Updates on News of Importance to Pharmacists

Insurer Cigna says it is using propriety algorithms and machine learning to predict which of its customers could overdose on prescription opioids within a 30-day period. Cigna’s predictive model was described by Mark Boxer, Executive Vice President and Global Chief Information Officer, who said the program gave the company a competitive advantage and is possibly saving lives. Cigna uses 16 different data-sets in the model, including health claim data, chronic disease historical data, and reported interactions with pharmacies. Once Cigna identifies a potential risk, a behavioral case manager is assigned to reach a patient. Cigna also requires clinicians to analyze data for potential opioid use and abuse patterns.

Bloomberg News reported the farm bill signed by President Trump on Thursday included a provision removing “hemp from a list of federally controlled substances.” The Food and Drug Administration now “plans to figure out how it will oversee and expected explosion in products containing the compound CBD.” According to the article, “For now, the FDA will continue to stop companies from marketing CBD as a drug or disease-thwarting dietary supplement without vetting and approval by the agency.”

CNBC reported the bill “loosened some federal restrictions on cannabis,” explaining that the bill “legalized hemp by removing it from the Controlled Substances Act while preserving the FDA’s authority to regulate the products.” The article added that “regardless of federal laws, companies have already started rolling out CBD products,” and “the farm bill will likely accelerate this trend.”

NBC News reported that FDA Commissioner Scott Gottlieb said, “We treat products containing cannabis or cannabis-derived compounds as we do any other FDA-regulated products — meaning they’re subject to the same authorities and requirements as FDA-regulated products containing any other substance. This is true regardless of the source of the substance, including whether the substance is derived from a plant that is classified as hemp under the Agriculture Improvement Act.”

Texas District Judge Reed O’Connor shook the healthcare world when he ruled the Affordable Care Act is unconstitutional. However, it could be years before a final verdict on that case, according to legal and policy experts who cautioned against jumping to extreme conclusions. Seventeen Democratic attorneys general asked O’Connor to enter a stay in his decision and a final judgement, and indicated they intend to appeal the case in Fifth Circuit Court of Appeals as soon as possible.

A congressional report released last week “blames U.S. prescription drug distributors and the Drug Enforcement Administration for not doing enough to mitigate the nation’s opioid addiction and overdose crisis.” The report, released by the House Energy and Commerce Committee after 18 months of investigating, focused on distributors McKesson, Cardinal Health and AmerisourceBergen and “cited examples of massive pill shipments to West Virginia, which has a population of 1.8 million and has by far the nation’s highest death rate from prescription drugs.”

The report found that McKesson, for example “shipped an average of 9,650 hydrocodone pills per day in 2007 to a now-closed pharmacy in Kermit, which has a population of about 400.” The report also said the DEA “still does not have a centralized way to analyze suspicious order reports submitted by drug distributors.”

Kaiser Health News reports how pharmaceutical companies will sometimes send direct reimbursement to patients, at their request, “when financial incentives like copay coupons and debit cards won’t work.” One policy expert argues, however, that patients needing to directly ask drugmakers for financial relief when coupons don’t work, “highlights just how dysfunctional the system is, and it just isn’t working for patients.” Moreover, “Daniel Nam, executive director of federal programs for AHIP, the America’s Health Insurance Plans, said direct reimbursement using checks is just another way for manufacturers to make insurance companies pay for expensive drugs, which helps jack up monthly premiums.”