Don’t Bypass Physicians

As physicians, our primary concern is ensuring the health and safety of our patients. The Food and Drug Administration has offered a new concept to make more prescription drugs available over the counter (OTC). Proponents claim it could improve patient health and outcomes, reduce patient costs and promote proper medication use. We are skeptical that it would achieve any of these goals.

The American Medical Association is concerned about patients taking certain drugs without physician involvement — especially patients with chronic diseases. No evidence has been offered that the innovative technologies underpinning this concept would actually allow patients with high blood pressure, high cholesterol, asthma or migraine headaches to self-diagnose and manage these serious chronic medical conditions safely on their own.

As a chronic condition evolves, treatment changes are often needed from a physician. Without physician involvement, patients might take the wrong medication or dose for their needs, potentially causing harm. Self-diagnosis and treatment conflict with the care coordination and disease management that new health care payment and delivery models are trying to achieve.

Contrary to claims that this will save patients money, out-of-pocket costs for insured individuals, including those under Medicare, would increase for drugs switched from prescription to OTC status because patients would need to cover the entire cost themselves. Higher costs would make it harder for patients to afford the medication they need.

Patients are more likely to take the medicine they need when they need it while under a doctor’s care. Physicians are one of the most important motivators in getting patients to take medication as directed. Any proposed expansion of OTC medications needs to preserve, not undermine, the patient-physician relationship.

Patients rely on physicians to provide sound diagnosis and treatment information and to help them meet their unique health needs. Expanding many prescription medications to OTC interferes with that important relationship without offering any real benefits to improve patients’ health or reduce their costs.

Peter W. Carmel is president of the American Medical Association. This post first appeared in USA Today.

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3 replies »

  1. Dear doctor, if the consumer cannot be even trusted to decide OTC medicine, what hope lies in having HDHP/HSA products that claim to empower patients to make their own decisions? And we pay for insurance for them to pay to us and not other way around.

  2. Just another effort to marginalize, if not minimize the role of physicians.

    Watch, this gets done and then someone sues their doctor for not advising them better for using an OTC, and yet not even telling the MD the drug was used.

  3. The FDA will essentially adopt a managed care strategy if they allow these drugs to be purchased OTC. The cost of drugs for these diseases is trivial at this point. Like managed care companies they are focused on physician costs and minimizing the role of physicians. It is the natural consequence of 20 years of a politically designed system that emphasizes cost over quality.

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