At the Forbes Healthcare Summit in November, CVS Health’s Chief Medical Officer, Troyen Brennan, took part in a panel discussion on solutions to curb the opioid epidemic and what can be done to help individuals already facing addiction. Other panelists included:
- Wilson M. Compton, MD, MPE, Deputy Director, National Institute on Drug Abuse
- Thomas R. Frieden, MD, MPH, Former Director, Centers for Disease Control and Prevention; President & Chief Executive Officer, Resolve to Save Lives
- Patrice A. Harris, MD, MA, Immediate Past Chair, Board of Trustees, American Medical Association
- Andrew Kolodny, MD, Co-Director of The Opioid Policy Research Collaborative, The Heller School for Social Policy and Management
Although each panelist offered a unique perspective, collectively the group agreed on factors that led to the public health emergency and where the response should be focused going forward.
The rise of a public health crisis
Frieden, who led the Centers for Disease Control and Prevention from 2009 to 2017, recounted how opioid misuse emerged as a public health crisis, noting the correlation between prescribing rates of opioids and the rapid increase in opioid overdose deaths. In addition, Frieden said that the CDC observed significant increases in other opioid-related adverse health events, such as rises in infectious diseases like Hepatitis C, motor vehicle accidents and elderly falls.
In 2015, 95 million Americans received a prescription for opioids. According to Kolodny, the real problem has been overprescribing, recognizing that many people who developed opioid addiction began by taking opioids exactly as prescribed by their doctors. Compton agreed, stating, “That’s why right-sizing prescriptions is key.”
Better treatment of pain is needed
Addressing the issue of over-prescribing opioids requires an evidence-based approach that appropriately takes into account the risks of addiction. Brennan pointed to the CDC Guidelines on opioid prescribing as an example of evidence-based research that CVS Health applied to its pharmacy benefit management (PBM) practices.
Harris, the former chair of the American Medical Association, said her organization had put out a call for physicians to be judicious in prescribing opioids. She also emphasized the importance for the medical community to have a complete understanding of pain and its potential treatments.
Kolodny pointed out that the most effective treatments for pain may not be an opioid. Furthermore Kolodny said, "Overprescribing opioids for acute pain like wisdom teeth removal is a huge problem. A young person may not be addicted from brief exposure, but studies show that they are much more likely to abuse opioids later"
Barriers to evidence-based treatment must be removed
While evidence-based treatment for addiction exists, panelists shared concern that too many individuals face challenges accessing the care they need. Harris said that research shows only about two in ten people who want treatment are able to get it, and she emphasized the need to eliminate barriers standing in the way.
Brennan pointed to steps that CVS Health took to promote access to medication-assisted treatments for addiction. For example, the PBM removed all prior authorizations for medications like Suboxone and placed it on the lowest cost-sharing tier of the formulary. Questioning whether it makes sense to cover these treatments given the costs, Brennan said our answer is yes.
Watch the full panel