Over-the-Counter Diabetes and High Blood Pressure Drugs Plan

Medications currently available only on prescription to treat diabetes and other common conditions could one day be sold over the counter, the US Food and Drug Administration has said.  The controversial suggestion comes as a possible way to encourage people with diabetes, high blood pressure, and high cholesterol to take their life saving drugs more regularly.

Up to one third of all adults in the US suffer from raised blood pressure, which can lead to heart disease, and 26 million in the country have diabetes, which can cause serious complications, including heart disease.  Around one in every six adults has high cholesterol – higher levels of LDLs – which can double their chance of heart attacks.  The cost to the nation’s healthcare facilities of these conditions is immense – diabetes alone cost the US $174 billion in 2007, according to the American Diabetes Association.  High blood pressure cost the country $76 billion in 2010 alone.  Separating the statistics out can be tricky, as diabetes itself can cause heart disease and high blood pressure, and if left untreated it leads to kidney disease, blindness, nerve damage and an array of other conditions.

Doctors have noted that many patients show resistance to taking their medication as prescribed, which can lead to conditions going untreated and leading to greater health issues.  Around a third of patients with high blood pressure, for example, stop taking their prescribed drugs at some stage.  So the proposal has been made that medications such as statins, used to lower cholesterol, and metformin, used for the treatment of high blood sugar in diabetics, could be made available over the counter.

The thinking appears to be that patients may be more diligent about taking their drugs if they can obtain them without going to their doctor every time they finish a course.  However, the idea, on which the FDA was inviting public comment up to the end of March 2012, does raise some questions.

Over the counter remedies are usually available only for minor, temporary illnesses such as flu, colds and upset stomachs, and the active ingredients involved have been licensed for sale without prescription because they are safe and have few side effects.  In the case of drugs that are currently available only on a doctor’s prescription a whole range of problems arise when patients gain access to them without advice.

A doctor will prescribe drugs for chronic conditions based on his expert knowledge of the condition and of the patient in particular. He will be aware of side effects and contraindications, and will know how to select the correct dose and avoid clashes between medications that interact with each other.

Under the new scheme patients may have to understand complex issues surrounding their disease, or be able to understand factors such as the actual level of their cholesterol – normally measured with a blood test.  For these reasons, the FDA has refused to allow over the counter sale of drugs such as statins in the past.

However new technology may be able to help in this situation, with ideas including point-of-sale computer information perhaps in self-serve kiosks to help customers understand the use and side effects of the drugs they plan to buy.

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