CVS Caremark Corp says it has taken the unusual step of cutting off access to powerful painkillers for more than 36 doctors and other healthcare providers found to prescribe the drugs at an alarmingly high rate.
The drugstore chain, which was drawn into a government crackdown on prescription painkiller abuse last year, began revoking the dispensing privileges of certain providers in late 2012, said CVS Chief Medical Officer Troyen Brennan.
"This isn't a definitive solution to the problem," Brennan said. "We wanted to share what it was that we did and have other people in healthcare, including other pharmacies, look at what we did and discuss what some more comprehensive solutions might be."
CVS disclosed the suspensions in a letter published on the website of the New England Journal of Medicine.
Abuse of opioid prescription pain-killers like Oxycontin ranks as the No. 2 cause of accidental death in the United States, CVS said. In 2009, painkiller use was cited in more than 15,500 overdose deaths, according to the U.S. Centers for Disease Control and Prevention.
The U.S. Drug Enforcement Administration has targeted large pharmacy chains like CVS and rival Walgreen Co, as well as distributors such as Cardinal Health, to stem the flow of prescription drugs where abuse is suspected.
The DEA revoked the controlled substance licenses of two CVS drugstores in Florida last September. In June, Walgreen reached a record $80 million settlement with the DEA to resolve allegations that its negligence in record-keeping and dispensing allowed the highly addictive drugs to reach abusers and be sold illegally.
Brennan said that CVS has not yet discussed its findings about suspect providers with the DEA or others.
CVS said the suspensions followed an analysis of prescriptions brought to its drugstores from March 2010 through January 2012 for hydrocodone, oxycodone, alprazolam, methadone and carisoprodol.
CVS said it first identified several dozen healthcare providers -- from a database of nearly 1 million -- with extreme patterns of prescribing high-risk drugs. CVS checked their prescription rates versus other providers in the same specialty and geographic region, the ages of the patients and the number of patients paying with cash for the drugs.
For instance, one "outlier prescriber" in the field of preventive medicine was prescribing on average more than 44,000 doses of high-risk drugs, compared with 662 for similar providers.
CVS asked 42 providers for more details about their prescribing habits. Six of those 42 gave what CVS said were legitimate reasons for the high volume of prescriptions; for instance, being medical director at a hospice prescribing painkillers.
The company said its stores and its mail-order pharmacy will no longer dispense controlled substances for 36 providers who it said could not justify their prescribing habits. Brennan said that an additional "handful" have been suspended as the company continues its analysis.
First published August 22 2013, 6:11 AM