Another interesting development apropos to recent rants on lowering medical costs, in part by breaking down some traditional delivery mechanisms in favor of a more quick-shop, commercial approach to healthcare: now the FDA plans "to expand the the middle ground between drugs that require a prescription and those that anyone can buy off the shelf." This new gray area for medications is termed "behind the counter" (BTC).
BTC has already gotten a lot of media play -- in the Wall St. Journal, USA Today, Reuters, etc. -- and apparently the FDA is serious enough about it to be planning a public hearing on the topic next month (Nov. 14 in Washington, DC). Wow.
BTC is modeled after the "pharmacist-only" prescription system on offer in many European countries. In other words, you could obtain the drug you need directly on-site at the drugstore after consultation with a pharmacist. There are still a ton of open questions with regard to regulatory framework and actual cost savings.
Cost savings will presumably come from bypassing the whole doctor-visit-for-prescription step, and also from increased use of off-label, generic drugs rather than their pricey brand-name counterparts. Seems to me like much of the cost-savings may well end up on the insurance end, meaning the health care system as a whole will save money. Still, the convenience and no-coverage-needed factors are significant benefits for patients.
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Here's the link to the FDA summary document. Looks like they're trying primarily to help the uninsured, by "increasing patient access to medications that may be underutilized, particularly by patients without health insurance because these medications otherwise would be available only with a prescription."
The LA Times reports quotes John Tilley, who owns four Zweber pharmacies in Downey, CA, and serves as president of the National Community Pharmacists Assn., as viewing the FDA's proposal as a "win-win" for patients.
His thinking is that pharmacists are trained to consult about routine medical information, and are often more accessible and spend far more time with customers than do their doctors. He emphasizes also that " greater access to medications might help patients without health insurance who otherwise might not be getting care."
"It's not like people would be getting these medications from a vending machine," Tilley said. "This would include an adequate level of care."
So, the question is: does BTC sound scary to you? As dicey perhaps as health clinics in Wal-Mart? Or is it possibly a boon to
people with diabetes, for obtaining things like blood pressure and cholesterol-lowering drugs
(statins) quickly and conveniently? What say?