Working Together to Combat Prescription Drug Abuse

Troyen A. Brennan, M.D., M.P.H., Executive Vice President and Chief Medical Officer of CVS Health, explains how CVS Health is working to halt the prescription drug abuse epidemic through advocacy and action at the local, state and national level.

Prescription drug abuse has become a national epidemic in recent years. The use of controlled substances has increased dramatically, with prescriptions for opioids jumping more than 300 percent between 1999 and 2010.

Overdose deaths increased from 4,000 annually to 16,600 during the same period. In fact, such overdoses are now the second leading cause of accidental death in the U.S., and more than 2.4 million people were considered to be opioid abusers in 2010.

Increases in substance abuse treatment hospital admissions, emergency department visits, and overdose deaths linked to prescription drug abuse place a huge burden on communities across the U.S.

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As the largest U.S. pharmacy company and as an employer of 26,000 pharmacists and nurse practitioners, CVS Health is uniquely positioned to play a role in helping to end the prescription drug epidemic. The size of our customer base, combined with our national computer network make us ideal partners in efforts to reduce prescription drug abuse.

Identifying Extreme Prescribers of High-Risk Drugs

CVS Health has been able to identify physicians and prescribers who exhibited extreme patterns of prescribing “high risk drugs.”

By studying their volume and share of prescriptions for high-risk drugs versus other providers in the same specialty and geographic region, as well as the ages of patients and their payment methods, the program identified 42 outlying prescribers. Those prescribes were then asked to provide additional information about their prescribing habits. Of these, only six identified legitimate reasons for their unusual prescribing practices.

Read the New England Journal of Medicine Perspective: Abusive Prescribing of Controlled Substances – A Pharmacy View

As a result of the analysis and outreach, CVS Health suspended controlled substance dispensing through our CVS Pharmacy stores and our mail service pharmacies for prescriptions written by the other 36 providers.

Implementing Federal and State Policy Changes

CVS Health is also working at the federal and state level to implement policy changes to curb prescription drug abuse. Our recommendations include:

• Mandatory utilization of Prescription Drug Monitoring Program (PDMP) data at the point of prescribing would require prescribers to review the patient’s pharmacy prescription history, showing the prescriber whether the patient is doctor shopping (utilizing more than one prescriber to obtain controlled substance prescriptions). Based on these insights, the prescriber can discuss the issue with the patient and halt inappropriate use. Forty-nine states have operational PDMPs.

• PDMP data pushed directly to the prescriber’s e-prescribing device would make the prescription-writing process more efficient and accurate at the doctor’s office. Prescribers instantly have the patient history before deciding whether the medication is for a legitimate medical purpose.

• PDMP interoperability across state lines would allow prescribers full visibility into patient prescription fill patterns and reduce or eliminate doctor and pharmacy shopping that occurs across state lines. PDMPs can currently share data across state lines in 22 of the 49 programs.

• E-prescribing for controlled substances is a tactic that has proven to be effective in reducing drug diversion and fraud.

• Daily PDMP data submission from pharmacies to the state database will ensure that each database is accurate and encourage use by reducing lag time between updates.

CVS Health Uses Data to Combat National Prescription Drug Abuse Epidemic

Prescription drug abuse in this country may be an epidemic, but it doesn’t have to be. Government measures, on the local, state and federal levels, may begin to help put an end to this crisis. And the private sector can also do its part. With the help of policy makers and regulators, we’re committed to advancing legislation, promoting technology and creating safer communities.