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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

#201

Post by Lanthanide »

api wrote: post #196
Lanthanide wrote: post #111

I live in a country where this scheme is already the norm (Saudi Arabia) and I can say that while it's not necessarily ideal, I much prefer it to the alternative. It plugs some seriously annoying holes in the healthcare experience and frees up doctors' time for more patients. As it is, the only medications that require a prescription to buy in Saudi are psychotropic ones, narcotics, and most recently, antibiotics. Th…

Off topic but: birth control is OTC in Saudi Arabia? That busts a stereotype.

Aisle 5, right next to the condoms and lube bottles =) and Victoria Secret makes money hand over fist here.

This would be off-topic here, but I think most people outside of the region would be stunned about the state of sex-change operations over here. They happen VERY frequently, albeit with a heavy veil of privacy.

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

#202

Post by Spooky23 »

mobilefriendly wrote: post #47
Spooky23 wrote: post #38

Sounds like a way to mimic the success of over the counter medications like ibuprofen, whose prices have been slowly creeping up for years. Many of the major profitable blood pressure and statins are off patent, so the drug companies need to make more money. I’m sure this status will limit or eliminate insurance contributions, so now you’ll pay more for generic because 50 million individuals lack the buying power of…

Incorrect. 200 mg Ibuprofen is 2 cents a pill at Walmart. https://www.walmart.com/search/?query=ibuprofen%20200mg%2050...

...And the generic gelcap that is heavily marketed and merchandises better costs 7x more.

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

#204

Post by microcolonel »

mirimir wrote: post #197
Engineering-MD wrote: post #136

Earlier quoted context omitted.

I’m not I agree. The first reason is that many medications carry significant risks. For instance you mention insulin. For someone already prescribed insulin, yes it should be easy to access in case they should be able to get more (and that is the purpose of a repeat prescription). However, to provide insulin over the counter to someone never previously prescribed it could be incredibly dangerous, and indeed fatal. Th…

I can't imagine safely prescribing anti-hyperlipidemia and anti-hypertension drugs without medical advice. Sure, we can all measure our own blood pressure. But choosing which anti-hypertension drug to use, or which combination, is nontrivial.

> But choosing which anti-hypertension drug to use, or which combination, is nontrivial.

Then why not consult a doctor? It is already an immense legal risk to recommend starting a course of drugs like this without seeking medical advice, I don't see why it would be any different if you could technically self-administer an anti-hypertension drug.

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

#205

Post by edtruji »

mobilefriendly wrote: post #47
Spooky23 wrote: post #38

Sounds like a way to mimic the success of over the counter medications like ibuprofen, whose prices have been slowly creeping up for years. Many of the major profitable blood pressure and statins are off patent, so the drug companies need to make more money. I’m sure this status will limit or eliminate insurance contributions, so now you’ll pay more for generic because 50 million individuals lack the buying power of…

Incorrect. 200 mg Ibuprofen is 2 cents a pill at Walmart. https://www.walmart.com/search/?query=ibuprofen%20200mg%2050...

Walmart physical stores “brick and mortar”, charges different price for the same product, taking into account different “factors” like local competition.

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

#206

Post by tptacek »

WillPostForFood wrote: post #139
tptacek wrote: post #84

Earlier quoted context omitted.

That is not at all the experience I have with my doctor, where the intake NP does a whole litany of the past several years worth of doctor visits before I’m seen. I’m ok and I think glad that pharmacists don’t even have access to that information.

On your first visit or every visit thereafter? I think the issue is the overhead of unecessary repeat visits.

Every visit thereafter.

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

#207

Post by microcolonel »

PatentlyDC123 wrote: post #184
cassowary37 wrote: post #163

I'm always struck by the intensity with which some HN folks hate their doc - reminded of this by the number of comments invoking conspiracy theories about docs scheduling extra appointments to bill more or push more generic drugs. Perhaps obvious but perhaps not: in the US and most EU countries I'm aware of, you can choose a new doc. You can shop around. Despite the flaws in online reviews, just as with Amazon, you c…

For me the issue is not exactly “burning down” the FDA, but rather changing its purpose from regulatory to only advisory (and hopefully changing associated statutes). The FDA provides a very valuable service by identifying the risks associated with various food and drug. It is one thing to educate the public and say “XYZ presents risk of ABC for this specific group of consumers.” It is a very different thing to also…

This is more or less how I've felt. There are so many high-risk behaviors which are perfectly legal, and when our right to take risks in those ways is challenged, there is generally backlash; but in the case of drugs we are legally prohibited from taking risks.

I think the FDA's prohibitive authority does more to protect the interests of established pharmaceutical manufacturers, than the interests of consumers.

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

#208

Post by microcolonel »

csdreamer7 wrote: post #164
refurb wrote: post #4

Similar to this idea, the province of Alberta in Canada allows pharmacists to write prescriptions for patients with only the only limit that they can't prescribe controlled substances.

I like this, with the exception of anti-biotics because misuse would spread immunity.

I think it would be possible to create a system of law which would encourage people to take their full course of antibiotics.

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

#209

Post by edtruji »

Engineering-MD wrote: post #136
Lanthanide wrote: post #111

I live in a country where this scheme is already the norm (Saudi Arabia) and I can say that while it's not necessarily ideal, I much prefer it to the alternative. It plugs some seriously annoying holes in the healthcare experience and frees up doctors' time for more patients. As it is, the only medications that require a prescription to buy in Saudi are psychotropic ones, narcotics, and most recently, antibiotics. Th…

I’m not I agree. The first reason is that many medications carry significant risks. For instance you mention insulin. For someone already prescribed insulin, yes it should be easy to access in case they should be able to get more (and that is the purpose of a repeat prescription). However, to provide insulin over the counter to someone never previously prescribed it could be incredibly dangerous, and indeed fatal. Th…

The cap for repeat prescription is at 3, at least were do I live which is in Puerto Rico. So the patients that needs those concurrent medications like levodopa or Humalog goes to see the Doctor and they ask for a prescription refill without date.

Big name pharmacies like Walgreens or CVS won’t dispatch u a medication without a prescription, the town pharmacies (Mom and Dad) would do it.

A week ago I avoid the hassle and loss of time (travel, waiting time, and $) just going through the town pharmacy and asking for a antibiotic, having a prescription won’t make any difference as the insurance plan won’t cover it.

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

#210

Post by StillBored »

jessaustin wrote: post #170
Lanthanide wrote: post #111

I live in a country where this scheme is already the norm (Saudi Arabia) and I can say that while it's not necessarily ideal, I much prefer it to the alternative. It plugs some seriously annoying holes in the healthcare experience and frees up doctors' time for more patients. As it is, the only medications that require a prescription to buy in Saudi are psychotropic ones, narcotics, and most recently, antibiotics. Th…

Things like... hypertension medications, ...are all OTC. This would be so nice. Every time I switch providers, I have to hear the same tired "Lisinopril is the modern blood pressure medication and it's certainly all that you need!" "No asshole, it doesn't work for me and it makes me cough 17 times a minute, 1440 minutes a day. Just give a water pill, which does work and has worked for years."

This is actually what irritates me and keeps me away from doctors. Its seems to be 99% seat of the pants guess work, and in my case the doctors seem to have a pretty poor batting average. I get that antibiotics are over-prescribed, but do I really need to have the same test run again for the 3rd time to see if I'm lying about the antibiotic not doing a darn thing?

I get that treatment is frequently trial and error when it comes to medications, but the doctor/patient/pharmacist loop is BS, particularly for minor/frequent issues.

Take for example that I seem to run myself into poison ivy a couple times a year while mountain biking. Do I really need to fight to see a doctor/nurse/whatever just to have the same prescription I've gotten the last couple years straight? Or for that matter, maybe I should experiment more with stronger allergy medications to avoid the nasty withdraw I seem to get from prednisone.

Worse, what irritates me, is like the GP, it seems a lot of the common "safe" prescriptions in the US are over the counter in the rest of the world.. I know this, but got myself quite a surprise last time I was in mexico, because the hotel gift shop had viagra next to the advil!

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