Prescription Drugs: Access through Innovation

With the shortage of pharmacists and lack of consumer access to prescription drugs, the distribution of medication has become a prominent and controversial topic in pharmaceutical debate. More than ever, the need for quicker methods of safe drug dispensing is critical to the quality of care and increasing demand for medicines by the aging baby boomers. Healthcare providers must find novel ways to protect consumers’ health by providing patients with access to prescription drugs in an efficient and secure manner. With the increasing need for improvement, I decided to venture out into the blogosphere this week to learn more about the discussions surrounding consumer access to prescription drugs. I found myself drawn to two particular blogs that both describe modern day evolutions in consumers’ access to medication and drug distribution by health care providers. The first post was found in an entrepreneurial blog called Springwise, which is one of the first Internet portals that allow spotters to discuss modern day technological innovations. Within this site, I found Anne Rogan’s discussion on InstyMeds' new “Vending Machine for Prescription Drugs” that allows patients to obtain their prescriptions using an automated dispensing machine for some of the most commonly used medications. The second blog comes from Ed Silverman’s Pharmalot, rated one of the top fifty best business blogs by The Times. His post “Behind-The-Counter Debate Moves Front and Center” discusses the implementation of a new category of drugs by the FDA, in which pharmacists will be given the authority to prescribe certain medications. My comments on these posts can be found below.

“Vending Machine for Prescription Drugs”
Comment:
Dear Ms. Rogan,

Thank you for the informative post on InstyMeds' innovative new prescription drug vending machine (see image to the right). You bring to light many of the advantageous benefits of using this product including saving “pharmacists the slow and potential error-prone process of counting out medications by hand” and the possibility to “alleviate [the] growing shortage of pharmacists”. However, I do think it is also important to discuss the potential negative effects of these automated machines. For one, you state that “the machines include several safeguards to insure patients receive the proper medications their doctors ordered”, how can one be sure that the right medicine is dispensed every time and properly stored in the vending machine? Utilizing your link to InstyMeds' website, and reading the company’s description of their equipment’s safety features, I am still not convinced that the majority of people would feel safe obtaining prescription drugs from a vending machine. With no pharmacist present, there is a greater concern for dangerous drug interactions going undetected and a lack of consultation that may negatively impact a patient’s health. You also present the argument that InstyMeds' prescription drug dispensing system may reduce the need for pharmacists and “potentially chip away at ever-growing healthcare costs”. I would like to expand on that by saying that one must take a complete cost-benefit analysis of the implementation of the new system. Even though, the number of pharmacists needed may be reduced, the machines still have their own maintenance costs and doctors must learn to “create prescriptions electronically”. As seen with electronic medical records, many doctors refuse to make this digital change. Nevertheless, even with the controversial issues surrounding this type of system, the product, as you stated, does have a lot of potential. One way of introducing this system which may put more consumers at ease, is to have the vending machines behind the pharmacy counter like the way El Monte Comprehensive Health Center is contemplating doing. This would eliminate the “counting of medications” and allow pharmacists to continue their consultation with patients to double check the vending machine’s success and ensure product safety.

“Behind-The-Counter Debate Moves Front and Center”
Comment:
Dear Mr. Silverman,

I thoroughly enjoyed reading your post this week regarding behind-the-counter medications. The content was very well rounded and enriched with credible resources and opinions from both sides of the debate regarding the “so-called third category of drug”. Before I began reading your post, I was completely opposed to pharmacists prescribing drugs due to the lack of personal relationship and understanding of a patient’s past and present healthcare needs. I agreed with the American Medical Association that a “lack of proper medical oversight could pose safety risks for patients”. However, the statement from Jerry Harrington you site also brings up a valid point that the behind-the-counter system “adds value because it can provide a transition from prescription status to OTC [over-the-counter] status”. This is supported by Tom Greco’s quote, which states “there are a lot of drugs that are available only by prescription that for all intents and purposes really don’t need to be prescriptions”. Overall, I still have my hesitations of giving more authority to pharmacists to prescribe current prescription drugs (see image on the left), but I can understand the desire to create another category of drugs for those that are borderline prescription and over-the-counter medications. I do believe that the questions brought up by Sid Wolfe from the Health Research Group at Public Citizen are very valid and still need to be addressed before the FDA can implement a new class of drugs. Due to the fact that some pharmacists may not have a good understanding of their patients’ needs and we do not have access to universal electronic medical records yet, I hesitate to fully support behind-the-counter drugs due to the greater risk of medical error.