I was poking around, looking for what is brewing in psychopharmacology; a field I am no longer particularly proud I spent a lot of time studying and working in. Strange, or maybe not so strange, that I’ve met both of the principals allegedly involved in this pharmacological ghostwriting scandal.
I saw Dr. Schatzberg when he led various sessions at a large professional meeting on the coast. My main memory of him is that he looked tired, maybe even a bit depressed. I was told I had to write a lot of articles and do a lot of research projects, so maybe someday when I grew up I could do this kind of work. I was told, often and a lot, that I had plenty enough neurons, so it would only take work, and a lot of it. Dr. Nemeroff actually came to Kansas between visits to the coasts. He was friends with my preceptor in psychopharmacology. He came to speak at our grand rounds, where we were awe struck by the large amount of patients seen, as well as the large amount of numbers and lovely statistics.
Why would a pharmaceutical manufacturer want to change a drug from prescription to over the counter (OTC)?
Well, one thing I’ve learned in my lifetime is – When the Question is “WHY?” then the answer is “MONEY.”
Oh, sure – in our economically-ignorant country, many people think – “Whee! I can buy any drug I want without spending money on a doctor’s appointment and without having to get a prescription! ”
These people are prime candidates for the Darwin Awards.
Yes, believe it or not, the “RX to OTC Switch” can actually HURT patients.
Drug patents expire relatively quickly, competitors are waiting at the gates with generic equivalents, and when a drug becomes OTC, there is a chance that insurance does not cover it.
This makes insurance companies and government programs (Medicare, Medicaid/Medi-Cal, etc.) very happy. They are so strapped for cash that even paying for a cheaper generic is a strain on the budget. When this kind of money is involved, you can bet that lobbyists are pressuring the government to ease their restrictions so that drugs once considered risky enough to warrant a prescription so that not just anybody can have access will be available to anyone who can walk into a drug store or click on a shopping cart on the web.
Patients will have to pay for OTC meds in cash money and doctors usually do not bother prescribing an equivalent drug. If they do not already know of an equivalent, they will probably — and generally do — just tell a patient to go buy it over the counter.
A patient who cannot afford the drug will go off it.
OK – so what’s the big deal if a cold medicine, allergy remedy or hair-restoring pill is no longer a prescription drug?