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.?"

Comments

Cue huge pushback from the AMA in 3...2...

[crazyjj]

I'm pretty sure the American Medical Association (made up of doctors) is going to go apeshit over even the suggestion of this.

Re:Cue huge pushback from the AMA in 3...2...

[swb]

As someone who had high blood pressure and triglycerides and was put on medications for both, I will tell you that the kind of monitoring the doctor did was minimal and could easily be replaced.

My "monitoring" was a couple of lipid panels run by the lab in his office, which could easily be outsourced to any place with lab techs who can draw blood. The rest of the monitoring was me taking my own damn blood pressure and charting the results in Excel.

The doctor's value was near zero as far as I can tell, and less than zero if you add in the work I did changing my diet and losing a bunch of weight (all of which I did in spite of his advice), which lowered my blood pressure and totally altered my lipid profile.

IMHO, what's needed is a new, "basic doctor" type degree that has the power to prescribe most meds and monitor most medical conditions but doesn't 8-10 years of education and training costing the GDP of a small country.

We have a doctor "shortage" because it costs $250k to become a doctor, the people who actually get the degree specialize where the easy money is (high level of non-insurance reimbursed business which is paid in cash, up front, no on call hours, etc, like dermatology) and nobody wants to practice in high-voume, low-margin areas like being a GP.

Re:Cue huge pushback from the AMA in 3...2...

[curunir]

And it's precisely because doctors are too busy that something like this makes sense. It's been the case for a number of years that doctors have been less able to keep up-to-date with the latest information on prescription drugs. Between the rate of release, marketing from the pharmaceutical companies and the various medical studies, it's ton of information to process. Doctors either choose to concentrate on a very limited subset of available drugs or they fall woefully behind. Pharmacists are, in my experience, much more able to keep up, since they only have to care about the medication side of the equation.

For what it's worth, I'm not talking about experience as a patient. In a previous job, I worked for a PBM (prescription benefits management) company and was in charge of integrating a third-part drug database into one of their web products. I attended conferences with doctors and pharmacists and both seemed to echo the sentiment that keeping abreast of both medical developments and new drug therapies was almost impossible. The conclusion that I reached was that it makes sense to decouple the diagnosis from the prescription process. Doctors should be free to recommend or prescribe specific medications, but they should prefer to simply supply a diagnosis and allow the pharmacist to prescribe the proper medication given a patients allergies, other medications and insurance.

This seems like a sensible step towards that.

Re:Cue huge pushback from the AMA in 3...2...

[mcgrew]

the massive workload in the ER comes from illegal aliens who use the ER for every little sniffle they get, and people who look like drug addicts looking for a fix.

Christ, man, how can you know they're illegal? Or even aliens? You do realise that 16% of American citizens are Hispanic, don't you? And if you live in a border state there's going to be an even higher percentage?

Those "people who look like drug addicts looking for a fix" are called "poor people". Both they and the Hispanics you seem to hate are at the ER because that's the only way the working poor can get health care in the US!

One in four Americans' only health care is the ER. If you want to end those long waits, lobby your congresscritter for Canadian or European style health care (NOT Obamacare) so those "illegal aliens" and "homeless junkies" don't have to "use the ER for every little sniffle they get".

PS: You're a God damned racist and classist bastard and I hope you learn what poverty feels like.

Generally, when prescription drugs....

[MEK]

... 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.