Recent concerns about opioid misuse and abuse have led payors, policymakers and retail pharmacies to attempt to restrict the dispensing of prescribed opioid dosage and duration.
One such policy of great concern is Walmart�s corporate policy that limits opioid prescriptions to seven days or 50 morphine milligram equivalents, which is causing harm to patients with acute, palliative, cancer-related, chronic pain and other medical conditions requiring amounts or doses greater than the policy allows.
Walmart is inappropriately interpreting the Center for Disease Control (CDC) guidelines for prescribing opioids to set these policies. Such arbitrary prescribing thresholds interfere with the patient-physician relationship, physician practice and patients� access to quality care and treatment.
In some cases, physicians have been inexplicably �blacklisted� where Walmart refuses to fill their prescriptions for controlled substances without explanation, and the physicians are left without a means of contesting the decision.
Walmart in explaining it’s policy
On multiple occasions, AMA has requested that Walmart be transparent by explaining the algorithm it uses to justify restrictions to prescriptions, but according to AMA, all of its letters have gone �without a meaningful response.� As part of continued efforts to resolve the issue with Walmart, the American Medical Association (AMA) sent a letter to Thomas Van Gilder, M.D., Chief Medical and Analytics Officer for Walmart, Inc. on September 24, 2019, regarding its corporate prescription opioid restriction policy, also referred to as its �refusal to fill� policy.
�Your �refusal to fill� policy also has disrupted legitimate medical practices that receive form letters telling them their prescribing rights under state law will be superseded by a Walmart-created algorithm that deems a physician unfit to prescribe,�
This is not an isolated occurrence. It follows on the actions of the DEA to decrease opioid prescription negligence by providers. The number of opioid prescriptions has decreased markedly due to education efforts by the DEA and education in alternatives to opioids for pain management.
Undoubtedly a corporate decision was made by Walmart that it could be held liable for overdoses by patients. Usually when a pharmacist questions a prescription he/she contacts the physician directly. The danger of computer algorithms acting
Some policies, practices attributed to the Guideline are inconsistent with its recommendations
AMA says Walmart �refusal to fill� policy interferes with the practice of medicine: Recent concerns about opioid misuse and abuse have led payors, policymakers and retail pharmacies to attempt to restrict the dispensing of prescribed opioid dosage and duration.