The Misaligned Uses for Specialty Pharmacy Drugs

Misaligned use of specialty pharmaceuticals happens when someone wants an easy way out, to look young forever, lose weight, or to build lean muscle mass into their seventh decade of life. Growth hormones and HCG are the miracle drugs today, and for a price, anyone can find a prescriber to work with as you jump start your dreams of perfection.

Botox really treats true medical conditions, and does not just erase wrinkles and forehead furrows. There could be a marketplace for these vanity sales. As such, these products should be priced differently than when they are used to treat well documented cases of disease or impairments that impact one’s lifespan and quality of life.

It’s good genes; what a simple yet powerful statement. Much of how your health evolves is based on your genetic make-up, which is beyond your personal control. Even if you are dedicated and focused on making a change to your personal make-up, most genetic markers can only be mildly influenced by outside intervention.

If you are genetically programmed to have a cow lick in your hair, no intervention is going to change the pattern of how that patch of hair is going to grow. There are examples of people who went through chemotherapy and radiation treatments to have all their hair fall out, and what grew back was very different than how their hair grew before treatment.

Someone with straight hair now has a natural curl or wave to their hair, or vice versa, following a course of treatment. This is an extreme example and can be attributed to a side effect of a drug therapy that influenced some aspect of your genetics. However, it is not normally easy to rewire how your hair grows, and honestly, I would never recommend chemotherapy over a Brazilian blow-out or the magic produced by a curling iron.

If you are genetically programmed to be 5-feet 10-inches tall, that is the height appropriate for you. It is a reasonably acceptable height based upon evolution and your genetic ancestry. There are ways to intervene and impact how tall you grow. Poor nutrition or a medical trauma in childhood could create a stunned growth pattern.

The opposite could be true, a pushy parent could find a provider to prescribe growth hormone injections for a perfectly healthy, normally-growing child (who does not have a diagnosis of short stature or a pituitary dysfunction). Why would a parent want to expose their child to daily injections and unnecessary medical appointments, just to grow beyond what they were genetically designed to be?

Maybe the assumption is that being over a certain height will provide a future benefit or advantage in sports or life to differentiate that child from someone else, but is that reason enough?

A true story

A new mom brings her 3-month old to the pediatrician for a routine check-up. The mother is anxious to see how the baby is growing and developing in accordance to the charts and averages listed in the baby books. The nurse, who has been working at the pediatrician’s office for more than 30 years, is cooing over the baby as she takes the measurements and documents them in the baby’s chart. Mom is curious about the growth information.

A little background

Mom is professionally employed in health care. Dad works for a large firm, so both are well-educated with diverse backgrounds and lots of resources for parenting help. They have read all the baby books and are trying to do everything in their powers to provide the best in life for their child.

Mom is overweight and has been all her adult life. Dad carries more weight than recommended, but is healthy overall. Aside from the weight, the couple has a strong relationship and have created a safe, secure, and balanced family.

Mom asks the nurse for the baby’s statistics for her record keeping and to see if the baby is progressing along the height and growth chart normally. On the growth chart, the baby is in the 75^th percentile for height and the 90^th percentile for weight, good indications of growth and development.

Mom is really concerned about the child being obese and wants to ensure doing all she can, as early as possible, to have a child with a healthy future. Mom shares her concerns about the baby’s development and desire for the child to not have a weight issue in childhood and onward. The nurse with 30 years of experience looks up at the new mom and quickly responds,

“You can’t plant sunflowers and expect roses to grow.”

Wow, right? The nurse laid it out plain and simple.

The take away

This family’s children are predisposed to the genetic factors (both the good and the not-so-good) from each parent. If both parents are overweight, there is a familial link that the children have a higher likelihood of being overweight.

The new mom heard exactly what she needed to hear. Mom smirked and understood that her expectations needed to be realistic and she could only control certain things in life, but she could have a positive influence over other aspects.

It might sound harsh when reading it in black and white, but mom understood what really mattered was not the indicators on paper about where the baby lined up against other babies. What mattered is that the baby was healthy, getting love, attention and nourishment.

You cannot predict, at 3-months of age, what a child’s weight will be at 9-years old. Plenty of factors, not only genetics, will contribute to how the child grows and develops over their lifetime.

Will the future of pharmacogenomics and personalized medicine have parents contemplating testing and interventions performed on a newborn as an insurance plan for preventing potential future illness and disease or even for cosmetic reasons?

Are we able to be patient and wait to see what will unfold naturally, or is specialized, personalized medicine—including some specialty pharmacy interventions—the “quick fix” that many demand, instead of considering alternatives that take longer to show results, but may be safer?

About the Author

Jill Schachte earned her BS in Pharmacy from Duquesne University and her Masters of Science in Pharmacy Business Administration (MSPBA) from the University of Pittsburgh. Jill has spent the past 20 years working in specialty pharmacy, starting as a clinical pharmacist at Stadtlanders Pharmacy and working in a variety of management roles in specialty pharmacy operations for CVS Health. Jill’s current role is on the CVS Specialty Professional Practice team, with a focus on accreditation and compliance for all the specialty pharmacy locations within CVS Health.