The FDA

I read a story today, it was interesting.  From an economic stand point there are some interesting concepts.  The story was about the FDA allowing some maintenance type drugs to be bought over the counter.  Drugs to control blood pressure and cholesterol were specifically mentioned.  And of course in the body of the story there were statements from doctors groups that were appalled at this idea.  The pharmacists were much more amenable to the idea.  The story went on to say that the FDA was looking to do this to reduce the costs to Medicare, which since the drugs were over the counter, they would no longer be covered, reducing health care costs to the government.

By reading the above, there are three issues discussed.  Let's explore them.  First, the FDA wants drugs for maintenance of some pretty serious conditions to be available for those would would self diagnose themselves.  Blood pressure is easy to monitor, the devices are readily available at many different retail stores.  The cause is a different story.  Most humans control their blood pressure through normal bodily functions.  I am not a doctor, so I wouldn't presume to know what these functions are, suffice it to say that for centuries we have survived as a race without these medications.  The medications may allow those of us with problems in the internal workings of our bodies to live longer and be more productive and happy.  But there are a multitude of formulations out there and, as a layman, I would not have a clue as to which I should buy.  That's what my doctor is for.  Perhaps a pharmacist could help as well.  By self medicating, it also removes another important part of the treatment, getting to the root cause.  Mostly it is diet, and there are some doctors that may try to convince a patient to change diet first, if that doesn't work then go to the medications.  Seems to me that there may be a argument to keep doctors in the loop.  I suspect though that in some cases doctors might be opposed to this because it will cost them money, no office visit...  Is that too cynical?

Second, there is the economic impact of making the medications more available.  Drug manufacturers would have to compete for your business.  When a drug is moved off prescription there generally is a decrease in price, since it is your dollars, and not the insurance company's dollars, you are spending.  We tend to be more frugal with our dollars.  Therefore for the drug companies to continue selling an over the counter drug, they must reduce the cost.  Then there is the effects of generics and its lower cost compared to the major drug, these price constraints on the drug companies will force them to deal with generics head and further push costs down.  As a general rule, moving a drug to OTC status should make it more affordable to the patient.

The third issue is much more insidious.  Lowering cost to the government insurance company, Medicare.  There may be economic benefit to do so, however, it has been my observation that instead of passing this saving on to the patient so that they can buy the less expensive drugs, the money will disappear down the Washington black hole and be absorbed into an inefficient system.  Leaving the patients to choose between eating and medication.  Not exactly a 'death panel' but the result may be similar.  The FDA does not set premiums for Medicare, so there would be no pressure to lower premiums.  And like so many other schemes from Washington, the money will be theirs to spoil who ever they desire, both sides of the aisle.  Seems like this leaves us as citizens holding the bag, once again.

Market forces are an overall good thing for the people, companies know that if they are over priced, they will not have the sales that generate profit.  And there is research and development to consider.  It takes years and millions of dollars to bring a new drug to the market.  Is the FDA going to reduce that cost?  If they do, will the bad apples bring drugs that may harm us?  Some regulation is OK, it is over regulation that we need to fear.