AMA Criticizes Express Scripts` Plan to Limit Opioid Prescriptions

Express Scripts recently launched a program, the Advanced Opioid Management program, which aims to reduce opioid abuse by limiting patient access to the painkillers. However, the American Medical Associations recently pushed back against the plan, claiming that it limits provider’s ability to treat patients effectively. 

In an interview with First Report Managed Care, Snezana Mahon, PharmD, vice president, clinical product development at Express Scripts, explained that the aim of the program is to “minimize early exposure and prevent progression to overuse and abuse at critical touchpoints.”

According to Dr Mahon, the program restricts patients within Express Scripts pharmacy network to an initial 7-day supply of opioids regardless of what their physician prescribes. The program also requires enhanced prior authorization for all long-acting opioids in order to prevent new users from obtaining these stronger opioids.

Dr Mahon also explained that the program was designed to work in tandem with physicians, not against their treatment plans. 

“We send automated messages directly to all opioid-writing physicians at the point-of-care via their Electronic Health/Medical Records (EHR/EMR) portal to inform them of potential duplicate therapy, misuse and abuse, drug-drug interactions, use of multiple prescribers or pharmacies—or when their patient is approaching morphine equivalent dose (MED) thresholds,” she said.

However, in a recent interview with The Associated Press, Patrice Harris, MD, Chair of the AMA’s Opioid Task Force, explained that a one-size fits all approach is limiting for physicians. 

“We want to be proactive in making sure the alternatives are available, versus a sort of blunt, one-size-fits-all-all approach regarding the number of prescriptions,” she said.

Dr Mahon recognized that the Express Scripts program is somewhat limiting but stressed that “safe opioid use does require the commitment of each of our touchpoints: physicians, pharmacists and patients.”

—David Costill