Should patients be allowed to use online questionnaires, patient kiosks or other self-assessment technologies to determine the need for and obtain medications which now require prescriptions? The FDA is taking up just that question this week in hearings at its DC headquarters.
The FDA is looking at ending prescription requirements for drugs used for several chronic conditions, including diabetes, asthma, high blood pressure, migraines and high cholesterol. It seems that the FDA has been paying close attention to the tech world, including movements like mobile tracking of health and the general trend toward self-assessment and consumer data collection.
According to iHealthBeat, the FDA thinks it might be a good idea to let consumers figure out whether they need certain medications by answering questions posed on a Website (a practice which, it should be noted, has been common on what are now rogue pharmaceutical sites) or perhaps respond to questions at a patient kiosk. I imagine that if enacted, such rules would apply to smartphones and tablets too.
A pharmacist from UC-San Diego quoted in the story argues that while some members of the public will be able to manage the information needed and make good decisions, others won’t. This is definitely a legitimate concern.
As I see it, though, our job in the health IT industry is to study models like these and see what failsafes we can put into to make self-prescribing as bulletproof as taking money out of an ATM machine.
It’s going to take sophisticated logic to get the right questions out there, smart machines to make inadvertent answers almost impossible, and crystal clear UIs to keep consumers oriented, but I think this has to happen. After all, consumers are adopting health IT more and more each day. The barn door is open and the horse is running around, so let’s saddle it and leverage that energy!
Some things to consider;
1. Some meds should not need prescriptions. An example is zyxal; derived from zyrtec but not as good a sedative as the original (keep in mind that these are antihistamines).
2. Diabetics ought to be able to note on some form of portal that their supplies are running low, and have that portal get ok’s from doctor and insurance company for refill – with minimal hassle. Of course this would work best if the patient’s pump, meter and CGM data were easily dumped to the portal for the doctor to do a sanity check and see if a visit was merited.
One huge concern; prescription insurance coverage tends to be useless without a prescription, and many drugs and supplies now covered under such plans might lose coverage – and become unaffordable to many people. That would be a very bad outcome of the proposed change.