Tag: pharmaceutical industry

CVS and the role of Pharmacies in the Opioid Crisis

This past week, CVS pharmacy announced another step in their response to the country’s ongoing opioid epidemic. They are expanding medication disposal options, by adding over 700 in store disposal units across the country. They also announced an expanded pharmacist counseling session for those prescribed opioids for the first time, to highlight the risks of addiction and dependence, while answering any patient questions. The CVS Health Foundation has additionally pledged $2 million to support federally qualified community health centers that deliver medication-assisted treatment.

On top of all of this, they have announced that they are limiting the prescription of opioids to seven days for acute prescriptions, limiting daily dose strengths, and requiring that immediate-release formulations of opioids to be used before prescribing extended release options. Not only does this make their practices consistent with recent CDC guidelines, but also as the largest pharmacy in the United States, CVS taking a stronger stance to limit the excess prescribing of opioids could set a precedent in the role that pharmacies play in the opioid crisis.

To combat this epidemic, we need buy in from facets of the medical industry, from individual doctors to health care systems, insurance companies and pharmacies, medication manufacturers and government officials. I commend CVS on their stance to address their role in this crisis, and hope that it serves as a moment of recognizing responsibility for this crisis. If we use evidence based interventions, and partnerships from behavioral health, to medicine, and governmental agencies, we can begin to reduce opioid dependence and addiction, and see a decrease in those lost to overdose.

Sources –

CVS Health Press Release – https://cvshealth.com/thought-leadership/cvs-health-enterprise-response-opioid-epidemic/cvs-health-responds-to-nations-opioid-crisis

CDC Opioid Prescribing Guidelines – https://www.cdc.gov/drugoverdose/prescribing/guideline.html

Are You Healthy?

To understand whether or not your healthy, you have to first understand what it means to be healthy. It seems straightforward, but in the modern age, this is a complex question.

We might at first be inclined to think that being healthy means that you don’t have any illness or injury. But is this always true? What if you have an illness that is managed by medication? What if a person has a disability but the disability doesn’t disrupt their daily life? What if you’ve been diagnosed with pre-hypertension but have no symptoms?

Joseph Dumit, Director of Science and Technology Studies and Professor of Anthropology at the University of California, Davis, discusses various changes to our view of health and illness since the rise of the randomized control trial in his book Drugs for Life: How Pharmaceutical Companies Define Our Health (Duke University Press, 2012). He argues “that being at risk for illness is often treated as if one had a disease requiring lifelong treatments, drugs for life” (6).

Dumit discusses a few prediseases in depth, looking at pre-hypertensive, pre-diabetes, and borderline high cholesterol. “Literally, a disease-sounding syndrome is produced by correlating risk factors and naming it in such a way that it becomes common sense to think about treating ‘it’ as a disease in and of itself” (165). Hence, health becomes a matter of risk where we are all bodies constantly at risk of disease. If you have pre-diabetes, are you healthy? How do we understand our health in a risk economy of health?

This intersects interestingly with Donald A. Barr’s claim, in his book Health Disparities in the United States: Social Class, Race, Ethnicity, & Health, that despite investing so much of our economy in health, US health indexes rank rather low; “[p]erhaps, our basic assumption–that more health care will lead, necessarily, to better health–is flawed.”

Is industry sponsorship a problem? Considerations for ethical research and medical publishing.

Clinical research and other drug development and testing activities can be funded, or “sponsored,” by a number of sources, including physicians, universities, government agencies, special interest groups, and pharmaceutical companies. Many people have an understandable concern regarding the reliability of research funded by the pharmaceutical companies that stand to make a profit from the drugs being tested.

While these conflicts of interest will probably always be a concern, it is important to note that there are increasingly more regulations and safeguards being put into place both within the industry and from external sources like the federal government in order to encourage the use of ethical practices in medical research and publishing.

I was also skeptical of the legitimacy and/or motives behind industry-sponsored research, however, what I didn’t realize until I began working within the medical publishing industry was the extent to which research and marketing activities are deliberately segregated by pharmaceutical companies.

For example, the parent company at which I’m currently interning encompasses both a medical publishing agency and a health care marketing agency. Although everyone works in the same building, the agency’s pharmaceutical clients generally require that any of the agency’s staff members who are involved with marketing or advertising for their company not be involved with the planning or publishing of the clinical research being conducted for their products.

So, contrary to what some may perceive to be true, it is not the case that marketing teams are soliciting particular studies or data to be collected in order to help them sell a product. Instead, physicians and researchers are designing and conducting studies based on the scientific and clinical value of the data being produced. In this way, the scientific information is originating from scientists and medical professionals and then being provided to marketing and advertising departments, and not the other way around.

Come back next week for part two of this discussion on the ethical considerations involved in medical publishing.