FDA may let patients buy drugs without prescriptions

[flintlock]

Posting just for giggles.

http://www.washingtontimes.com/news/2012/apr/29/fda-may-let-patients-buy-drugs-without-prescriptio/?page=all#pagebreak

[charliebrown]

Re: FDA may let patients buy drugs without prescriptions

Amen, I have a maintenane med I take. Every year it cost me a doctor's visit and time off of work to here the doctor say ...
Do you still have condition XXX? I say yes, then he writes a script. Then it has to flow through the insurance, and I'm sure they get there cut.
Hopefully besides saving the doctor's visit, my insurance premiums might tick down two, because they do not have to pay for these maintenance meds,
and the maybe the costs of the med's might come down too given that some patients would shop around if they have to pay the full freight instead of
a $20 co-pay.

[srivatsan]

Re: FDA may let patients buy drugs without prescriptions

Amen, I have a maintenane med I take. Every year it cost me a doctor's visit and time off of work to here the doctor say ...
Do you still have condition XXX? I say yes, then he writes a script. Then it has to flow through the insurance, and I'm sure they get there cut.
Hopefully besides saving the doctor's visit, my insurance premiums might tick down two, because they do not have to pay for these maintenance meds,
and the maybe the costs of the med's might come down too given that some patients would shop around if they have to pay the full freight instead of
a $20 co-pay.

Same experiences with me too... However Allegra did became OTC now and therefore, one less hassle. But flonase still I believe is prescription.

Recently, I had to do cash-only treatment for my wife's dental problem as insurance was not a good option at all. It [Cash-only] worked out cheaper, diagnosis was more clear, money was a factor but so was right decision. I really wish [or curse] medical/insurance and grad school fee bubbles somehow die very fast and very soon so that more commoners can get real deal.

[LorenS]

Re: FDA may let patients buy drugs without prescriptions

Any chance that my dog's heartworm or arthritis medicine will go Rx free?

This vet stuff is just as bad.

[flintlock]

Re: FDA may let patients buy drugs without prescriptions

I have mixed feelings. I can see room for abuse, but then people need the freedom to screw up every now and then. Even an OTC like Tylenol can wreck your liver. But if people are not required at some point to have some responsibility, I think they completely lose the ability to think for themselves. People today tend to shut off their brains completely when it comes to medicine and just turn over their health to people who don't always have their best interest in mind.

It doesn't mean you can't still ask the doctor for dosing advice. We could certainly save billions in time and money by cutting out all the hands in the pie so to speak. Economic friction I call it. I'm afraid at some point medicine will get so expensive that people will die from the complete lack of it a lot more than from prescription mistakes. There are always trade offs. Safety/ cost/ convenience. We could always be made safer. We could be required to live in germ free bubbles and wear foam padded clothes. Its not like people aren't already killing themselves with RX mistakes. But then I'm afraid people have become so used to the nanny state mentality already, that anything they can buy without a RX is treated like candy.

[dbarberic]

Re: FDA may let patients buy drugs without prescriptions

Considering that the practice of modern western medicine has become nothing more than a series of if/then questions always resulting in a prescription, why even bother with the middleman (the doctor).

Pharmaceutical companies already market directly to the consumer, let the consumer self diagnose and decide their own drugs to take.

Big pharma can even create little tests (like the love quizzes in Cosmo) that will tell you what drugs are best for you to take.

[lakedaemonian]

Re: FDA may let patients buy drugs without prescriptions

Considering that the practice of modern western medicine has become nothing more than a series of if/then questions always resulting in a prescription, why even bother with the middleman (the doctor).

Pharmaceutical companies already market directly to the consumer, let the consumer self diagnose and decide their own drugs to take.

Big pharma can even create little tests (like the love quizzes in Cosmo) that will tell you what drugs are best for you to take.

Same as Flintlock I have mixed feelings as well......particularly with how Big Pharm can market direct to folks in the US.....people will do what they are told by their television.

We're fortunate to not have(yet) direct Big Pharm marketing to the masses down here yet(unless it's so subtle I can't see it..eek).

On a recent trip to Cambodia I visited a local Pharmacy....the prescription med supplies of our group were fast depleting so we did a recce to find some more.

I was able to order whatever I wanted without a script(and without ID or professional qualification), including virtually unlimited amounts of opioids If I so chose...all the pharmaceuticals purchased appeared to be western Big Pharm manufactured/packaged...and they were quite cheap in US dollars.

Even with a decent knowledge(enough to be dangerous to self and others) of pharmacology I found the prospect a bit frightening......the US Docs I was with found it pretty dodgy too(they were not asked for ID/quals either), but their country their rules.

A whole lotta personal responsibility there.......which I don't mind for me...but I also try to avoid prescription meds unless absolutely necessary.

But beyond the immediate and superficial and personal responsibility issues and debates about making prescription drugs, non prescription there's a fairly serious issue to consider:

Drug resistant bacteria and over prescription/misuse of antibiotics


Cipro is no longer an antibiotic "magic bullet"

Cipro is classified as a 2nd generation broad spectrum quinolone antibiotic.

3rd and 4th gen quinolones haven't had nearly the success of Cipro, in fact a bunch of them have been pulled.

And as I understand it, there's very little in the current pipeline.

We could be looking at a quite serious issue regarding drug resistant bacteria with a decreasingly effective weapon to fight it.

If anything, when it comes to some antibiotics, I'd be leaning towards tighter, rather than looser, prescription control measures.

A realistic scenario could see drug resistant bacteria significantly increase at a time when our arsenal to defeat it weakens with nothing promising in the pipeline.

That would be a challenging public health decade+.

Just my interested amateur student 0.02c

[rogermexico]

Re: FDA may let patients buy drugs without prescriptions

MD with 25 years experience speaking.

Long overdue. American MDs are handing out dangerous stuff like ridiculously overprescribed flouroquinolones for viral sinus infections and statins for women who've never had a heart attack anyway. So it's not that I think the public and pharmacists will never come to harm, it's just that american docs aren't doing anything to prevent harm in their prescribing patterns anyway.

But I do think pharmacists alone could handle most prescriptions without any MD or nurse practitioner collecting money along the way.

Say, that's another point. More than half of primary care visits in my area are to "nurse practitioners" or PAs whose corporate paymasters are charging just as much as for real doctor advice anyway.

I don't see why mexico should be freer than the USA, really.

[rogermexico]

Re: FDA may let patients buy drugs without prescriptions

I also try to avoid prescription meds unless absolutely necessary.

Pass a law forbidding insurance companies to cover routine outpatient drugs, repeal medicare drug coverage and three things would happen:

1) Most drugs you need as an outpatient would be as cheap as in vietnam or mexico

2) No one will take antibiotics unless they REALLY NEED THEM.

3) The whole country would get healthier very fast.

I'm a doc and I buy all my own meds from CANADA. Omnaris nasal spray $120 in the states and only $39 in the great white north.....

[lakedaemonian]

Re: FDA may let patients buy drugs without prescriptions

Pass a law forbidding insurance companies to cover routine outpatient drugs, repeal medicare drug coverage and three things would happen:

1) Most drugs you need as an outpatient would be as cheap as in vietnam or mexico

2) No one will take antibiotics unless they REALLY NEED THEM.

3) The whole country would get healthier very fast.

I'm a doc and I buy all my own meds from CANADA. Omnaris nasal spray $120 in the states and only $39 in the great white north.....

I accept your subject matter expertise without question.......BUT...I'm scratching my head reading what you posted when it comes to:

1.) drug prices drop

2.) antibiotic use drops

I don't get how that works?

------

On the topic of respective drug prices.....I wonder if drug prices will eventually equalize or at least see price gaps close in different markets.

I've read where pharmaceuticals in Greece meant for domestic use are being re-exported for profit/cash flow for other drugs(sacrifice the one for the good of the many it sounds like).

Same here.....we are able to get some drugs for my wife's family here far cheaper than in the US....what was a "oncer" has turned into a perpetual request.

[rogermexico]

Re: FDA may let patients buy drugs without prescriptions

I accept your subject matter expertise without question.......BUT...I'm scratching my head reading what you posted when it comes to:

1.) drug prices drop

2.) antibiotic use drops

I don't get how that works?

------

On the topic of respective drug prices.....I wonder if drug prices will eventually equalize or at least see price gaps close in different markets.

I've read where pharmaceuticals in Greece meant for domestic use are being re-exported for profit/cash flow for other drugs(sacrifice the one for the good of the many it sounds like).

Same here.....we are able to get some drugs for my wife's family here far cheaper than in the US....what was a "oncer" has turned into a perpetual request.

The price will drop and the use will go down for the same reason... because the drug will not be sold unless it is paid for out of pocket.

Now with drugs covered - pt sees a 5 dollar copay on a 90 dollar prescription.

If there is no coverage - price drops to a market clearing price but even 90 dollars dropping to 25 pt will think twice before agreeing to pay for the drug.

Also, the pharmacist will tell the pt that amoxicillin is cheaper and just as effective as cipro or levaquin - something the docs don't seem to do...

[lakedaemonian]

Re: FDA may let patients buy drugs without prescriptions

The price will drop and the use will go down for the same reason... because the drug will not be sold unless it is paid for out of pocket.

Now with drugs covered - pt sees a 5 dollar copay on a 90 dollar prescription.

If there is no coverage - price drops to a market clearing price but even 90 dollars dropping to 25 pt will think twice before agreeing to pay for the drug.

Also, the pharmacist will tell the pt that amoxicillin is cheaper and just as effective as cipro or levaquin - something the docs don't seem to do...

Cheers!

Wow...didn't know Cipro and such were so expensive up there......cheap as chips down here.....most common broad spectrum antibiotics like Doxy AND the higher end magic bullets are all single digit $ for prescriptions down here of the ones I've personally had filled.....most scripts from most things are well under $20NZ per.....but subsidies and such from our national health care may be distorting that a bit.

We do seem to have a bit more pharmacist latitude down here.....it seems like we have some things down here that require pharmacist(not pharmacist sales assistant) approval for sale that would be considered doctor's prescription only up there.

Seems to work....although it's gone a bit backwards with formerly over the counter methamphetamine precursors.

[doom&gloom]

Re: FDA may let patients buy drugs without prescriptions

yeah, amazing what you can buy in Mexico OTC. Doesn't seem they have "that kind" of a drug problem either.

My wife is a pharmacist. I bet should could easily list dozens of drugs off the top of her head that should be OTC no problem.

Like anything else, follow the money....

[flintlock]

Re: FDA may let patients buy drugs without prescriptions

A lot of business today seems predicated on convincing people that the businesses are only acting in the people's own best interest. They are careful to always have a grain of truth in this, but we all know that's not really what its about. Its as if profits for profit sake has become a dirty word. Now everyone is looking for some competitive advantage, but when it involves using the force of the law to restrict competition, you can't help but be cynical. If you want to look at the most successful segments of commerce today, just look at the one's most chummy with government. Its almost become a prerequisite for success. English Kings used to hand out monopolies to supporters as gratitude for loyalty. Some things never change.

[shiny!]

Re: FDA may let patients buy drugs without prescriptions

Any chance that my dog's heartworm or arthritis medicine will go Rx free?

This vet stuff is just as bad.

For the last couple of years I've been buying Ellie Mae's heartworm meds from an Australian vendor. Even with shipping it's far cheaper than what I pay in the U.S. for the exact same stuff.

PM me and I'll give you the website.