GOLDBERG: Drugs of choice

Consumer groups oppose FDA flirtation with medical freedom

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Next week, the FDA will be holding a hearing about letting consumers buy commonly used prescription drugs without a prescription, signaling FDA recognition that empowering consumers to make health care choices is the key to better health at a lower cost. The agency’s proposal is a refreshing departure from the usual administration’s practice of expanding government’s role in our daily lives. Yet so-called consumer groups that want the government to tell Americans how to eat, what cars to drive and what medicines to take are opposing even this small step toward medical freedom.

Indeed, the FDA proposal recognizes that individuals, armed with increasingly individualized information on what’s best for them, can make better decisions than a system where what is spent on health care is determined by bureaucrats. More consumers want more personal responsibility and freedom in making health care decisions, not less. They want to spend less time and money on medical care. So why would some groups oppose making more medications that have been widely used for years - for such conditions as high cholesterol, migraines, and hypertension - more accessible?

Groups such as the Center for Science in the Public Interest and Public Citizen claim the FDA proposal will “permit” people to use more medicines without solid information. On the contrary, the explosion of diagnostics, applications and online communities has increased our ability to responsibly take control of our health and well-being. In today’s digital world, we can use our smartphones to obtain test results and access information tailored to our diagnosis, genetics, health goals and lifestyle. Making drugs for osteoporosis prevention, birth control, migraines, cholesterol and erectile dysfunction available without a prescription would, with appropriate safeguards and new health-information tools, empower people to look after themselves. In fact, evidence shows that moving prescription drugs over the counter (OTC) helps people stay on track with their treatment regimen.

Critics often point to what they claim is misuse of cough medicines as an argument for more FDA regulation of OTC products, not less. But a recent survey I conducted on how American families treat coughs and colds underscores the opportunity self-care can offer to improve health. Over the past year, 61 million consumers avoided missing work, school or other scheduled appointments due to illness because they had access to OTC cough medicines to alleviate their symptoms. And nearly 75 percent of all consumers surveyed complemented cough and cold medicine use with rest, fluids (including chicken soup) and other “home” remedies.

The nearly a third of patients who see a physician for a cold wind up spending $7 billion on office visits and another $2 billion on antibiotics a year even though antibiotics don’t work for such ailments. If we were all forced to run to the doctor and get a prescription every time we coughed or were stuffed up, we would be spending a lot more money treating symptoms that can be alleviated effectively by OTC medicines in our pharmacy or supermarket and, more often than not, resolve on their own.

So why do some groups want to keep Americans shackled to our current system of care? As Eric Topol notes in “The Creative Destruction of Medicine,” access to our “own data and information - whether it be DNA sequence or biosensor remote monitoring - will soon be unprecedented, and surely each individual has more at stake about his or her health than the busy physician who is looking after hundreds to thousands of patients … But change cannot take place unless consumers are the driving force.” Without the ability to conveniently access and use more medicines we know and trust in tandem with such valuable personal health information, the paternalism of the present health care system will prevail. Opponents of the FDA proposal are afraid of losing control over our lives.

There is wisdom in the crowd. The benefits of consumer empowerment outweigh the risks that, in fact, can be managed mostly by we the people by educating each other. Turning more prescription medicines into OTC products not only saves time and money. It enhances our ability to sustain health rather than just treat disease.

Robert Goldberg is co-founder and vice president of the Center for Medicine in the Public Interest.

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