More on Pricey Pills

Kerry Howley had an article in Reason Magazine this month related one of my pet peeves. Her claim was that prescription requirements have the net effect of raising the cost of medications and negatively impacting our health. I guess I have the soul of a libertarian. I couldn’t agree more.

Some of the points that she made:

1. Prescriptions were originally simply written instructions given by a doctor outlining which and how much medication one should take. It was only in 1951 that the FDA established a requirement for prescriptions for certain drugs
2. Along with that requirement came a directive that labels on prescription medications would NOT be decipherable by the layperson – meaning that a doctor with external knowledge would have to enlighten you on the correct dosage…
3. Most developed countries allow pharmacists to dispense many of the drugs that require a prescription in the U.S.
4. The main determinant of whether or not a drug is listed as prescription-only in the U.S. is the pharmaceutical companies. Generally, they prefer to have the drug available only by prescription as long as it’s under patent, because they can sustain significantly higher prices that way. They then go over-the-counter when it loses patent, since their branding allows them to sell at higher price and volume over the generics

I’d add that pharmaceutical companies are not the only ones that benefit from prescription requirements. There’s another interest group into this equation: The medical establishment. It’s prescriptions that keep us going back for those 2 hour wait, 10 second face-time doctor visits, list priced at $215 and discounted to $60 for our insurance companies.

The Cosmo view: The only medications that reasonably should be regulated by prescription are those that can cause harm to others, or significant harm to the individual, if used improperly. Meaning only when there is a significant public health interest in regulating their use.

Examples of such drugs might include (I’m not even sure I’d include them to tell you the truth, but for now…)

1. Some antibiotics, because overuse legitimately can rapidly lead to the emergence of drug resistant strains that can impact all of us.
2. Drugs that can be used as strong narcotics or stimulants, or in the manufacture of such drugs.

Most drugs should not be regulated, and that includes, but of course is not limited to:

1. Cholesterol reducing and blood pressure reducing drugs
2. Birth control pills
3. Various skin treatments
4. Diabetes medications
5. Viagra and the like
6. Many psychiatric drugs such as antidepressants and anti-psychotics

Yes, there’s a medical insurance issue here as well. Prescription drugs are generally covered by insurance. Over the counter medications are not. But mostly I’ve found that the cost of the deductible on most prescription drug policies is higher than full price for over the counter drugs… Enough said.