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U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

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Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#61

Post by vibrio »

stochastic_monk wrote: post #55
jl2718 wrote: post #46

Bravo. The AMA/FDA/insurance cartel cannot die soon enough. I don’t care if you want a free market, or you want socialized medicine, both are preferable to government-enforced racketeering.

You mean the AMA and FDA should stop preventing patients from taking contraindicated combinations or failing to understand the risks they’re taking on by self-medicating? Pharmacology is complicated and dangerous. Letting corporations go hog-wild will harm many people.

...that and we'd better start inventing some new antibiotics now. As it is now, physicans can barely prescribe them responsibly. If they are available as cold medicine antibiotic resistance will surge even harder than it is now. antibiotic resistance is a dramatically underappreciated problem.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#62

Post by JumpCrisscross »

ams6110 wrote: post #35
JumpCrisscross wrote: post #28

Earlier quoted context omitted.

> Presumably only for trivial conditions id [ sic ] hope I'd hope not. I used to be asthmatic. At one point in my life, getting--and paying co-pay for--a doctor's appointment was not easy. There were nights when I weighed suffering a little longer against the risk of triggering an ER visit. Being able to go to a pharmacy to get albuterol would have made a tough time easier with minimal risk to anyone else.

Why are you no longer asthmatic? Did you move to a less polluted/better climate area? Change your diet? Something else?

> Why are you no longer asthmatic?

I managed the allergic reactions that were causing it. Far too late in life, I discovered I'm allergic to grass. So I avoided hiking in grass and started popping a Zyrtec when my dog came back from running around in it. (I'm still allergic to my cat, but unless he sleeps on my chest it's manageable.) Solved the problem sufficiently that I no longer have an inhaler.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#63

Post by [deleted] »

stochastic_monk wrote: post #55
jl2718 wrote: post #46

Bravo. The AMA/FDA/insurance cartel cannot die soon enough. I don’t care if you want a free market, or you want socialized medicine, both are preferable to government-enforced racketeering.

You mean the AMA and FDA should stop preventing patients from taking contraindicated combinations or failing to understand the risks they’re taking on by self-medicating? Pharmacology is complicated and dangerous. Letting corporations go hog-wild will harm many people.

[deleted]

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#64

Post by rdiddly »

When you already know what drug you need and just need somebody to sign a prescription, it's a very silly and awkward process to find a doctor, make the appointment, wait for the appointment, show up to the appointment, fill out the history forms and so on, meet with the doc, tell them you've got [disease] and the drug for it is [drug], let them examine you until they agree with your "diagnosis" of [disease], and let them recommend and prescribe [drug]. It makes you feel sorry for the doctor almost.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#65

Post by davismwfl »

ars wrote: post #49
davismwfl wrote: post #40

Earlier quoted context omitted.

Many times they still charge more for the prescription med still. Great example I just saw. We all know ibuprofen has been available as an OTC for a long time. Cheap to buy too, The one difference in this example, the one 800mg pill is less harsh on the stomach than taking 4 of the 200mg pills. Which is the reasoning usually for this type of prescription, that and convenience for the patient.

> but insurance has paid $35 or more Insurance does not actually pay that much. Because of drug rebates (paid by the drug manufacturer), clawbacks, and Co-Pays, in total the drug manufacturer gets about the same as they would for the OTC drug. See here: https://money.cnn.com/2018/05/07/news/economy/drug-prices-re... (and that article barely scratches the surface). Destroying that entire money-network would be probabl…

Rebates and incentives are very common when a drug is on patent, but not once it is available as a generic. Insurers have to pay the generics generally and have no rebate for those, though I am sure there are exceptions. Even the article you linked points that out, and a drug like ibuprofen that is generic at this point, has no rebates or incentives, only a negotiated fee on the class of medication generally.

When I worked on doing data analytics for one of the large speciality pharmacies a while back, some of their medications had rebates in the low 5 figure range, the medications were typically a low 6 figure prescription. But for the generic meds they carried, there was no rebate and insurance paid the full fair at whatever was negotiated for the class of medications. That was a fun/educational project but also a bit depressing seeing how the system works. The pharmacies are also in this weird middle position where they have to process a lot of the data (and business rules), but can easily get squeezed out of the profit if they aren't savvy.

I am with you, destroying the supply chain money antics would be a huge benefit in the US to cutting down the waste and useless spending.

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#66

Post by kian »

majewsky wrote: post #44
ams6110 wrote: post #35

Earlier quoted context omitted.

Why are you no longer asthmatic? Did you move to a less polluted/better climate area? Change your diet? Something else?

I would be interested in this as well. I feel like my asthma got worse since I moved to an apartment next to a busier road.

I can't speak for JumpCrissCross, but there are 3 things that improved my asthma:

1) Eating better. Low level inflammation is terrible for people with auto-immune disorders, to which the trio of asthma, eczema, and allergies belong.

2) Moved closer to the ocean - salt air is great for the lungs, and really has a way of helping deal with any allergies you might have to local pollen

3) RUN! seriously, aerobic exercise for 45 minutes to an hour (anything less doesn't count) is a literal life-changer. Yeah, it really does suck for the first two weeks (if you're doing it every other day), but after that you'll start to feel amazing. You'll lose weight, which also helps with the breathing. And you'll have way more energy and higher happiness levels, which will help you want to move around more and be outside, which again will help with your asthma. Seriously, if I could do only one, this one is it. Run. Or swim if you can't (I only run on sand or dirt because my knees are shot).

Best of luck!

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#67

Post by bharris62 »

ComradeTaco wrote: post #60
veridies wrote: post #52

Earlier quoted context omitted.

I have type 1 diabetes, and this is a constant fear of mine. It’s absurd that I should have to go through my insurance company to be able to get more medicine if I need to.

I don't know if this is helpful to you, but Walmart pharmacies have inexpensive insulin if you ask for it.

This is regular insulin, its quite unstable (by unstable I mean that its release mechanism is quite slow and requires a lot of planning compared to more modern 'fast acting' insulins.

with that said, as a type 1 - if I was in a predicament you bet i would go, if i recall they sell it for 25 a vial, whereas a vial of normal, fast acting insuling is ~250.

*usd

Re: U.S. to make More Drugs Easily Available, Cutting Role Doctors Play

#69

Post by Communitivity »

There are better ways to go about this. As others have noted, there must be a mechanism for a continual prescription to be easily filled, e.g. insulin, metformin, etc. I could see a long term prescription that has to be renewed each year and is good at any pharmacy.

For the short term prescriptions though, cutting the doctor out of it makes people much more susceptible to marketing (instead of 'ask your doctor if you need X' we'll get 'You need X if you have any of a, b, and c...get it now before it's too late'.

Also, the doctor is aware of your health history and can spot reasons you specifically shouldn't take a drug, or better alternatives. Maybe you are overweight and one diabetes drug would work for you, but this other one will also help you lose weight. Maybe you have a loss of kidney function, and shouldn't be taking metformin. Your pharmacist should catch drug interactions, but they can't catch problems that would result from your past medical history.

For me this is big pharma getting their way, at our cost, in more ways than one.

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