CNN.com: No prescription for the Pill? The FDA considers allowing over-the-counter sale of the pill. The price would be right, and on the surface of it, it would be an extension of a woman’s discretion over her own body. But I think this is a very very bad idea. It comes down to the amount of irrationality, eccentricity and bad judgment there is around so many matters related to sexuality and sex. Because of the possible complications of hormonal treatment, skipping gynecological checkups (as unpleasant as the exams can be) would be tempting but potentially disastrous. Then there’s taking the pill continuously to suppress the inconvenience or discomfort of menstruation, which can be quite medically dangerous if unsupervised. And the problems with potential overdoses (for example, in an ill-advised attempt to induce an abortion). And the considerable potential for adverse interactions with other prescription medications, which no lay person can be expected to recognize or track. By all means, women should learn as much as they can about the incredibly complicated reproductive cycle and its hormonal manipulation, but by all means allow an MD who is qualified to do so and committed to “first doing no harm” be an expert consultant.
Can you really trust the pharmaceutical companies who manufacture and distribute oral contraceptives to give you reliable and complete information in an unregulated market, when the only protective considerations toward their “customers” they have are around product liability costs? Take a look at some of the direct-to-consumer ads for other medications and tell me if they appear to be thoughtful comprehensive attempts to make you an informed careful consumer, or if they’re just trying to sell you something while making the most perfunctory of nods in the direction of product safety, usually in rapidly-scrolling small print. Don’t you bet the industry is just salivating at the potential expansion of this market, and that they will trot out any number of physicians in their pockets to talk about how medically safe this will be?
Other drugs being considered for release from prescribing requirements include antihypertensives, oral diabetic agents, and anti-cholesterol medicines. I’m ambivalent about some of these as well, especially the antihypertensives.
Addendum: an article that develops a more comprehensive critique of the medical advertising phenomenon. “If direct-to-consumer advertising empowers anyone, it’s drug companies.” This comes from a thought-provoking anti-consumerist webzine I was just pointed to, Stay Free.
