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FDA May Let Patients Buy More Drugs Without Prescriptions
Hugh Pickens writes "The Washington Times reports that the Food and Drug Administration may soon permit Americans to obtain some drugs used to treat conditions such as high blood pressure and diabetes without obtaining a prescription. They may allow patients to diagnose their ailments by answering questions online or at a pharmacy kiosk in order to buy current prescription-only drugs for conditions such as high cholesterol, certain infections, migraine headaches, asthma or allergies. Some pharmacists embrace the notion that they should be able to dole out medication for patients' chronic conditions without making them go through a doctor. 'This could eliminate the need for a physician visit for certain meds that may have been prescription prior to this change,' said Ronna Hauser, vice president of policy and regulatory affairs for the National Community Pharmacists Association. 'However, there may be circumstances when a patient might need a physician visit and diagnosis and original prescription to start therapy but could continue on that therapy with pharmacist refill authorization capabilities.'" (Read more, below.)
Hugh Pickens continues: "Medical providers at public hearings to obtain input on a new paradigm urge caution, saying the government should not try to cut health care costs by cutting out doctors. 'Patients rely on physicians to provide sound diagnosis and treatment information and to help them meet their unique health needs,' says Peter W. Carmel, President of the American Medical Association. 'Expanding many prescription medications to OTC interferes with that important relationship without offering any real benefits to improve patients' health or reduce their costs.'" Other countries seem to do fine with pharmacists being closer to the front line of medicine recommendations; why couldn't the U.S.?"
I'm pretty sure the American Medical Association (made up of doctors) is going to go apeshit over even the suggestion of this.
What political party do you join when you don't like Bible-thumpers *or* hippies?
I am hugely thrilled at this prospect. It would mean that I can have more respect for my doctor, rather than looking at her as a person with a magic signature. For the past several years I have been going to a "Minute Clinic" which is a nurse-operated room, in which the nurse takes my vitals, reads questions off a computer screen and enters the answers, and then gives me a prescription. There is definitely room for medical judgment there, but mostly that judgment is used to send you to a doctor if the computer tells the nurse to do so. There's no reason for me to need to see a person for many types of illnesses when a questionnaire can suffice - no reason other than institutional inertia.
My mom used to tell me about the old days when you asked the pharmacist for medicine - told them what your problem was and they would give you the cure. There's another profession rooted in the old ways for no good reason. The pharmacy takes pills out of one container, counts them, puts them into another container, and sticks a label on it and bills my insurance. Takes 15 minutes and requires a highly trained pharmacist for reasons I cannot fathom.
I have a hard time believing people go into primary care medicine (or pharmacy, for that matter) to see jerks like me, who just want a piece of paper that says I can have my pills. Seems like this could be a benefit for all.
... are re-classified as no longer needing to be prescribed, insurance companies stop covering the cost of such drugs. Lots of expensive drugs (for allergies, for gatrointestinal problems) once covered by insurance are now totally NOT covered. A big win for insurance companies.
Credo quia impossibilis -- Tertullian
A few of my acquaintances are pharmacists, and one of their biggest contributions to the overall health and care of patients is drug interaction and reconciliation. Basically, what this means is that they check that a patient's drugs do not interact with each other in a negative way. They also help patients reduce the number of dependencies on medication. When you start to automate this process, you will need to have a centralized system that handles all patients' drug information as you have now removed the role of various trained medical professionals. A patient will not know that his need for a prescriptive drug may adversely affect his health because he is already taking another drug. That's sort of why we have pharmacists and doctors.
Statins and albuterol are quite safe for most people, but letting the average guy decide to use them is pretty dangerous. To quote George Carlin: think of how stupid the average person is, then realize that half of them are stupider than that.
I think what makes a lot more sense is for long-term prescriptions - a kid with asthma is going to need an inhaler for years, and a kid allergic to bee stings or peanuts or something is going to need an Epi-Pen for the rest of his life. It makes a lot of sense to give a prescription for a year or two.
But on the other hand, the prescription is a good "timer" - my father has high cholesterol (even on a near-no cholesterol diet) so he's on Lipitor and will be for the foreseeable future. His prescription lasts almost exactly 3 months, at which time he goes to his cardiologist for bloodwork anyway. That makes sense to me - most of these conditions require some attention, and having the prescription run out is a good way to get it.
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