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CVS Health – Right idea, wrong solution?

September 26, 2017

In a Sept. 21st press release CVS Health announced that its pharmacies and clinics will begin limiting and even deciding which opioids patients can access.

The company states in that press release that the protocol will apply to “… all commercial, health plan, employer and Medicaid clients as of February 1, 2018 unless the client chooses to opt out.”

The justification is that the company wishes to assist in combating opioid abuse, which is fine. Everyone, from President Trump to the general public, wants to curb opioid abuse. Still ,the company’s actions might not be purely altruistic.

There are many reasons for the opioid abuse epidemic, and pharmacies are often chastised for “blindly” refilling prescriptions, even when they have a doctor’s prescription on file directing them to do so.

That makes them targets for both civil and criminal prosecution, giving the company strong incentives to cover its own derriere.

To that end, CVS now seeks to limit initial prescriptions to new patients to seven days, refuse to fill extended-release prescriptions, and adjust the daily dosage frequency based on the per dose strength of the medication.

The presser implies that the changes will only be applied to patients utilizing its “enterprise” pharmacies and health clinics, but never specifically limits those changes to their own facilities.

Even just their own enterprise locations account for the management of medications for 90 million CVS proprietary plan member patients, if their website is accurately reporting its impact.  That’s 1 out of every 3 or so people in the United States.

Indeed, language within the presser leaves the impression that the company may take their campaign nationwide, outside their own businesses.

Is that the right approach?

Certainly, CVS Health has every right to conduct business as it sees fit within its own organization, and some of their other initiatives, such as providing medication disposal facilities for unused medications are laudable.

What could be lost in the hue and cry are the patient’s needs.

For instance, what about the patient who is the victim of a new injury with a long and painful recovery period? How about a patient newly diagnosed with fibromyalgia, or a terminal cancer patient?

While they might be considered new to the CVS system, they may well need medication for more than seven days, and in the case of chronic or terminal conditions, patients may be better suited to use extended-release medications rather than having to take a pill every 4 or 6 hours.

The real question is, will the CVS policy just drive more people to the streets?

There are many causes for opiate dependency, not the least of which is the failure of pharmaceutical researchers to come up with non-opioid pain medications, such as effective topical analgesics or better non-addictive medications such as those in the NSAID family.

Certainly some of the blame can be placed on doctors more intent on billing patient hours than focusing on patient needs. Equally to blame might be the failure to adequately secure medications in the home.

Blame can also be assigned to our permissive, molly-coddling, safe-space culture. You know, the one that mandates that no one should ever develop inner strengths that prevent them from looking for a chemical solution to the ordinary problems of life.

In short, the problem goes far beyond concocting a one-size-fits-all company protocol, leaving one to wonder just how much good the CVS approach will accomplish, and at what cost in human suffering.

From → op-ed

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