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Medicine Science

FDA May Let Patients Buy More Drugs Without Prescriptions 392

Posted by timothy
from the but-prescriptions-are-sacred-and-perfect dept.
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.?"
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FDA May Let Patients Buy More Drugs Without Prescriptions

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  • Fantastic (Score:4, Interesting)

    by Anonymous Coward on Tuesday May 08, 2012 @12:42PM (#39929585)

    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.

  • by MEK (71818) on Tuesday May 08, 2012 @12:43PM (#39929597)

    ... 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.

  • by swb (14022) on Tuesday May 08, 2012 @01:07PM (#39929967)

    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:Fantastic (Score:2, Interesting)

    by Anonymous Coward on Tuesday May 08, 2012 @01:29PM (#39930327)

    1 Medication interactions
    2 going through your list of problems and finding meds which do not make other things worse.
    3 people on slashdot may be able to look up and understand a great deal about medications and things but for Average Joe this would be bad. Most people cant even follow a typed out list of instructions after the physician visit I really don't think they are going to read the package insert on any medication (It should come with every drug you are prescribed)
    4 understanding what things really mean, every condition has a wide variance in how it presents and the effect on the patient, If I write COPD as a diagnosis (fairly common) that could look very different depending on where they are in the disease course and several other factors. What drug does the patient get?, Is it add driven?, should I put them on spiriva, proventil, symbicort, advair, daliresp, theophyline, prednisone, oxygen? do they need a nebulizer? The pattern of I have x thus I need y is not all there is to it, some drugs shorten your lifespan but the benefits of those drugs in some patients outweigh that risk, sadly these discussions are not had with patients by many physicians as the time is not there (10 minute visits, of which the nurse is rooming the patient for 4 minutes and it takes 2 minutes for them to walk from the lobby to the room.)
    Medicine is a hard business the hardest part of which can often be dealing with the social aspects of it, your doctor is overworked and probably does 2-4 hours of work after being done with clinic hours (likely more depending on call schedules and hospital work loads).

  • by afidel (530433) on Tuesday May 08, 2012 @01:46PM (#39930603)
    And Nurse Practitioners can even write (some) prescriptions. In my mind this is proposal only makes sense since we're already at an unbearable cost for medicine and yet if we continue doing things the way we're going costs will have to rise as we'll need more bodies to provide services for our aging population. In Germany (and I believe much of Europe) pharmacists can prescribe drugs for all sorts of common ailments, which is especially nice give the much more restricted office hours.
  • by roman_mir (125474) on Tuesday May 08, 2012 @04:59PM (#39933939) Homepage Journal

    If you want to end those long waits, lobby your congresscritter for Canadian or European style health care

    - well that's stupid. USA used to have a system that was much better than what its current system is but also it was much better than the systems found around the world, which are going to fail, by the way, because they are part of the reason the economies of the socialist nations are being destroyed. They are not the entire reason, of-course, the entire reason is everything that governments do, from social security to health care and education and all monopolies that they protect, including the banking industry.

    USA used to have cheap and affordable health care and insurance based on actual free market [slashdot.org], that was before the gov't decided to collude with the insurance, drug manufacturing and health care industries, which combined with the Federal reserve allowed to create more fake money, part of which could be sent to the politicians.

Stupidity, like virtue, is its own reward.

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