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Hy-Vee announces new restrictions on opioid prescriptions

Company joins others in effort to reduce overdoses

Pharmacy technician Xander Riley attaches a label to a prescription for a patient at the Hy-Vee Drugstore, 1520 Sixth St. SW, in Cedar Rapids, Iowa, on Friday, Jan. 4, 2019. As of Jan. 1, Hy-Vee pharmacies no longer allow a subsequent fill of a Schedule II controlled substance, or a refill of a Schedule III or Scheduled IV controlled substance more than 72 hours early without authorization from the prescriber. (Jim Slosiarek/The Gazette)
Pharmacy technician Xander Riley attaches a label to a prescription for a patient at the Hy-Vee Drugstore, 1520 Sixth St. SW, in Cedar Rapids, Iowa, on Friday, Jan. 4, 2019. As of Jan. 1, Hy-Vee pharmacies no longer allow a subsequent fill of a Schedule II controlled substance, or a refill of a Schedule III or Scheduled IV controlled substance more than 72 hours early without authorization from the prescriber. (Jim Slosiarek/The Gazette)
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Hy-Vee no longer will allow its pharmacies to refill prescriptions of certain controlled substances more than 72 hours early without a doctor’s authorization.

The policy, effective as of Jan. 1, pertains to refills for Schedule III and Schedule IV drugs or subsequent fills of a Schedule II prescription.

“Our goal is to have as few unused opioids in the marketplace as possible,” Hy-Vee Director of Public Relations Christina Gayman said.

Federal guidelines state no refills are permitted for Schedule II controlled substances. Rules also mandate Schedule III and Schedule IV controlled substances can be refilled if authorized on the prescription, but only refilled up to five times within six months.

Hy-Vee pharmacies are also not accepting coupons for these prescriptions from GoodRx, a mobile app that tracks prescription prices across various pharmacies.

The policy was implemented in Iowa as well as seven other states where Hy-Vee operates pharmacies — Illinois, Kansas, Minnesota, Missouri, Nebraska, South Dakota and Wisconsin.

“The opioid epidemic in the United States claims the lives of more than 100 people every day, and Hy-Vee is continually working to assist in the fight,” said Kristin Williams, senior vice president and chief health officer for Hy-Vee in a statement.

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“Implementing this 72-hour policy is one more step toward combating the opioid epidemic in communities throughout the eight states we serve.”

LIMITING UNUSED PRESCRIPTIONS

Opioids currently are the main driver of drug overdose deaths in the United States, leading to 47,600 fatalities in 2017, according to the federal Centers for Disease Control and Prevention.

Of those overdose-related deaths in 2017, more than 35 percent involved a prescription opioid.

From 1999 to 2017, nearly 218,000 Americans died from overdoses involving prescription opioids.

Prescription opioids commonly are used to treat chronic and acute pain.

In response, a number of companies nationwide, including West Des Moines-headquartered Hy-Vee, have announced steps to help reduce the overall number of opioid prescriptions.

CVS Caremark, for example, in partnership with the Des Moines-based Wellmark Blue Cross and Blue Shield, this past year implemented an opioid medication management policy.

Starting in April, opioid prescriptions for acute — or short-term — pain are limited to seven days for first-time users.

The policy will “limit the excess quantities (of opioid medication) in the community” to prevent misuse, Wellmark Chief Pharmacy Officer Matt Hosford said.

A merger between CVS Health and insurance company Aetna, valued at $69 billion, was approved to move forward after a U.S. District Court judge for the District of Columbia ruled in the favor of the deal earlier this week.

State response

The state of Iowa also is taking a tough stance on prescriptions, implementing a sweeping reform of controlled-substance monitoring in Iowa.

On July 1, a law went into effect requiring prescribers and pharmacists to report dispensed controlled substances to the Prescription Monitoring Program, a database of patient use of controlled substances.

To further limit misuse, all Schedule II, III and IV prescriptions must be issued electronically by 2020.

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The federal Drug Enforcement Administration defines Schedule II drugs as those with a high potential for abuse and include oxycodone and fentanyl. Schedule III drugs have a moderate to low potential for physical and psychological dependence and include products such as Tylenol with codeine. Schedule IV drugs have a low potential for abouse, the DEA says, and include drugs such as Xanax, Darvocet and Tramadol.

Hy-Vee pharmacies, as well as hundreds of pharmacies across Iowa, also offer naloxone to individuals without a prescription to counter the overdose epidemic.

Naloxone, an opioid overdose reversal drug, was made more readily available to Iowans through a standing order by the Iowa Department of Public Health in 2016. The order effectively serves as a prescription, allowing pharmacists to distribute naloxone and similar medication to anyone who needs them.

A map of participating pharmacies can be found at the Iowa Department of Public Health’s website, at https://bit.ly/2yAasJj.

Naloxone can be administered to anyone experiencing an overdose, but is not effective for the long term. Individuals experiencing an overdose should seek medical attention. Health care professionals urge those with questions regarding their controlled-substance prescription to call their pharmacist or doctor.

l Comments: (319) 368-8536; michaela.ramm@thegazette.com

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