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.”
In this case, the most obvious reason is more money for pharmaceutical companies. I certainly cannot think of anything — I mean any way shape or form — that can benefit patients.
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?
Filed under prescription drugs by on Aug 14th, 2011. Comment. 
A Minneapolis nurse was accused of stealing pain medicine from a patient. She had a fentanyl habit to feed, and didn’t seem to mind that it left her patient in substantial pain. Unfortunately for her, the patient was a Dakota County Sheriff’s Deputy.
Some women just make bad choices.
The reason I bring this up is not to wonder about if this woman is guilty or not. I can tell you that I share one opinion with the judge — that people who ask for a lot of continuances may be getting everyone angry. Read more on Addiction And Nurses…
Filed under Addictions, News, prescription drugs, Substance Abuse by on May 10th, 2011. Comment.
One of my Frequently Asked Questions is “why do you hate prescription drugs so much?”
And the answer is, I DON’T. Not at all. I have used, and will continue to use, prescription drugs whenever they are the best treatment for an individual.
What I DO hate is the way they are mis-used, and the way some companies push their drugs for inappropriate purposes, or in dosages that are harmful when they could be helpful in (usually lower) doses. Read more on A Remarkable Medicine And Its Champion…
Filed under prescription drugs by on Apr 29th, 2011. Comment.
My psychopharmacology preceptor told me a long time ago that the best and most efficient way to know what is happening in pharmacology is to check out the business news. He was right.
I want to applaud the FDA for doing something perhaps a bit audacious, surely without precedent, but something I consider correct and appropriate.
They declined acceptance of Contrave, a pill for obesity, and requested a longer term and larger study.Bravo. It’s rare that I give the FDA a “standing O.” The folks at Orexigen pharmaceuticals concocted Contrave — an amalgam of 400mg. of Wellbutrin sustained release and a couple of different doses of naltrexone, 48 and 16 mg. Here is the clinical trials record if you are interested. Read more on Prescription Diet Drug Makes Food Taste Horrible…
Filed under News, prescription drugs, weight by on Mar 29th, 2011. Comment.
Here are some phrases that you might not expect to hear sweet, friendly Dr. G use very often:
“No, there is no way in hell I am going to renew that prescription as written.”
“Read my lips. No more oxycodone. We gotta get you into a rehab, sweetie.”
“Sure, you can see another doctor. I don’t know how long it will take to get an appointment. If I am your doctor, you go on a tapering schedule. Today.”
“If I did what you want, I could kiss my license goodbye. I am not prescribing outside my specialty and certainly not this crap. Yes it is crap. I am sorry you don’t like how I talk, but it is crap. I can start getting you off it.”
These are all things I have actually said. Usually loud, yelling over the patient. Read more on Pill Mills Are Death Traps — Marginally Legal…
Filed under Addictions, prescription drugs by on Mar 28th, 2011. Comment.
I was making one of my rare but periodic attempts to watch commercial television. Sometimes I amaze myself that I have not given up, especially when I saw a few minutes of “the View.” I mean, someone has to get in there and promote stereotypes about women, and they are doing an incredible job, what with asking women involved in politics about bathing their babies or something.
Claire Danes in "Romeo + Juliet"
I admittedly learn a great deal from the commercials.
Like Claire Danes — whom I used to consider a Shakespearean-quality actress — does not seem to be getting any good roles, because she did this incredible commercial, where her eyelashes and face were photographed every couple of weeks. Admittedly, after four to six weeks, she had pretty lush looking eyelashes compared to week 1.
Here is the prescription drug— yes prescription drug — she was advertising. On the website they have Brooke Shields, too.
Filed under prescription drugs by on Mar 2nd, 2011. Comment.
He was in his mid-fifties and seemed pretty clueless. What’s more, he had more abnormal movements than any 20 people and looked like he was dancing with an invisible partner.
It's Dangerous To Take Drugs Prescribed For Someone Else
He sat at home all day trying to get himself involved in things like doing laundry and watching television so that he could get himself tired enough to sleep, focused enough to avoid the voices. He was safe — no forced hospitalization was necessary or even possible here. He promised that he would not harm himself no matter what the voices said, but it became clear that he lived in a world where devils and demons gave him a continuous commentary on everything from why Obamacare would never help him to — the size of his wife’s behind. There may have been some exhortations to harm self or others in the distant past, but they were indeed distant.
He said he had no medicine for the past ten years. I asked how he lived and he said his family was no help, but his woman was. He was married to someone else but this woman was the only person who knew his day-to-day life and she had brought him to the clinic, so I got a release signed and got her in there. I told her he said he had no medicines in say, the past ten years or so. She started laughing.
“He ought to be telling you the truth. He gets his Mama’s old Seroquel whenever he can. Makes the voices shut up so he can sleep a little. ” Read more on Taking Mama’s Pills…
Filed under prescription drugs by on Feb 10th, 2011. 2 Comments.
One usually thinks of a doctor as one who gives out prescription – sometimes much too easily. I’m often known as the doctor who declines to push drugs.
I take these things seriously. I’ve studied long and hard and know what drugs can do – both positively and negatively. If the risks outweigh the benefits, I can be down-right stubborn. However, I’ll always have an alternative that can help.
I’m reminded of one case where a woman wanted Chantix (varenicline) – a prescription medicine FDA approved to help people stop smoking — and I said “No.” To my knowledge and experience, the drug has some problems. The last patient I saw who was already taking Chantix asked me for a renewal. I told her that the symptoms of which she was complaining would probably disappear completely if she got off the Chantix. I never saw her a second time. Read more on Its Not Only The Smoking That Can Kill You…
Filed under prescription drugs by on Jan 27th, 2011. Comment.
Am I a Brit-snob? Never thought I was, but maybe I am turning into one. Or maybe it is because The Daily Mail has more detail about the trial of Michael Jackson’s doctor — and better pictures. Whatever. The truth of the matter is that when the story about Michael Jackson’s death first came out, I had to look up the generic name of Propofol, because I have never used it. I mean, why would I be hanging around with general anesthesia? For that matter, why would a cardiologist be hanging around with general anesthesia?? Money alone? Possible, I do not know what this guy’s finances were like. But I have never personally known or heard of a starving cardiologist — although I suspect that those who do insurance only no co-pay may be closer to it than they want to admit. But I suspect this guy was not one of those. “Rescuer?” Perhaps. Although I cannot quite see Michael Jackson as a “victim” needing saving. Someone basking in the glare of celebrity? More likely. A rich person’s doctor, maybe — a doctor wanting to work with famous people. I have felt the pull of that one myself. But I ran like crazy when I figured out these folks are more interested in getting the prescriptions they want – usually recreationally — rather than in getting something that might actually help any actual medical problem they might have. “Celebrity” may be a new kind of pathology, where people imagine themselves as uber-people who have more rights than other people, and who can buy pretty much anything they want. Some doctors are easier to buy than others –otherwise how could tobacco companies present medical experts who say smoking won’t harm you? Who can put a price on credentials, or even signatures? I think this man sold it all. Sure, The Mail has verified — other stories, other places, too — that his purchase of large amounts of propofol was legal, and that his credentials were real. This is not substitute for “ethics,” which people often say they will teach in medical school, but which are, basically, impossible to teach. How can you teach something that life-experience will be the only thing to test you on? Ethics are learned young, far before medical school, and internalized. Read more on Celebrity Pathology Requires Ethics To Treat…
Filed under Celebrities, prescription drugs by on Jan 11th, 2011. Comment.
“I wants me some of them-there antidepressant pills.”
He was a 47 year old good old boy of the sort I had treated in Oklahoma and other rural parts west –a real cowboy. He had herded animals and done the rodeo and all of that.
No, he had never seen a psychiatrist before, ever. He had been out crying on the front porch, and it was a next door neighbor who had somehow convinced him that there were medications and he did not have to tell his whole life story to get pills. Well, maybe that would work with a general practitioner, but he was not only disappointed but also angry that it was plainly NOT going to work with me. Figuring he had been had, he broke down and told me the story. I could understand at once why he had been reluctant to get into this, for we went through half a box of Kleenex while he gave me a plot that was worthy of a tear-jerky country song. Read more on A Cowboy’s Lesson — Antidepressants Won’t Work Well With Alcohol…
Filed under depression, Diagnosis, medicine, prescription drugs by on Dec 22nd, 2010. Comment.