When I go to my local pharmacy to pick up a prescription, I also pick up other medicines. Aspirin, Ibuprophen, alcohol, peroxide, polyethylene glycol, lidocaine rubs and more are readily available off the shelf. So are a plethora of vitamins, minerals, and cosmetic products. The bottom line is that when I get my prescription, I invariably add something off the shelf. Where did this idea that you have to have a prescription come from?
Prescribing medicines to cure illness goes back to Samaria about 2000 BC. However, the process of controlled prescription medicine in the United States is just over 100 years old. In 1906, the Food and Drug Administration (FDA), a federal consumer protection agency, was tasked to oversee the Pure Food and Drugs Act. Medicines were separated. Some were officially prescribed and controlled while others in “harmless” general use could be purchased off the shelf.
Significantly, medical research, medicine production, and medicinal sales have become very competitive. Billions of dollars are on the line in the rush to get FDA approvals and to get doctors to prescribe a particular medicine. However, there is a growing trend by patients to be allowed to try a medicine without having to fight the prescription process. The “right to try” is now supported by federal legislation.
As a result of the current Chinese coronavirus pandemic, the prescription process is fraying. Rather than aiding patients, it is now functioning as a barrier to “right to try”. This barrier has even become political, and involved governors of a couple of states threatening doctors who prescribe drugs that may help their patients suffering from the contagion.
One of the most referenced anti-coronavirus drug combinations, Hydroxychloroquine and Zithromax, require a prescription. However, doctors are loath to prescribe the off-label combination even though initial testing shows remarkable results in stabilizing coronavirus patients and eventually curing them. Notably, both of these drugs have a long history of usage by hundreds of millions of people worldwide. The health risks are well understood.
My question is straightforward. Why is this combination not off the shelf? The answer, of course, is it could be dangerous. Well, aspirin, ibuprophen, alcohol, peroxide, vitamins, and mineral have negative properties. If the “right to try” has any meaning here, then this combination ought to be off the shelf to make it quickly available to people who are likely to come in contact with the contagion or are experiencing symptoms of the disease. In other words, let the patient take the risks just as they do with off the shelf products.
Less I be misunderstood, I am not advocating for the elimination of the prescription process. What I am advocating for is getting the doctors and pharmacists out of the political process and allowing them to be advisers and advocates for their patients rather than a barrier to their treatment. (Notably, other treatments are becoming available and a vaccine is likely, but in the short term making this combination available provides hope for millions and frees up the nation to get back to business.)
One final point. Protecting the elderly, infirmed and endangered shouldn’t amount to sequestering them in fear behind closed doors – as the Chinese government did and does with many of their citizens. These Americans deserve as much right to live their lives unencumbered as do their twenty-something grandchildren.
Get the prescription process out of the way or at least change it to be more accommodating for the ultimate consumer, the patient.
