PBMs underpaid pharmacies; exemption from vaccines proposed; opioid dispensing declines; nonaddictive pain med sought; and Cigna and Express Scripts to merge

WV legislators decided September 18 to draft a bill to make it easier for families to get medical exemptions from vaccines for their children.  Currently, parents who do not want their children to be vaccinated must fill out a form to request a medical exemption.  A state immunization officer will make the determination if the exemption is granted.

How much did the 2016 CDC opioid prescribing guideline for chronic pain change prescription practices?  According to a new study in the Annals of Internal Medicine, it may have contributed to improved prescribing behavior.   In January 2012, 6,577 opioid prescriptions were dispensed per 100,000 persons; by December 2017, that number had declined to 4,240, according to the findings in the study.   Researchers also estimated that 14,195,471 fewer opioid prescriptions were filled from March 2016 to December 2017.  The CDC’s Guideline for Prescribing Opioids for Chronic Pan, released in March of 2016, recommended evidence-based practices for opioid use for patients 18 years and older in primary care settings in treating chronic pain outside of active cancer treatment, palliative care, and end-of-life care.

Although CVS Caremark and Optum RX have sued the State of Ohio to keep most of its report of PBM financials secret, the State did release figures September 18 showing that while PBMs pocketed $223 million, CVS Caremark UNDERPAID Ohio pharmacists $335.8 million, while Optum RX UNDERPAID pharmacies $21.3 million dollars.  This report validates claims of PBMs reimbursing independent pharmacies at a level that is NON-SUSTAINABLE for business.

Among legislation overwhelmingly passed September 17 by the U.S. Senate, the National Institutes for Health is directed to research a nonaddictive pain medication.  Another provision clarifies that the FDA has the authority to require prescriptions for opioids to be packaged in set amounts, such as three or seven days.   The package creates new federal grants for treatment centers, training emergency workers and research on prevention methods.  The House of Representatives passed similar legislative proposals earlier this summer.

The federal government gave the go-ahead to the proposed merger between Cigna, one of nation’s largest health insurers, and Express Scripts, a major pharmacy benefit manager.  The deal is valued at $52 billion.  Cigna and Express Scripts say they can improve care for patients and lower health-care costs.  The deal is to close by year’s end.