FDA May Let Patients Buy More Drugs Without Prescriptions 392
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.?"
Cue huge pushback from the AMA in 3...2... (Score:5, Insightful)
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... (Score:5, Insightful)
Doctors are busy enough they don't need to do things just "to make more money." We have a shortage of doctors in the USA, ever try to get an appointment with a specialist who doesn't have a several week wait?
Fact is these are serious chronic conditions that need some monitoring by doctors. This is backed up by the evidence. So please stop with the "docs are greedy" bull shit.
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Insightful)
dging by what I've seen at waiting rooms doctors have no shortage of work load
Yeah, and you can bet they want to KEEP it that way.
This cannot and will not work (Score:5, Insightful)
Re:Cue huge pushback from the AMA in 3...2... (Score:5, Insightful)
Reminds me of the contact lens industry.
1) Eye doctor determines your prescription
2) New appointment necessary with someone else for "contact lens fitting"
3) Order your contacts anywhere you like for 1 year
4) The doctors force you to pay for a new set of appointments, no matter how happy you are with your current prescription
This is obvious protectionism. I don't need a "fitting" every year. My contact lens size has never changed. I don't need a new prescription until I determine that I'm not seeing well enough anymore. I'll come in for a new apointment when my eyes are bothering me. Otherwise, leave me alone, dammit!
They're prescriptions for a reason (Score:5, Insightful)
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.
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Insightful)
From one of the articles:
Move would increase patients’ out-of-pocket costs
This is why its going to happen. Anything to make the middle class more miserable is always implemented. Doesn't matter if it makes sense or not. If it'll cost more and make people miserable, it's a go.
Isn't some of that stuff super expensive? I think one big problem is having to pay list price for blood pressure medication, you'll have future darwin award winners thinking... hmm doc says I need to take this $175/month OTC pill thats no longer covered by insurance for my blood pressure or I'll have a heart attack... but this advertisement says aspirin helps with heart attacks and a three month supply is like $3/month.
Certain infections makes me worry about massive over-non-prescription issues. I can see the "womens magazines" headlines already: Kids got sniffles? Here's the secret answers for the pharmacist so you can give your kid zithromax every time they get a virus...
It strikes me as about as unintelligent as removing preventative care like immunizations from coverage... in other words that guarantees we're going to be stuck with it.
Re:Generally, when prescription drugs.... (Score:5, Insightful)
Right, but the difference between becoming 100% over the counter and what is being suggested is that they are still prescription drugs, you are just prescribing them to yourself by answering a list of questions. Making it so a person like me who has been sucking on the same albuterol inhaler for 20 years doesn't have to go to the doctor every time it's time for a refill, which is usually every couple months. Or for a refill on the Advair dry inhaler which is EVERY month. For something that hasn't changed in years, I see no reason why the doctor still needs a cut. It would also make it easier for asthmatics who run out of meds during the weekend. Do you know how long it takes to get the doctor on call to return your call? It's faster to go to the ER which I have done for just that reason. Helping increase our healthcare costs. I am all for this.
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Insightful)
Exactly.
Sure, it is *theoretically* possible for doctors to provide more, but they generally don't.
I'm in Canada and I'm on thyroid medication. Every single year:
I go to the doctor
He orders the same blood test
I take it
The results come in. He uses a computer program to see the dosage required (I see the program) , and writes a prescription.
I could do this whole thing myself given that computer program and ability to prescribe myself. Well, a nurse could certainly do it and a pharmacist could certainly do it.
This is the case for most general practice. You simply don't need a family doctor for most things. A lesser health professional will do in most cases.
If there are complications, you will no doubt be referred to a specialist anyways.
I 100%, we need a new 'basic doctor'... or empower nurses or nurse practitioners more like they do in Washington State.
If engineers worked like doctors worked, you'd need a licensed professional engineer with a PhD to install a wireless router in your home.
Re:Cue huge pushback from the AMA in 3...2... (Score:5, Insightful)
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... (Score:5, Insightful)
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' [msn.com] 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.
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Insightful)
Enough with nanny laws. Let people do what they want to their own bodies. What's hard about that concept? I mean, unless you're talking about public health issues (like, say, antibiotic overuse), it's not really anyone else's business. Doctors should be doctors, not gatekeepers.
And as for "misdiagnosis", the more people you remove from the equation, the less people there are to sue. Eventually it comes down to just you and the store you bought it from - and what are you going to do, sue them for selling you something that's perfectly legal to sell because you used it stupidly? Think you'd have much success suing Home Depot for selling you the saw that you used to accidentally cut off your finger because you used it wrong?