CVS Caremark Sets Limits on Off-Label Treatments for COVID-19


CVS Caremark’s new quantity limits will not affect members who are already receiving these medications for their approved uses.


CVS Caremark is setting limits on the quantities of certain medications being used off label to treat coronavirus disease (COVID-19) symptoms.1

The pharmacy benefit manager (PBM) will set new “appropriate” limits on the quantity of hydroxychloroquine (Plaquenil) and azithromycin (Zithromax Z-Pak), along with 1 protease inhibitor and albuterol inhalers.

However, CVS Caremark members who already take the treatments-which are approved for the treatment of lupus, bacterial infections, HIV, rheumatoid arthritis, and asthma-can bypass the new quantity limits.

Hydroxychloroquine, which is under investigation for the potential treatment of mild-to-moderate COVID-19, has been in high demand since President Donald Trump indicated that it could be an effective treatment for the virus. Although ASHP added the drug to its shortages list on March 19, Teva said it would donate 10 million tablets to US hospitals.

CVS Caremark is “working with clients to implement new measures to balance the burgeoning interest in off-label use of certain medicines to treat COVID-19 pneumonia with the ongoing needs of members who use these drugs for chronic conditions,” the PBM said in a press release.

CVS Caremark quickly identified changes in prescribing patterns, which “enabled us to take proactive steps to help ensure the integrity of the supply chain,” said CVS Caremark President Alan Lotvin, MD. “We are taking additional steps today to limit stockpiling that could result in future shortages and gaps in care. We will continue to anticipate and support the needs of our clients, who collectively provide prescription drug coverage for more than 90 million members.”

CVS Caremark also recently worked with clients to make it easier for members to refill most 30-day prescription maintenance medications earlier than usual by waiving commonly used early refill limits, which require members to use most of the medication on hand before obtaining a refill.

“Since CVS Caremark announced this new policy on March 10, it has assisted more than 239,000 members in refilling their 30-day prescription maintenance medications,” the PBM said.

CVS Caremark expects to see a 20% increase in members receiving a 90-day prescription supply of prescription medicines in the coming weeks.

In addition, CVS Caremark is extending previously-approved prior authorizations (PAs) for most medications set to expire before June 30.

For example, if a current PA is set to expire on May 15, the expiration date will be extended to August 15. “This step will enable members to refill most medications without renewing an existing prior authorization - not only providing them peace of mind, but also helping to reduce the volume of phone calls and other administrative burdens on physicians’ offices and pharmacies,” CVS Caremark said.


1. CVS Health helping protect supply of medicines potentially useful for COVID-19 treatment [news release]. CVS Health’s website. Accessed March 25, 2020.

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