No Blank Script: Walmart Announces Tighter Controls for Opioid Prescriptions

On May 7, 2018, Walmart issued a press release to announce the pending introduction (within 60 days) of new restrictions on how it will fill prescriptions for opioid medications. These new initiatives will apply to all Walmart and Sam’s Club pharmacies and pharmacists in the United States and Puerto Rico.

Walmart indicated that these changes are “an effort to continue to be part of the solution to our nation’s opioid epidemic,” and it reflects a further expansion of the company’s Opioid Stewardship Initiative. The move from Walmart follows a similar initiative by CVS that went into effect in February. Increasingly, retail pharmacies are stepping up efforts to stem the spread of opioid addiction, prevent overdoses and curb over-prescribing by doctors.

What Doctors Need to know, and What it Means for Patients with Legitimate Prescriptions

Walmart is the fourth-largest pharmacy chain in the US and these changes (being introduced over the course of a 60-day period) are likely to touch a number of patients. The retailer will move to restrict initial acute opioid prescriptions to no more than a seven-day supply, while also limiting a day’s total dose to no more than the equivalent of 50 morphine milligrams. Meanwhile, in states where the law for fills on new acute opioid prescriptions is less than seven days, Walmart and Sam’s Club will follow state law.

In addition to these immediate-term changes, by January 1, 2020, Walmart and Sam’s Club will require e-prescriptions for controlled substances.

In terms of patients needing acute or short-time pain management, in the event that the pain lasts longer than a seven-day supply (and still warrants treatment with these medications), the patient will have to consult his/her physician in order to obtain a new prescription.

Such restrictions have prompted concern that requiring patients to obtain a new prescription after seven, or sometimes only three days (depending on the state), can become too costly due to mandatory co-pays. Dr. Steven Stanos, former president of the American Academy of Pain Medicine explained that the organization applauds “any action that seeks to limit the over-prescription of opioids,” but added, “That needs to be balanced with the very real need of patients.”

For this reason, doctors and patients should be engaging in dialog about current and alternative medications and possible savings options, as they formulate a strategy for effective pain management.

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