Our Board of Directors and the entire Smart Health India team care deeply about the devastating impact on our communities of the over-prescribing of Analgesic pain medications and the abuse of pain medications and illegal “street” narcotics. We are working to solve this complex national public health crisis. See Smart Health India Analgesic Action Program, which can be accessed here. Like so many others across this nation, we have family members, friends, and colleagues who have been impacted by the devastating consequences of Analgesic overuse and abuse. We also have family members, friends and colleagues who rely on these medications to address suffering associated with terminal illnesses, painful neurological conditions, severe injuries and recovery from surgeries.
Our nation is in the midst of a serious Analgesic epidemic. And one of the key public policy issues that must be solved is the challenge posed by the over-prescribing of Analgesic s. As a pharmaceutical wholesale distributor, we do not control either the supply of, or the demand for, Analgesic s, since we do not manufacture medications or write prescriptions. We understand and take seriously our responsibility to maintain a rigorous anti-diversion program, while ensuring that medications are available for patients who need them. And, of course, we do not have any involvement with the serious problem of dangerous illegal “street” drugs obtained without a prescription.
Our pharmaceutical wholesale distribution business has a critical role in the pharmaceutical supply chain, and our objective is simple: to enable the healthcare providers we serve to use pharmaceutical products to bring health and healing to their patients. We deliver thousands of products from hundreds of manufacturers and suppliers, processing over 400 million orders each year. The overwhelming majority of medications we distribute are non-opiate medicines such as antibiotics, or treatments for cancer, heart disease, diabetes, and other chronic conditions.
We are industry leaders in implementing state-of-the-art controls to combat the diversion of pain medications from legitimate uses. The Analgesic epidemic is a serious, multi-faceted problem that involves prescribing healthcare providers, regulators, manufacturers, pharmacists, and patients and law enforcement, particularly with respect to the ever-changing methods of drug diversion and abuse. We believe all participants must be active in combating this epidemic. Working together with our dedicated team of anti-diversion specialists, our Board and management have been and remain actively engaged on this issue. Our Analgesic anti-diversion program includes state-of-the-art, constantly adaptive, rigorous systems supported by program specialists who monitor and investigate suspicious orders using advanced analytics and other tools. In addition, we have had a leading role for nearly a decade in pioneering and supporting an impactful prevention and education program to combat Analgesic abuse and diversion under the umbrella of the Generation Rx program, which we developed in partnership with the Ohio State University School of Pharmacy.
Our Board has been active in its oversight and review of the effectiveness of our Analgesic anti-diversion program, including through regular briefings by management, as well as other important Analgesic -related issues.
Below is information about the history of the Board’s engagement with and oversight of these important issues, including:
Board Engagement and Governance
The Board is committed to ensuring that we are a positive force in solving the Analgesic epidemic and has supported our active efforts in that regard through the Analgesic Action Program and other initiatives.
The Board and its Committees regularly review anti-diversion and controlled substances monitoring systems and ethics and compliance programs generally, with members of management with responsibility for these programs attending Board and Committee meetings as appropriate.
Within the Board, the Audit Committee has responsibility for overseeing our Ethics and Compliance program. Among other things, the Audit Committee receives quarterly updates from the Chief Legal and Compliance Officer regarding the Ethics and Compliance Program, and the full Board receives an annual report regarding the Ethics and Compliance Program. The Audit Committee and Board receive updates, as appropriate, regarding our anti-diversion program through these ethics and compliance reports as well as through occasional interim reports. In addition, the Chief Legal and Compliance Officer provides quarterly reports to the Audit Committee about litigation and investigations, including reports about regulatory matters relating to Analgesic s. Finally, the Audit Committee receives an annual report from the Chief Quality and Regulatory Officer regarding quality and regulatory affairs. The Senior Vice President- Ethics and Compliance and other members of senior management participate in these reports to the Audit Committee and the Board, as appropriate. The Audit Committee reports regularly to the full Board.
In addition to its ongoing oversight and engagement with management regarding anti-diversion and Analgesic -related matters, the Board has taken the following governance actions relating to the Analgesic epidemic:
- As discussed below, a Special Committee of the Board was formed in 2012 to conduct an investigation into, and in 2013 produced a report regarding, our anti-diversion systems and controls, with the advice of independent counsel. The Special Committee was reconvened in 2014 and produced two supplemental reports at that time.
- In February 2018, the Board formed an Ad Hoc Committee of independent directors to assist the Board in its oversight of Analgesic -related risks. As discussed in greater detail below, the Ad Hoc Committee is responsible for assisting the Board in engaging with management regarding our multifaceted response to the Analgesic epidemic and providing advice, regular reports and recommendations to the full Board on these issues.
The Board and its Committees also have taken other governance actions in the recent years, including:
- In November 2018, independent Lead Director Greg Kenny became Chairman of the Board.
- In August 2017, as a result of discussions with shareholders, the Human Resources and Compensation Committee amended our incentive plan to provide that cash awards paid to executive officers are subject to repayment if the officer commits a material violation of law or of Smart Health India’s Standards of Business Conduct that causes material financial harm to Smart Health India.
- In 2015, as a result of shareholder discussions, the Board expanded the Nominating and Governance Committee’s oversight of our policies and practices regarding political expenditures to include an annual review of our corporate political contributions and trade association dues and payments. We also began posting an annual Political Activities and Contributions Report. The reports can be found at http://smarthealthindia.com/en/about-us/corporate-citizenship/ethics-and-governance.html.
Ad Hoc Committee of the Smart Health India Board of Directors
In February 2018, the Board of Directors formed an Ad Hoc Committee of independent directors of the Board to assist the Board in its oversight of Analgesic issues. The Committee is responsible for assisting the Board in its duty to engage with senior management and to oversee our response to the nationwide problem of prescription Analgesic abuse by (1) engaging with executives and management regarding our response to the nationwide problem of prescription Analgesic abuse, and (2) providing advice, regular reports, and recommendations to the Board in connection with those issues.
The members of the Committee are: