Response to Media Stories About the Opioid Crisis

As a company, we are deeply concerned by the impact the opioid epidemic is having on families and communities across our nation—and we’re committed to being part of the solution.

In our role as a distributor, we maintain – and continuously enhance – strong programs designed to detect and prevent opioid diversion within the pharmaceutical supply chain. We only distribute controlled substances, including opioids, to DEA-registered and state-licensed pharmacies. For many years, sales of controlled substances ordered by pharmacies in the U.S. have been reported to the DEA as required for their internal ARCOS database.

McKesson is working with others to advance a series of company initiatives focused on helping to address the opioid epidemic, offer thoughtful public policy recommendations – including the Prescription Safety-Alert System (RxSAS) technology proposal – and support innovative programs and partnerships that we believe can have a meaningful impact on this challenging issue. We’ve also contributed $100 million to the Foundation for Opioid Response Efforts (FORE), a 501(c)(3) non-profit dedicated to combating the opioid crisis in the U.S. We are committed to acting with urgency and working with others to end this national crisis.

We’ve prepared a short Q&A to address several misconceptions about the opioid epidemic, the role distributors play in the industry, and what McKesson is doing to help address the crisis. We’d also encourage you to visit the website of the distributor trade association, the Healthcare Distribution Alliance, for more information.

What does McKesson do?

As a pharmaceutical distributor, we deliver medicines prescribed by licensed doctors to licensed pharmacies, so they are available for patients who need them, when they need them, where they need them. In many cases, McKesson makes deliveries to our more than 40,000 pharmacy customers across the country within a matter of hours, in both urban and rural areas. These deliveries include both over-the-counter and prescription medications.

In the case of controlled substances, we have to balance our mission to deliver medicines to pharmacies against our important efforts to prevent and detect illegal diversion of those drugs. Controlled substances only represent a small share of our overall business – the two schedules of controlled substances that include opioids (but that include other drugs as well) constituted only about 3.1% - 4.2% of the Company’s total enterprise revenue.

What role does McKesson play in the pharmaceutical supply chain?

As a pharmaceutical distributor, McKesson operates as one component within the pharmaceutical supply chain. McKesson, like other distributors, delivers medications ordered by pharmacists to fill prescriptions written by doctors. Other participants in the pharmaceutical supply chain include:

  • The Drug Enforcement Administration (DEA), which has regulatory oversight for all DEA-registrants (doctors, pharmacists, distributors), sets yearly quotas for the volume of opioids that can be manufactured, and has exclusive access to the ARCOS information that can help identify over-prescribing and pharmacies filling an excessive number of opioid prescriptions.
  • Drug manufacturers that design, develop and promote the medication
  • Healthcare providers who prescribe the medication
  • Pharmacists who dispense the medication
  • Private and public health insurance groups that determine what they will pay for
  • State medical and pharmacy boards that oversee the doctors and pharmacies in their jurisdiction

How does McKesson evaluate high-volume orders?

McKesson has developed a variety of tools to evaluate customer orders in an effort to identify potential diversion. With the benefit of modern, sophisticated data analytics tools, over the last five years we have enhanced our monitoring system to survey and analyze large volumes of data, in order to identify potential bad actors more quickly.

When considering the volume of opioids distributed to certain pharmacies by McKesson and other distributors, it’s important to put that data in context. For example, from 2007 through 2012, McKesson distributed approximately 151 million doses of oxycodone and hydrocodone in West Virginia. During the same six-year period of time, McKesson distributed nearly 2 billion doses of all prescription drugs in West Virginia.

What is McKesson doing to help fight the crisis?

We have taken action, including educating pharmacies and hospitals that purchase from us about the importance of compliance with DEA regulations, as well as how to identify potential warning signs of prescription abuse and diversion. We are also working with others to advance meaningful solutions to tackle the opioid crisis, including (among other efforts):

  • creating a nationwide clinical alert system that uses patient prescription history to identify patients at risk for opioid overuse, abuse, addiction or misuse. The system would provide real-time clinical alerts, integrated into pharmacist workflow, across state lines;
  • offering complimentary pharmacist training by independent medical experts on how to administer opioid overdose reversal medications such as naloxone;
  • supporting opioid addiction prevention and treatment-focused organizations;
  • and actively advocating for public policies that will help address the opioid epidemic.

Additionally, McKesson contributed $100 million to the Foundation for Opioid Response Efforts (FORE), a non-profit dedicated to combating the opioid crisis in the U.S.