In a move that could help the government trim its burgeoning health care costs, 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.
The FDA says over-the-counter distribution would let patients get drugs for many common conditions without the time and expense of visiting a doctor, but medical providers call the change medically unsound and note that it also may mean that insurance no longer will pay for the drugs.
“The problem is medicine is just not that simple,” said Dr. Matthew Mintz, an internist at George Washington University Hospital. “You can’t just follow rules and weigh all the pros and cons. It needs to be individualized.”
Under the changes that the agency is considering, patients could 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.
By removing the prescription requirement from popular drugs, the Obama administration could ease financial pressures on the overburdened Medicare system by paying for fewer doctor visits and possibly opening the door to make seniors pay a larger share of the cost of their medications.
The change could have mixed results for non-Medicare patients. Although they may not have to visit a doctor as often, they could have to dish out more money for medications because most insurance companies don’t cover over-the-counter drugs.
“We would expect that out-of-pocket costs for insured individuals, including those covered by Medicare, would be increased for drugs that are switched from prescription to OTC status,” said Dr. Sandra Adamson Fryhofer, who testified last month on behalf of the American Medical Association in an FDA-held public hearing.
Pharmacists and doctors have lined up on opposite sides of the issue. Often trying to combat a public perception that downplays their medical training, pharmacists embrace the notion that they should be able to dole out medication for patients’ chronic conditions without making them go through a doctor.
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4 Responses
Probably not great from a public health perspective, but it would lower costs. Since people would have to pay for the drugs themselves, instead of through insurance, it would create competition and bring prices down. It does mean that people with good insurance coverage would have higher costs.
This is a very bad idea.
1) What will happen if the drug price does not come down? There are drugs for high blod pressure and diabetes that are not cheap. One drug to consider is Atrovastin for a bottle of 90 tabs could set a patient back $206-. Glipizide any where from $4.00-$50.00 for a bottle of 100. I could go on so as as you see OTC is not the way to go if insurance companies will not pay.
2)Also a consideration that if a patient for argument sake can’t afford the above meds and has neither medicaid/medicare where are they to get the money for he meds if no insurance coverage and are not eligible for the above mentioned gov’t programs?
So as one can see it is not as easy as one thinks.
The patients taking Atrovasatin (Lipitor) can switch to a cheaper statin. Right now the doctors generally don’t care about cost since insurance pays, and most people only pay co-pays. The drug companies have no need to lower prices unless faced by competition. You will see Atrovasatin falling price, since competition will be allowed shortly. Lipitor always had competition from less expensive drugs (Simvastatin/Zocor for example), but under the current system most doctors had no reason no to choose the most expensive drug (which was marketed to doctors).
And paying the real price means people will consider alternative treatments. Instead of Glipizide (an obsolete diabetes drug with serious side effects), people might feel more of an incentive to diet and exercise.
There might be a need for a Medicaid program for OTC drugs, but most of them are quite cheap to begin with.
In many countries one can buy contact lenses without an optician’s RX. That is one thing that is irksome and easy to change.