Dive Brief:
- Major U.S. retailer Walmart will limit initial prescriptions of opioid painkillers to no more than seven days of supply, aiming to check abuse of the addictive drugs.
- The new restrictions will apply to all Walmart and Sam's Club pharmacies in the U.S. and Puerto Rico within the next 60 days, the company said in a May 7 statement.
- Additionally, Walmart intends to begin requiring electronic prescriptions for all controlled prescriptions as of Jan. 1, 2020. E-prescriptions are easier to track and can't be as readily duplicated or altered.
Dive Insight:
Walmart's move follows prescribing guidelines issued by the Centers for Disease Control and Prevention in 2016, which included a recommendation to limit how much drug is given for the treatment of acute pain.
Noting that long-term opioid use typically begins with acute pain treatment, the government health agency suggested a three-days' supply would likely be sufficient in most cases and more than seven days' worth rarely needed.
Walmart said it would follow local laws in states which have restricted opioid dispensing for acute pain to less than seven days' supply.
Beginning this August, pharmacists at the retailer's stores will also be able to use a tracking tool called NarxCare that the company hopes can help inform dispensing decisions.
Regulators and state governments have increasingly looked to limits on prescribed drug supply as a tool to counteract opioid abuse and misuse.
Earlier this year, the Food and Drug Administration asked manufacturers of the over-the-counter diarrhea drug loperamide to package the drug in smaller containers. Better known by the brand name Imodium, the drug is sometimes abused to ward off withdrawal symptoms of opioid use.
At the time, FDA chief Scott Gottlieb indicated the agency's focus would likely turn next to immediate-release formulations of opioids like Vicodin (acetominophen/hydrocodone) and Percocet (acetominophen/oxycodone). "If more immediate release opioid drugs, in particular, were packaged in three or six-day blister packs; then more doctors may opt for these shorter durations of use," Gottlieb said in a Jan. 30 statement.
The Centers for Medicare and Medicaid Services has also proposed implementing a supply limit for initial fills of opioid prescriptions for the treatment of acute pain among Medicare Part D patients.
Below the federal level, legislatures in 28 states have enacted new laws or guidelines to limit opioid prescriptions, according to Ballotpedia.
More than 17,000 Americans died from prescription opioid overdoses in 2016 — part of a larger drug abuse epidemic that claimed over 42,000 lives that year, according to data from the CDC.
A new report from the Iqvia Institute for Human Data Science, published in April, did give some glimmer of hope, finding prescription opioid volume declined 12% last year — the largest drop in more than two decades. Yet, as CDC data showed, abuse of heroin and synthetic opioids like fentanyl have become as large of a public health concern as prescription painkillers.