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    McKesson Supports Opioid Limits

    Another large company pledges its support for helping to fight the opioid epidemic.

    The CEO of McKesson, John Hammergren, recently issued a statement in support of declaring the opioid epidemic a national emergency, along with other recommendations.

    In the statement, Hammergren offered support for President Trump’s intention to declare the opioid epidemic a national emergency—a move the President promised months ago, but that has yet to be announced. Under a national emergency, emergency funds could be freed, along with a waiver on certain health-care restrictions, which could increase medical personnel in rural areas. Hammergren said that “this vital exercise of executive authority will provide much needed resources to help tackle the opioid crisis in new ways and with a deepened sense of urgency.”

    Related article: The Other Side of Opioid Limits

    Hammergren stressed that combatting the opioid epidemic would require a variety of actors—“doctors, patients, pharmacists, insurance companies, government payers (such as Medicaid and Medicare), distributors, manufacturers, law enforcement, and regulators”—all working together. He added that the epidemic is “one of our nation’s most pressing public health crises,” and that McKesson is “committed to being a part of the national solution.”

    In addition to supporting the declaration of a national emergency, McKesson gave a variety of other recommendations. These changes, he said, “can be acted upon quickly.”

    One of the biggest recommendations is support for a supply limit. They explicitly mention PhRMA’s recent 7-day limit, but a variety of other organizations, such as CVS and Express Scripts, have recently announced similar changes. In addition, McKesson also supports the DEA revisiting its annual quota of opioid production—currently, the DEA is proposing a 20% reduction in the opioid supply for 2018. According to Kristin Hunter Chasen, the Director of Corporate Public Relations for McKesson, the distributor supports that 20% decrease and is even encouraging the agency to review the potential effects of an even larger quota reduction.

    Other recommendations include:

    • Use analytics to identify at-risk patients, and integrate a National Patient Safety System into the pharmacy dispensing process
    • Require e-prescribing for all controlled substances
    • Require all payers and providers to use opioid management programs
    • Improve sharing among state-level PDMPs
    • Permit partial refills to reduce unused medication
    • Use the power of the FDA’s Risk Evaluation and Mitigation Strategies program, which allows the FDA to manage the safe use of a medication.

    When asked about the potential for limits to go too far, Hunter Chasen added that while it is important to curb abuse and misuse, “it is important that we also protect the availability of these medicines for patients with legitimate needs such as a chronic illness, a serious injury, or cancer.”

    Related article: Pharmacy Community Reacts to 60 Minutes/Washington Post Investigation

    Most of the recommendations described by Hammergren involve broader policy decisions. On the ground level, Hunter Chasen said that McKesson has been tackling the problem in a variety of ways. Some of these include pouring resources into their Controlled Substance Monitoring Program, which reports controlled substance transactions to the DEA and uses an algorithm to identify suspicious orders. McKesson also created an opioid taskforce in 2015, which released a paper earlier this year that recommends many of the policies Hammergren put forward in his statement.

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