The California Medical Association (CMA) has received reports from physicians that Walgreens pharmacists are refusing to fill controlled substances prescriptions without additional information from the prescriber. Physicians are being asked to provide information on diagnosis, ICD-9 codes, expected length of therapy and previous medications tried and failed.

Walgreens has also sent letters to prescribers that provide an overview of its newly revised policy on good faith dispensing of controlled substances and cites a pharmacist’s corresponding responsibility to ensure that every prescription for controlled substances is “issued for a legitimate medical purpose.”

This new policy appears to be in response to recent investigations and actions by the Drug Enforcement Agency (DEA) related to prescription drug abuse. While proper prescribing and dispensing of controlled substances must be encouraged, CMA is concerned with issues related to patient privacy, administrative burdens and re-diagnosing by pharmacists arising from the inconsistent application and implementation of this policy.

CMA has confirmed with the Medical Board of California, other California-based health professional associations and other state medical societies that this policy is being implemented throughout California and nationwide. In some states, other large chain retail pharmacies are also implementing similar policies and it is likely that other pharmacy chains in California will follow suit.

CMA will be working with the American Medical Association, other state medical societies, and California-based groups to ensure that disruption of legitimate patient care and physician time is minimized. CMA remains committed to addressing concerns about prescription drug abuse in California and is working with the legislature, regulatory bodies and law enforcement to find effective solutions.

For more information on this emerging issue, please see "Fact Sheet on Changes to Walgreens Policy on Filling Prescriptions for Controlled Substances".

If you or your patients have difficulties filling prescriptions for controlled substances at any pharmacy in California, please report problems to CMA's Center for Legal Affairs at legalinfo@cmadocs.org or (800) 786-4262.