Editorial: Should the Government and Insurance Companies Pay for "Lifestyle" Drugs?

Should taxpayers and insured individuals "pay the bills" for those who, of their own choice, mistreat and abuse their bodies (e.g., alcohol abuse, tobacco abuse, STDs) to the point they are required to have healthcare, including medications?

Should taxpayers and insured individuals pay for drugs for ED, contraceptives, weight control, and other drugs that are taken for the "convenience and enjoyment" of the individual patient?

In summary, we have two different scenarios here; one where a conscious decision was made that resulted in serious health conditions, and the second, where the medication is not for a serious health condition but for the convenience, desires, or pleasure of the patient.

In other words, should taxpayers and insured individuals pay for drugs resulting from a poor decision made by an individual or simply because the individual wants something that is convenient and "enjoyable"?

This puts us in a very awkward position of wanting to care for those in need but at the same time realizing that it cannot be done indefinitely. We are empathetic, but at the same time we question how far it will go.

The original purpose of indigent health programs and insurance programs was to provide a mechanism for providing health care to those that really need it and couldn't afford it. Also, in the case of health insurance, they prepaid for health services through pooling of resources and sharing the risk. However, it seems that government programs and even some insurance benefits have gone far beyond "need" and are being significantly abused.

Many indigent programs are being abused by patients because they have come to the point that they feel it is their "right" and that they have a "right to free health care" (even though some do not even pay taxes), and the system is abused by the pharmaceutical industry because it is simply a mechanism for them to "sell more drugs."

It's about time that "enough is enough"! We cannot afford to pay for everyone's mistakes, desires, convenience, and pleasure!

If a patient has a serious condition or a patient is in real need of being treated so they can function as a productive member of society, then they need to be provided the proper care. However, how long can we continue to pay these escalating costs resulting in out-of-sight taxes and insurance rates? We cannot even afford to provide the care that has already been committed by the federal and state governments, and we stand a good chance of breaking the system so that care will not be available to any patients in the future. Things need to change so that we only pay for what is needed�not what is convenient, not what is desired, not what is pleasurable, and not what is resulting from seriously bad decisions. After all, if treatment is available, what motive is there not to make the bad decisions?

This is not meant to be calloused but a statement of reality and fact. There comes a point in time when individuals must own up to their own responsibilities and reap the benefits/consequences of their own decisions.


Loyd V. Allen, Jr., PhD, RPh

Physicians are encouraged to try nondrug treatments for insomnia by WellPoint Inc., prior to prescription drugs. This is based on the results of a study showing 3.5% of participants reduced the quantity of prescription drugs they took to improve sleep and saved WellPoint $14 each in the five-state experiment. The company plans to expand the program in an effort to cut costs for drugs, diagnostic imaging, and other services; specifically, physicians will be urged not to prescribe medicine until they examine the patient's lifestyle and consider behavioral changes.
http://www.courant.com/business/hc-sleep0619.artjun19,0,3460788.story

From a recent survey, doctors don't trust PHARMA website's drug information about their own products. Only 27% of doctors trusted the information. However, doctors still prefer to receive information online and only 15% opted to receive information from sales reps.
http://www.therapeuticsdaily.com/news/article.cfm?contentValue=1796510&contentType=sentryarticle&channelID=33

The British government found that GlaxoSmithKline PLC withheld findings on the suicide risk of Paxil. In the U.S., Sen. Charles Grassley sent a letter to the FDA suggesting they conduct their own investigation into whether the company withheld findings on the suicide risk of Paxil. The British regulatory agency had found that Glaxo knew Paxil was associated with a higher risk of suicidal behavior as far back as 1998.
http://blogs.wsj.com/health/2008/06/12/sen-grassley-asks-fda-to-probe-glaxo-communication-on-paxil-risks/

Web-monitoring combined with medications and advice may help lower blood pressure, according to a study in the June 25 issue of JAMA. Those patients where a pharmacist was involved resulted in a drop in systolic BP by an average of 14.2 points after one year; 56% in the pharmacist-intervention group got their conditions under control. The problem associated with this is the decrease in reimbursement to the physicians, as they must pay to integrate the web-system into their practice, pay for the pharmacist's time, and receive less reimbursement because of fewer patient office visits.
http://www.reuters.com/article/internetNews/idUSTON47303120080624?pageNumber=2&virtualBrandChannel=0

A physician has been sued because of sloppy penmanship that resulted in putting a patient's health at risk; the patient was given the wrong medication for several months the lawsuit contends. Lithium carbonate was dispensed instead of lanthanum carbonate.
http://www.therapeuticsdaily.com/news/article.cfm?contentValue=1800538&contentType=sentryarticle&channelID=33

Generics have been delayed reaching the market after settlements are reached between the companies involved. In a 12-month period, 14 of 33 agreements were reached that included both a restriction on the generic company's ability to market a drug and compensation that is paid to the generic manufacture to keep the drug off the market.
http://online.wsj.com/public/article/SB121141847788912819.html?mod=2_1566_leftbox

Generic Lipitor will not be available in the U.S. until November 2011 according to an agreement that has been reached between Pfizer and Ranbaxy Laboratories. However, the agreement does allow the generic version in seven other countries, including Australia, Canada, Belgium, Germany, Italy, the Netherlands, and Sweden.
http://www.nytimes.com/2008/06/19/business/19drug.html?_r=1&ref=business&oref=slogin

MARTINDALE: The Extra Pharmacopoeia First Edition (Reproduction)
2008 (Originally published in 1883)

In 1883, Wm. Martindale wrote in the preface to this first edition,

"Sixteen years have elapsed since the publication of the last British Pharmacopoeia, and during this time a number of new drugs have been introduced, many official ones have been put to new uses, and a number of nonofficial preparations of both have of necessity been employed in pharmacy. Operative surgery has been revolutionized by the Antiseptic Treatment of Wounds, Dermatology by the use of Petroleum Ointments, and Therapeutics by the introduction of such important drugs and definite chemical remedies as Salicylic Acid and Salicin, Chloral Hydrate and Croton-Chloral Hydrate, Chrysophanic Acid and Eserine, Gelsemium and Gelsemine, Homatropine and Hyoscyamine, Jaborandi and Pilocarpine, Nitrite of Amyl and Nitroglycerin, Oleated Preparations and Hypodermic Injections. To shortly describe these and their uses is the purpose of this little book."

This reproduction is small, measuring 3.5 inches wide, 6 inches tall, and 7/8 inches thick, but consisting of over 300 pages. It is a very entertaining and educational book. If you use "MARTINDALES" on a regular basis, you definitely need to get a copy of this reproduction of the very first MARTINDALES, published in 1883, for your collection.

Available at: www.pharmpress.com

Most U.S. medical schools do not adequately monitor the money, gifts, and free drug samples that pharmaceutical companies routinely provide to doctors and trainees. Sixty of 150 schools received a "failing grade." Twenty percent are in the process of revising their policies.
http://www.therapeuticsdaily.com/news/article.cfm?contentValue=1790532&contentType=sentryarticle&channelID=33

Neat and Tidy Journals
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