Don’t blame distributors
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