Forbes November 8, 2024
Joshua P. Cohen

There is a tendency to overlook the multiple factors that contributed to the problem of prescription opioid misuse, abuse, overuse and diversion that began in the 1990s. Typically, the media has focused on drug manufacturers and doctors running pill mills as the chief villains. It’s important, however, to shed light on other stakeholders which possibly drove the opioid crisis, including payers and pharmacy benefit managers.

The prescription drug supply chain for opioids is extraordinarily complex and highly regulated. The key stakeholders include pharmaceutical manufacturers, federal and state regulators, wholesaler distributors, pharmacies, payers, PBMs, physicians and patients. Except for the patient, every stakeholder in the prescription opioid supply chain is licensed, and supply is regulated by the federal and state governments.

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