Don’t blame dis­trib­u­tors

Modern Healthcare - - OPINIONS LETTERS -

Re­gard­ing “Drug-diver­sion turf war,” (March 5, p. 8): Pre­scrip­tion drug abuse is a se­ri­ous prob­lem, but blam­ing the dis­trib­u­tor for how phar­ma­ceu­ti­cals are ul­ti­mately sold and used is deeply mis­guided and will cre­ate a sup­ply chain choke­hold that could threaten the abil­ity of le­git­i­mate health­care providers and pa­tients to get the med­i­ca­tions they need.

Drug dis­trib­u­tors play an in­dis­pens­able role in the na­tion’s health­care sys­tem. They pur­chase, ware­house and de­liver drugs ev­ery day to ev­ery corner of the coun­try, all for lit­er­ally cents on the dol­lar. Equally im­por­tant, dis­trib­u­tors make sub­stan­tial in­vest­ments to track and mon­i­tor the use of the drugs they de­liver. They have spent mil­lions on an­tidi­ver­sion spe­cial­ists and ad­vanced an­a­lyt­ics sys­tems. Dis­trib­u­tors have also reg­u­larly halted drug dis­tri­bu­tion to hun­dreds of phar­ma­cies sus­pected of di­vert­ing the drugs they re­ceive and cre­ated pro­grams to ed­u­cate fam­i­lies and com­mu­ni­ties about med­i­ca­tion safety and the dan­gers of pre­scrip­tion drug abuse.

But drug dis­trib­u­tors can­not and should not, now or ever, pre­scribe a sin­gle phar­ma­ceu­ti­cal, or as­sume a tan­gi­ble role in how pre­scrip­tion drugs are used—or, sadly, abused. The ac­tions taken against Car­di­nal Health ef­fec­tively call for a com­plete “do over” of the health­care sup­ply chain and a rad­i­cal re­think­ing of the role of dis­trib­u­tors. By tar­get­ing dis­trib­u­tors, the Drug En­force­ment Ad­min­is­tra­tion is all but or­der­ing them to take re­spon­si­bil­ity for ev­ery step of the sup­ply chain, and the im­pli­ca­tions are sober­ing. Should dis­trib­u­tors su­per­vise the doc­tors who write the pre­scrip­tions and the phar­ma­cists who fill them? Should they truly be held ac­count­able when le­gal drugs are not used for le­git­i­mate med­i­cal pur­poses? Would any­one ever de­mand that the pizza de­liv­ery man show up at the same house the next morn­ing to make sure the fam­ily is ex­er­cis­ing?

The DEA and other stake­hold­ers must pur­sue so­lu­tions that won’t trig­ger dan­ger­ous un­in­tended con­se­quences. The na­tion’s phar­ma­ceu­ti­cal sup­ply chain is al­ready very frag­ile, with nu­mer­ous drug short­ages pos­ing a wors­en­ing threat, and health­care providers de­pend on drug dis­trib­u­tors to keep a vast lo­gis­ti­cal in­fra­struc­ture flow­ing in a safe, cost-ef­fec­tive man­ner. But the stark re­al­ity is that this en­force­ment ap­proach could com­pel dis­trib­u­tors to sim­ply stop de­liv­er­ing con­trolled medicines. They can­not risk be­ing held re­spon­si­ble ev­ery time a le­gal drug is im­prop­erly sold or mis­used. These are not il­le­gal nar­cotics, where it’s sen­si­ble to go af­ter the mid­dle­man. Drug dis­trib­u­tors are the good guys per­form­ing an es­sen­tial ser­vice.

No mat­ter how well-in­ten­tioned the DEA’S ac­tions were to combat a very real prob­lem, le­git­i­mate pa­tients will suf­fer the con­se­quences if dis­trib­u­tors are un­able to de­liver the drugs doc­tors, phar­ma­cies and hos­pi­tals need. Lee Perl­man

Pres­i­dent GNYHA Ven­tures

New York

Perl­man

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