacies, including those in the Virgin Islands. The CVS policy includes limiting to seven days the supply of opioids dispensed and the dosage for certain prescriptions for patients who are using opioids for the first time, which will help to prevent addiction.”

In their letters to the PBMs, the attorneys general asked that the companies adopt similar measures as CVS, which include 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 and WellDyneRx.

In their letters, the attorneys general wrote, “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 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 the Centers for Diseases Control and Prevention (C.D.C.), opioids were involved in 33,091 deaths in 2015 and opioid overdoses have quadrupled since 1999.

In addition to Mr. Walker, those joining one or both of the letters include attorneys general from Alabama, Arizona, Connecticut, Delaware, Georgia, Indiana, Iowa, Louisiana, Maine, Michigan, Montana, New Hampshire, Rhode Island, South Carolina, Utah, Virginia, West Virginia and the District of Columbia.