CVS Caremark Uses Data to Combat National Prescription Drug Abuse Epidemic; Program Details Published in New England Journal of Medicine Online

PRESS RELEASE

WOONSOCKET, R.I., Aug. 22, 2013 -- As part of its continuing efforts to combat the national prescription drug abuse epidemic, CVS Caremark (NYSE: CVS) is tapping its extensive database to identify and halt inappropriate prescribing of high risk drugs such as opioid painkillers. By evaluating data on prescriptions filled at CVS/pharmacy, CVS Caremark identified providers with extreme patterns of prescribing such high-risk drugs and suspended controlled substance dispensing for those who could not justify their prescribing habits. Details of the unique program were published online first on The New England Journal of Medicine website at nejm.org.

"Prescription drug abuse in this country is an epidemic, but it doesn't have to be," said Troyen A. Brennan, MD, MPH, Executive Vice President and Chief Medical Officer of CVS Caremark and co-author of the article, "Abusive Prescribing of Controlled Substances — A Pharmacy View." Brennan added, "CVS Caremark, one of the largest providers of prescription drugs, is committed to mitigating prescription drug abuse by advancing legislation, promoting technology and creating safer communities."

In a recent new effort, CVS Caremark identified problem prescribers by studying their volume and share of high-risk drugs versus other providers in the same specialty and geographic region, as well as the ages of patients and their payment methods. The program identified 42 outlying prescribers who were then asked to provide additional information about their prescribing habits. Of these, only six identified legitimate reasons for their unusual prescribing practices. As a result of the analysis and outreach, CVS Caremark suspended controlled substance dispensing through the company's CVS/pharmacy locations and the CVS Caremark Mail Service pharmacies for prescriptions written by the other 36 providers.

"While this program is not a comprehensive solution to prescription drug abuse, it is an important first step that is in line with the ethical duty pharmacists have to ensure that a prescription for a controlled substance is appropriate," said Mitch Betses, R.Ph., Senior Vice President, Pharmacy Services of CVS/pharmacy and a co-author. "We know there are many ways to fight prescription drug abuse and we are committed to continuing to identify solutions to stop the improper use of controlled substances."

The use of controlled substances has increased dramatically, with prescriptions for opioids jumping more than 300 percent between 1999 and 2010. Overdose deaths increased from 4,000 annually to 16,600 during the same period. Such overdoses are now the second leading cause of accidental death in the U.S., and more than 2.4 million people were considered to be opioid abusers in 2010.

The NEJM article highlights the role pharmacies can play in helping to curb the national epidemic of prescription drug abuse. The authors also call on lawmakers and regulators at the state and federal levels to enact policy changes that mandate more transparency into controlled substance prescribing, such as mandatory use of electronic prescribing, and a national, uniform program for prescription drug monitoring.

CVS Caremark also is working at the federal and state levels to implement policy changes to curb prescription drug abuse, including:

• Mandatory Electronic Prescribing for Controlled Substances: The company is urging federal regulators to require e-prescribing for these classes of drugs to reduce "doctor shopping," drug diversion and fraudulent prescriptions.
• Improved Prescription Drug Monitoring Programs (PDMPs): These state-run databases are operating in 46 states to help providers and pharmacists identify patients at risk of overdose and drug abuse, but improvements are needed to encourage interoperability between different states and make PDMP data directly available to prescribers and dispensers.
• Proper Prescription Drug Disposal: CVS Caremark is committed to working with the Drug Enforcement Administration and other federal and state officials on more innovative and effective ways to manage drug take-back initiatives.

In other activities to help curb prescription drug abuse, CVS Caremark supports the Medicine Abuse Project, a multi-year initiative of The Partnership at Drugfree.org with the goal of preventing a half million teenagers from abusing prescription medication by the year 2017. In addition, all CVS/pharmacy locations throughout the U.S. participate in the Sharps Compliance Takeaway Environmental Return program, which provides customers with the ability to safely dispose of their unused, expired or unwanted drugs using affordable medication disposal envelopes. The postage-paid envelopes allow customers to mail their unwanted prescription and over-the-counter medications through the U.S. Postal Service to a licensed, secure facility for safe destruction. Controlled substances cannot be disposed of using this program.