Transcript Thomas Moriarty Presentation - Conference of Western Attorneys

Conference of Western
Attorney Generals
Panel Discussion
Tom Moriarty
Executive Vice President and General Counsel
CVS Health
July 19, 2016
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Opioid abuse is a national epidemic
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The U.S. vastly outpaces worldwide
consumption of opioids
Source: OverDosed: A Comprehensive Federal Strategy for Addressing America’s Prescription Drug and Heroin Epidemic; Sen. Ed Markey’s Office
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This is a complex problem, requiring a multifaceted
approach across multiple key stakeholders
1. Preventing diversion of controlled substances into illicit channels
–
Pharmacy Robberies
–
Internal Diversion
2. Shifting prescribing habits
–
CDC opioid prescribing guidelines
–
Recent state prescribing limits: MA, VT, CT and others
3. Supporting safe and environmentally friendly methods of drug disposal
4. Education as a key preventative tool
5. Leveraging technology to strengthen the prescribing safeguards
•
Mandate e-prescribing for controlled substances
•
Cross-state PMP data sharing (ex. NABP Interconnect)
6. Expanded access to addiction treatment providers
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CVS is responding to the nation’s opioid abuse
epidemic in a number of different ways
Compliance Initiatives
Supporting Safer Communities
TODAY’S
AREA OF
FOCUS
System Enhancement Initiatives
Public Policy Advocacy
Strategic Alliances
Partnership for Drug Free Kids
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CVS Safer Communities Program
Keeping our communities safe through education and service
1. Educational Programs
2. Consumer Drug Disposal
3. Expanding Naloxone Access
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We are proud to announce the launch of our Rx Drug
Abuse Prevention website at CVS.com
Launched in May 2016, our
Safer Communities website is
an educational resource for
consumers.
• CVS pharmacy is dedicated
to helping the communities
we serve address and
prevent drug abuse
• We strongly believe the best
efforts in prevention occur
through effective education
• Because of the reach we have within communities through our customer base,
we are uniquely positioned to educate the consumer
Visit: www.cvs.com/prescription-drug-abuse
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The Safer Communities Website has three key components
For Parents and Families: Tips and information to help prevent
accidental poisoning and abuse by educating patients to take their
medication as directed, secure their medications in the home and
dispose of unwanted or expired medications appropriately.
• Location finder for disposal units
• FDA guidelines for disposal
• Links to additional resources (e.g. Partnership for Drug-Free Kids,
Medicine Abuse Project, NIDA)
For Law Enforcement: Online resource for local law enforcement
agencies to learn about receiving a drug collection unit as part of our
Medication for Disposal for Safer Communities Grant Program
• Hot link to grant application
Community Advocates: Links to CVSHealth.com content that
highlights our partnerships, proactive work and related media articles
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Resources for
patients, law
enforcement
and
community
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Promoting our site through a variety of mechanisms
CareCheck Plus Rx Receipt Messaging
CVS.com bottom banner
CVS.com Fly down banner
Chain wide Circular snipe
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Educating teens one classroom at a time: Pharmacists
Teach Program- One Choice Changes Everything
• Launched October 2015
• Pharmacist community outreach program targeting
teens
• Purpose: to dispel widely held belief in this age group
that Rx drugs are safer to abuse than street drugs
• Includes powerful, moving video testimonials from
those whose lives have been affected
• Content produced in conjunction with the Partnership
for Drug-Free-Kids
• Pharmacist reach out to local middle and high school
administrators to offer program
• Designed as a 35 minute presentation for teens in a
health class setting
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We have conducted 2,700+ presentations to over
100,000 students during the ’15 -’16 school year
Presentations delivered in 39
different states
Program resonates strongly with
our Pharmacists’ sense of purpose
in their communities.
Have received strong positive
feedback from students and faculty
alike.
Schools are currently scheduling
presentations for the 2016-2017
school year.
We are developing a Parent program for the coming school year that is designed to help
parents talk to their kids about prescription drug abuse, identify signs of addiction and provide
resources to get help.
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CVS Safer Communities Program
Keeping our communities safe through education and service
1. Educational Programs
2. Consumer Drug Disposal
3. Expanding Naloxone Access
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A number of concerns exist with respect to
operation of pharmacy drug disposal kiosks
1. Safety Concerns
2. Diversion and Theft Concerns
3. Operational Concerns
4. Conflicts Between State - Federal Hazard Waste
Regulations
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Drug take back falls within the “household hazardous
waste exception” under the federal environmental rules
• State law can be more restrictive and in those states, pharmacies
may have to register as a household hazardous waste collection site
or adhere to other management standards for household hazardous
waste collection activities
• Even under the household exception, drugs dropped off by assisted
living facilities, nursing homes, and other non-household users
(doctors’ offices, walk-in clinics, etc.) would not fall within the
exception.
• The Pharmacies cannot control who drops waste materials into the
container and whether those waste materials are “hazardous” as
defined by federal or state law
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CVS supports consumer drug disposal in many ways
1 Mail-back programs
• Convenient and easy to use
• Mail back programs bring the solution directly to where it is
needed - the home
• Available at all CVS/pharmacy locations
2 Hosting Drug Take Back Events
• Have issued an “open invitation” to all law enforcement agencies
nationwide to hold drug take back events at our locations
• Promote the event in-store in the weeks approaching the event to
help drive awareness and community participation
3 Law Enforcement Collection Unit Grant Program
• Created this program in response to multiple requests from police
departments who wanted to start a program, but lacked funding to
purchase a collection unit
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Medication Disposal for Safer Communities
Law Enforcement Grant Program
Launched in 2014, CVS and the
Partnership for Drug-Free Kids are donating
free of charge, drug collection receptacles
to police departments
Collection units are installed in the lobby of
police departments and are available for
citizens to safely drop off medications for
disposal.
Police track the amount of drugs collected
and dispose of them via incineration.
Police Departments Can Apply Online:
http://www.cvs.com/content/safer-communities
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Over 600 collection units donated across 41 states, 36+
metric tons of drugs destroyed since program inception
Waukesha County, WI
Leesburg, VA
Broome County, NY
Demopolis, AL
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Longmeadow, MA
St. Augustine, FL
Iowa City, IA
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Innovative Public-Private Partnership
• Working with City of Milwaukee, WI on an
innovative public – private partnership to
increase options for safe and
environmentally responsible drug
disposal
• Pilot program will consist of a mail-back
drug disposal program run by City of
Milwaukee Police Department
• CVS/pharmacy locations will act as
points of distribution for mail-back
envelopes to members of the community
• Envelopes will be mailed to City of
Milwaukee Police Department for
destruction
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CVS Safer Communities Program
Keeping our communities safe through education and service
1. Educational Programs
2. Consumer Drug Disposal
3. Expanding Naloxone Access
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Naloxone Standing Order – National Landscape
We expect to expand our
program to the following
states:
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Florida (July)
Texas (July)
Colorado (July)
Idaho (July)
Oregon (July)
Washington (July)
Alabama (Q4)
Hawaii (Q4)
Illinois (Q4)
South Dakota (Q4)
As of July 2016, 31 states will be able to fill naloxone under
standing order and we expect a total of 35 states by year end
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Some final thoughts on opportunities
to pursue…
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Fueled by high street demand, Pharmacy robberies
have become more brazen and violent
• Have seen gangs use
minors to conduct
robberies
• Consider enhanced penalties
for robberies of pharmacies
and other healthcare
facilities
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PMP use is more effective when data is shared
across state lines
• NABP PMP InterConnect
allows participating state
PMPs to share data across
state lines
• Provides prescribers and
pharmacists a fuller view
of patient activity upon
which to make decisions
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Strongly recommend adopting mandatory
e-prescribing for controlled substances
• Mitigates prescription forgeries
• Mitigates altered prescriptions
• Enhanced patient safety
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Ideal future state… state PMP checks seamlessly integrated into
e-prescribing software for controlled substance prescribing
1 Prescriber initiates
2 E-prescribing software
e-prescription for a
controlled substance
connects to state PMP
and provides patient
utilization report to
4B Initiate addiction
treatment if needed
3 Prescriber can then review PMP
4A Continue to prescribe if
appropriate
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data at the point of prescribing and
determine appropriate next steps
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