Drugs of choice

Con­sumer groups op­pose FDA flir­ta­tion with med­i­cal free­dom

The Washington Times Daily - - Opinion - By Robert Gold­berg

Next week, the FDA will be hold­ing a hear­ing about let­ting con­sumers buy com­monly used pre­scrip­tion drugs with­out a pre­scrip­tion, sig­nal­ing FDA recog­ni­tion that em­pow­er­ing con­sumers to make health care choices is the key to bet­ter health at a lower cost. The agency’s pro­posal is a re­fresh­ing de­par­ture from the usual ad­min­is­tra­tion’s prac­tice of ex­pand­ing gov­ern­ment’s role in our daily lives. Yet so-called con­sumer groups that want the gov­ern­ment to tell Amer­i­cans how to eat, what cars to drive and what medicines to take are op­pos­ing even this small step to­ward med­i­cal free­dom.

In­deed, the FDA pro­posal rec­og­nizes that in­di­vid­u­als, armed with in­creas­ingly in­di­vid­u­al­ized in­for­ma­tion on what’s best for them, can make bet­ter de­ci­sions than a sys­tem where what is spent on health care is de­ter­mined by bu­reau­crats. More con­sumers want more per­sonal re­spon­si­bil­ity and free­dom in mak­ing health care de­ci­sions, not less. They want to spend less time and money on med­i­cal care. So why would some groups op­pose mak­ing more med­i­ca­tions that have been widely used for years — for such con­di­tions as high choles­terol, mi­graines, and hy­per­ten­sion — more ac­ces­si­ble?

Groups such as the Cen­ter for Sci­ence in the Public In­ter­est and Public Cit­i­zen claim the FDA pro­posal will “per­mit” peo­ple to use more medicines with­out solid in­for­ma­tion. On the con­trary, the ex­plo­sion of di­ag­nos­tics, ap­pli­ca­tions and on­line com­mu­ni­ties has in­creased our abil­ity to re­spon­si­bly take con­trol of our health and well-be­ing. In to­day’s dig­i­tal world, we can use our smart­phones to ob­tain test re­sults and ac­cess in­for­ma­tion tai­lored to our di­ag­no­sis, ge­net­ics, health goals and life­style. Mak­ing drugs for os­teo­poro­sis preven­tion, birth con­trol, mi­graines, choles­terol and erec­tile dys­func­tion avail­able with­out a pre­scrip­tion would, with ap­pro­pri­ate safe­guards and new health-in­for­ma­tion tools, em­power peo­ple to look af­ter them­selves. In fact, ev­i­dence shows that mov­ing pre­scrip­tion drugs over the counter (OTC) helps peo­ple stay on track with their treat­ment reg­i­men.

Crit­ics of­ten point to what they claim is mis­use of cough medicines as an ar­gu­ment for more FDA reg­u­la­tion of OTC prod­ucts, not less. But a re­cent sur­vey I con­ducted on how Amer­i­can fam­i­lies treat coughs and colds un­der­scores the op­por­tu­nity self­care can of­fer to im­prove health. Over the past year, 61 mil­lion con­sumers avoided miss­ing work, school or other sched­uled ap­point­ments due to ill­ness be­cause they had ac­cess to OTC cough medicines to al­le­vi­ate their symp­toms. And nearly 75 per­cent of all con­sumers sur­veyed com­ple­mented cough and cold medicine use with rest, flu­ids (in­clud­ing chicken soup) and other “home” reme­dies.

The nearly a third of pa­tients who see a physi­cian for a cold wind up spend­ing $7 bil­lion on of­fice vis­its and an­other $2 bil­lion on an­tibi­otics a year even though an­tibi­otics don’t work for such ail­ments. If we were all forced to run to the doc­tor and get a pre­scrip­tion ev­ery time we coughed or were stuffed up, we would be spend­ing a lot more money treat­ing symp­toms that can be al­le­vi­ated ef­fec­tively by OTC medicines in our phar­macy or su­per­mar­ket and, more of­ten than not, re­solve on their own.

So why do some groups want to keep Amer­i­cans shack­led to our cur­rent sys­tem of care? As Eric Topol notes in “The Creative Destruc­tion of Medicine,” ac­cess to our “own data and in­for­ma­tion — whether it be DNA se­quence or biosensor re­mote mon­i­tor­ing — will soon be un­prece­dented, and surely each in­di­vid­ual has more at stake about his or her health than the busy physi­cian who is look­ing af­ter hun­dreds to thou­sands of pa­tients . . . But change can­not take place un­less con­sumers are the driv­ing force.” With­out the abil­ity to con­ve­niently ac­cess and use more medicines we know and trust in tan­dem with such valu­able per­sonal health in­for­ma­tion, the pa­ter­nal­ism of the present health care sys­tem will pre­vail. Op­po­nents of the FDA pro­posal are afraid of los­ing con­trol over our lives.

There is wis­dom in the crowd. The ben­e­fits of con­sumer em­pow­er­ment out­weigh the risks that, in fact, can be man­aged mostly by we the peo­ple by ed­u­cat­ing each other. Turn­ing more pre­scrip­tion medicines into OTC prod­ucts not only saves time and money. It en­hances our abil­ity to sus­tain health rather than just treat dis­ease.

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