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.
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Possibly, but judging by what I've seen at waiting rooms doctors have no shortage of work load. I think they may be inclined to let this one slide.
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.
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.
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Measuring vitals and dispensing medication ARE routinely performed by nurses (though, IIRC, only a Registered Nurse can dispense meds, a Licensed Practical Nurse can't).
Re:Cue huge pushback from the AMA in 3...2... (Score:5, Interesting)
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Funny)
I wonder how many Pharmacists in other countries get sued for misdiagnosing or prescribing drugs...
They are trying to cope with a lawyer shortage.
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?
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My doc already does this, except for the 'minor' surgical procedures. In fact, a tech takes my vitals, confirms symptoms, and even draws for tests.
My doc still hands me meds when he has them, though.
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I would.
Just as I'd rather have a technician solder a CPU onto my board, rather than an engineer. The tech has more experience. - Likewise the nurses would be more-experienced than doctors to remove tonsils if they did it day-after-day-after-day.
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:5, Interesting)
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.
Re:Cue huge pushback from the AMA in 3...2... (Score:5, Informative)
Christ, man, how can you know they're illegal? Or even aliens?
Well, the American College of Emergency Physicians seems to think so:
In some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens. As a result, hundreds of emergency departments have closed. In Los Angeles, for example, 10 hospitals have closed in the past five years because of uncompensated care.
http://www.acep.org/content.aspx?id=25206 [acep.org]
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:5, Interesting)
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.
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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.
https://en.wikipedia.org/wiki/Nurse_practitioner
Nurse Practitioners (Score:2)
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.
Self monitoring is the present solution (Score:2)
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.
As patients we should be able to monitor ourselves, we should be able to do research into our conditions ourselves. We need doctors for sophisticated treatments, expensive diagnostic exams, and specific information about our conditions. We don't need doctors appointments for asthma if we know what medication we are on and have had a prescription in the past. We don't need mandatory appointments for GERD if acid reflux medication is OTC and we can afford it. We don't need doctors appointments for blood gluco
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Thanks for raising all our insurance rates. Nothing like unnecessary testing.
Retesting. (Score:2)
And then you have the other side of the coin, where not enough testing is done, and retesting must be ordered. Often, this means redoing previous tests to give relevant context to the new tests. It would be cheapest to order the right amount of tests the first time.
All this talk about unnecessary testing, while important, has some doctors a bit gun-shy. This too, is bad, and leads to more expensive care.
(I'm not knocking your comment. You're right. You just brought up the context, and I'm playing off
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In some places, patients can. I haven't been able to nail it down, but some law changed somewhere, and labs are no longer willing to permit walk in patients. Maybe this is just a California thing. Don't know. (Our laws are notoriously messed up.)
You should be able to walk into a lab and receive a test, any test, just as long as you pay for it. To deny patients this ability is to deliberately increase both risk and cost.
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You should be able to walk into a lab and receive a test, any test, just as long as you pay for it. To deny patients this ability is to deliberately increase both risk and cost.
What should be and what is are very different things. I was getting a blood test in a lab, and realized I didn't know my blood type. So I walked up to the counter, plunked down my credit card, and said I wanted my blood type tested. Sorry, no can do, you need a prescription.
I think it's obscene to have to ask permission from duly deputized government agents to get a blood test. But that's the way it is. I've seen all sorts of comments, but none addressing the fundamental question - why do I have to ask perm
Re:Cue huge pushback from the AMA in 3...2... (Score:4, Informative)
You do realize that long-term usage of high blood pressure medicines, especially at a young age like I started them at (22), can cause kidney damage and the blood tests are meant to find those issues before they become a huge problem.
So, it's not unnecessary testing. It's just that the doctors are too lazy/cheap to order it. Why not force them to make certain any potential problems are mitigated before they become LARGE issues?
You should thank me for enforcing preventative care instead of waiting for a kidney transplant.
Let people test themselves. (Score:2)
Thanks for raising all our insurance rates. Nothing like unnecessary testing.
If Insurance rates are too high then let people test themselves with their own money. A blood test only costs 60 bucks and a comprehensive test is maybe 200 bucks max. You should be able to walk into CVS or Walgreens and buy a blood test on the spot and have your blood analyzed at a lab. You shouldn't have to ask your doctor for a blood test.
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Fact is these are serious chronic conditions that need some monitoring by doctors.
Yeah, but how much? That's the big question. For simple things like hypertension that's easily controlled with a medication or two, a script could handle it - input age, sex, weight, allergies, co morbid conditions and a couple of other things and out pops some pills. The next problem is getting the patient to take them and seeing if they work.
Carefully checking the efficacy of a blood pressure medication is probably something that needs a human, a physical exam of some limited sort and some lab work (at
Generally, when prescription drugs.... (Score:5, Interesting)
... 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.
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>insurance companies stop covering the cost of such drugs
He speaks the truth. This is a very smelly change. It benefits only the drug companies and the insurance companies. The doctors get cut out of the loop and the patients (who might be unaware that statins don't [blogspot.com] work [blogspot.com]) will carry on buying them because they don't have to visit one of the few enlightened doctors that understands this.
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Depends on the drugs you require...
For me, without insurance, 1 drug is $10 per quarter( $40 for the year), the other is $900 per quarter($2,700 for the year) total outlay $2,740 .. with my insurance I pay an extra $120 a year for drug coverage so with my insurance I pay $10 per quarter for 1 and I pay $600 for a full years supply of the other for a total outlay of $760 for the same drugs ..
To get the drug coverage, I simply see my primary doctor 1 time (covered 100% by the insurance) and get 2 prescript
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Generally, when prescription drugs are re-classified as no longer needing to be prescribed,
Some of the most common drugs never needed to be prescribed.
The system is setup so that while a drug is under patent, it's also under prescription.
Then the pharmaceutical companies soak the insurance companies for big payouts.
Once the patent runs out, the generics show up, the drug is taken off the prescription list,
and the pharmaceutical company replaces it with a slightly tweaked version that is under patent protection.
Rinse, repeat, buy last year's blockbuster drug (at prescription strength!) over the co
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.
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+1 informative
BTW someone talked about prescription drugs being patented (and therefore overpriced). You can always ask your doctor for over-the-counter versions, if you don't want the prescription version. It's a business transaction & just like any business transaction you negotiate the deal. You don't have to just blindly accept what the salesman (doctor) is handing you.
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BTW someone talked about prescription drugs being patented (and therefore overpriced). You can always ask your doctor for over-the-counter versions, if you don't want the prescription version. It's a business transaction & just like any business transaction you negotiate the deal. You don't have to just blindly accept what the salesman (doctor) is handing you.
Some of the doctors I've been to recently have made a point of acting like this was not the case (when I agree it clearly is). As in:
"I can prescribe you this version or I can prescribe you this other version, which includes something a little extra. I think either one will help your problem. It's up to you."
"Well... how do I decide? What's the cost difference between the two?"
"I don't know."
I think to some extent they're not bullshitting me, because that's a complex question. It's largely the insurance com
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I'm told that this is maddening for a certain subset of people who experience different effects from the different versions; but it makes it substantially easier to do price-comparison at the point of sale, with somebody who can tap the insurance details into their system and actually q
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It's more complex even than you have stated. The cost is going to depend upon which drugstore you go to, what your insurance company has negotiated with that drugstore (considered a trade secret BTW).
It's a nightmare.
And anyone who claims that Americans are not cost conscious when it comes to medical expenses is being willfully obtuse. They system is designed to make it impossible to comparison shop. You have a procedure done and you don't even know how many different entities are going to send you a bil
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On the other hand, price for drugs drop when demand increases and I'm sure it would increase if people can just buy heart or bloodpressure meds OTC from the pharmacist. You won't need insurance..... you can just pay cash directly. Like I do. Like my parents do.
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i dont think that normal basic econ applies to big pharma. The manufacturing facilities are VERY expensive to license or re-tool, so the production level is not easily or quickly adjusted to demand. This moves things in the opposite direction than you would expect. Also, they have no reason ( especially if patented ) to reduce price for any reason. Look at the prices of the same drugs in the US and Canada. The difference in cost isnt only based on the Canadian government kicking money into the pool, a lot o
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!
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Yes, and contacts are just like treatment for hypertension and diabetes... you have no idea what you're talking about.
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Yes, because the entire reason your prescription can change year to year has absolutely nothing to do with the fact that the shape of your eye lens is constantly changing.
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Change eye doctors. Never even heard of anything like that. Where are you?
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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.
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Having people pay for medications out of pocket might actually be a big positive on the overall cost of medical care in this country. Right now doctors often prescribe expensive on-patent drugs that have little or no benefit over off-patent cheap drugs because of pressure and marketing from pharmaceutical companies.
One example of this is a new family of drugs (DPP-4 inhibitors) one of which is sitagliptin. It regulates production of insulin in type II diabetic patients very well. It costs $250 a month and i
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I asked a med student friend of mine (in canada) at one point about this sort of thing years ago. Apparently some places have 'bulletins' that go around regularly about all the common diseases this week/month and what's going on, and from that they know what 90% of case load is going to be for some doctors (the front line ones generally at walk in clinics that sort of thing).
If you show up with the common ailment of the month, or if there's really no different options for treatment for disease A and diseas
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I'm pretty sure the American Medical Association (made up of doctors) is going to go apeshit over even the suggestion of this.
Made up of lobbyists more like. http://politicalcorrection.org/factcheck/200906110008 [politicalcorrection.org]
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Fuck 'em. The vast majority of minor problems and many major ones could be addressed by a "checklist/flowchart" system.
Physicians only have a few minutes to go through their PERSONAL checklist/flowchart, and they often know less about the problem than the patient.
My wife had Lyme and Rocky Mountain Spotted Fever, courtesy of the tick invasion of the South that so many LOCAL physicians don't even think to consider. She had to download and present info to (multiple) docs until they sent her for testing which
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I'm pretty sure the American Medical Association (made up of doctors) is going to go apeshit over even the suggestion of this.
Yup. A few months ago I was listening to NPR, and there was a spokeswoman from the AMA arguing that it should be illegal for people to sequence their DNA, because only a doctor is qualified to interpret the data. She didn't want to outlaw a treatment or drug, but mere knowledge about your own body.
The AMA would outlaw oral thermometers if they thought they could get away with it.
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Fantastic (Score:4, Interesting)
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.
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Because the pharmacist is the one that's likely to see that the doc-in-a-box prescribed indomethacin to deal with that gout attack you're having, but that you're already on an ACE inhibitor for your high blood pressure and thus at risk for getting dangerously high potassium levels from the combin
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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
Praise the FDA! I am FREE to PEE!! (Score:3)
This cannot and will not work (Score:5, Insightful)
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Can't you replace all of that with a very small shell script?
I mean dpkg and its conflict detection code wasn't even all that cutting edge back in '93, I'm not seeing it as being a big challenge now. I guess what I'm asking is when was the first line of error detection code written that had an "and" clause and output an error message? The 50s I'd think?
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The problem is getting all that information in one place, not really the basics of sorting out interactions. It'd need to be a large, centralized database (at least covering the entire country) and would need to, if this sort of change happened, also track a decent chunk of non-prescription medication somehow.
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"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."
Beats not being able to afford care. I'll take the trade.
Up next, education (Score:2)
Just Wait for the Catch (Score:3)
TFA mentions the impact on Medicare for prescription drug costs, but it doesn't discuss the impact for non-seniors. My prescription drug plan doesn't cover over-the-counter medication. As of last year my flex pay plan won't let me buy over-the-counter medication with pre-tax dollars. Together, both of those mean that moving all these drugs to non-prescription will make them significantly more expensive to me and all the millions of other people who pay for them now through their insurance.
Now, of course, you might think that insurance providers would be happy to fund these drugs even while over-the-counter, since it's far cheaper to subsidize (for example) blood pressure or cholesterol-lowering medication for life than cover one emergency trip to the hospital and bypass surgery, but I really don't think most insurance providers think that way.
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OTOH, its even cheaper to not cover the blood pressure medication and have you pay for it OTC and still take it and get the benefits.
Its also cheaper f
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Its also cheaper for the insurance company not to cover the blood pressure medication, have you not buy it OTC, and have you die from a heart attack before you are able to get (and rack up a bill for) medical attention that they would have to pay for.
Yeah. Because nobody ever has a heart attack, gets rushed by ambulance to the emergency room, gets put on oxygen and in-home hospice care, and dies a month later. Good cost/benefit analysis there.
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TFA mentions the impact on Medicare for prescription drug costs, but it doesn't discuss the impact for non-seniors. My prescription drug plan doesn't cover over-the-counter medication. As of last year my flex pay plan won't let me buy over-the-counter medication with pre-tax dollars. Together, both of those mean that moving all these drugs to non-prescription will make them significantly more expensive to me and all the millions of other people who pay for them now through their insurance.
This is just my suspicion, but I suspect the pharma companies would be against it for this reason. Since they can fleece the insurance companies with the higher profit margins while protecting demand, the overall profit rises. Insurance companies will probably support it saying that such measures will help lower medical costs, mostly to them by allowing them to drop the drugs from their coverage.
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What's your copay for a doctor visit? I think for me it might be $30. Are the prescription drugs still cheaper?
Who came up with the idea? (Score:2)
I'm sure some pharmaceutical organisations helped the FDA a little bit in coming up with this idea...
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Unlikely. This move will lower the demand and/or price of the product leading to less profits. It's more likely support for this is coming from within the insurance realm.
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.
Prescription through marketing (Score:4, Funny)
"Ask your Rx Kiosk Today about Effluvium DX."
"Effluvium. For Whatever You Have."
Patients taking Effluvium have reported Dry Mouth, Disorientation, and Spontaneous Testicular Detonation. Effluvium should not be taken before operating heavy machinery, using social media, driving or eating. Read and sign the Effluvium arbitration agreement and release from liability before taking Effluvium DX.
Re:Prescription through marketing (Score:4, Funny)
In double-blind trials, differences in the rates of testicular detonation were statistically insignifcant between the male and female trial groups.
Hypochondriacs UNITE! (Score:2)
Lisinopril (Score:3)
Lisinopril. It's one of the most common prescription medications on earth, and is so inexpensive that it's easily affordable without insurance. Yet doctors hold your refills hostage to expensive monthly office visits, which consist in their entirety of a nurse practitioner taking your weight and blood pressure, measurements anyone with high blood pressure already takes at home. This nonsense must stop.
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some patients end up with hyperkalemia with lisinopril (this can be fatal is severe enough), if you are on lisinopril you should be having a lab draw once a year (probably a bmp or at least a K and Cr. )
http://www.drugs.com/drug-interactions/lisinopril.html [drugs.com]
well just read it for yourself
I have no problem with a lab drawing once a year. I do have a problem with paying a benjamin a month for a completely unnecessary office visit just so the doctor will push the button allowing my next refill. It's a little too similar to the business model used by crack dealers.
Misses the point (Score:2)
The point of prescription drugs is to prevent unauthorised purchase. This system can be easily tricked.
Win for doctors, insurance, and drug companies (Score:3)
The reason it's a win for doctors is that in our "fee for service" system they don't make much on a simple office visit, especially if they have to take the time to write a prescription. There's also ongoing overhead for prescriptions - whenever you run out of refills the pharmacy has to reauth, which takes up staff time. (This last is why the office where my son works has additional staff on hand on fridays, which is the day that everyone does their refills.) It may also reduce liability, although exactly how that will play out is harder to predict.
It's an obvious win for insurance because most OTC stuff isn't covered. And likewise for drug companies, who will sell more product, a lot of it to people who don't really need it.
The big losers will be patients. Sure, some people will have easier access to the meds they need. But costs will overall be higher, and some of the meds they are talking about aren't all that safe. Statins, for example, may be great at treating high cholesterol, but over time they can cause liver damage. Most of the antihypertensives are reasonably safe when taken at the correct dose, but take a bit too much and things like positional vertigo can occur. And as others have pointed out, the inability to track OTC meds can result in serious drug interactions or overdoses. Indeed, this is already a serious problem with acetaminenophen - so many different products contain it that it's easy to get an overdose, and boom goes your liver.
What about prescription eyewear? (Score:3)
I still cannot fathom why I have to have a prescription to order new eyeglasses or contact lenses. Yes, you should get your eyes checked out regularly, but a 2-year old prescription is still way better than no glasses at all!
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you dont.
Got all the info? go online to zenni optical and buy your own.
The problem is most people dont have all the tools to figure out their info to order the lenses.
Good. Avoid the "doctor must provide" scam. (Score:2)
Seriously. If I want an extra strong foot cream, I have to take the time off work, go the physician, pay the physician, and then pay for the foot cream. Tell me again how this isn't a racket?
How about access to others as well? (Score:2)
I do know that having antibiotics in a field emergency kit is important. IF you are 3 days from civilization and impale yourself on something you really need to start taking an antibiotic to avoid infection. This would go a log way to making it easier to build a full civilian first aid field kit than having to do it "illegally" by scavenging unused pills for the kit.
I know that the majority of civilians are too stupid to self medicate with things like that, but anyone with advanced field first aid traini
Lipitor (Score:2)
What about birth control? (Score:3)
What about birth control? If 90% of women are using it, why can't we just get it over the counter without having to pay for a doctor's visit first?
How will it work with insurance? (Score:2)
How will this work with insurance, or is that point? Once these are available without prescription, insurance plans don't need to pay for them and the patient pays 100% of the cost?
Not Good! (Score:2)
Comment removed (Score:3)
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Since insurance (both private and government programs like Medicaid) tends to cover prescription drugs but not OTC drugs, making existing drugs OTC rather than prescription, while it may drop the retail price, often makes them less accessible to poor people.
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Then you get into the big-dog medications like Advair and the co-pays can be in excess of $100. (Mine is) but to get thi
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for corporate drug pushers (aka "drug companies") and their shareholders.
Its the other way around. Now instead of getting insurance to pay $500/month or whatever for prescription blood pressure pills, you'll have to try to get $500/month from the end user directly... good luck with that.
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Try being diabetic. What a dick-dance to get basic survival supplies which are RATIONED to maintain a REVENUE stream...
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"Every doctor I've ever had is extremely dismissive of any condition and very impatient to get the appointment over with. My experience with doctors has primarily been that they are roadblocks to efficient medical care. I can't count the number of times I have had to educate a doctor about my wife's Type I diabetes and insulin, or the number of times that I have received diagnoses that were completely out of line with symptoms."
You and a considerable army of other people. My wife knows more about managing h
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" I know plenty of people that go to the doctor every time they have a scratchy throat to bitch and moan until they get azithromycin."
and the doc is not giving it to them. he is giving them a remarked placebo. Most doctors are doing this to whiny patients.
There is a pill that looks just like it and is even labelled the same except the pharmacist bulk bottle has a PL on it and is stored by all the other placebos.
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Oral contraceptives still remain RX only. Glad theology trumps science, no matter which party is in office.
Actually, I think there's a good health safety argument for making any hormone-based medication a prescription. I don't think this is an example of the Roman Catholic Church exerting its influence over US public policy (though there certainly appear to be valid related examples in the area of women's health).
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There are some things that are obvious, e.g. conjunctivitis.
Only conjunctivitis isn't that obvious, because viruses are actually the most common cause, and it could also be caused by allergies, fungal infections, or whatever else.
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If an adult wants to inject used motor oil into their veins, more power to them. But if someone tries to sell used motor oil as "Magic Tree Oil" that will cure cancer, then it time for someone to force them to offer proof.