OTC AH, HMOs, & FDA

When I lived on the U.S. East coast, I never suffered from allergies. When I moved West…whammo. There is something in the air out here, not indigenous to the East, that my nasal passages aren’t at all happy about. To make things even more annoying, the allergies have steadily gotten worse as I get older. (I’m looking after my parents, so moving isn’t an option at this point.) But that’s not my complaint. No, what irks me is that there’s still only one OTC (over-the-counter) antihistamine available to me, and it isn’t the one I want.

Claritin has been available OTC since late 2002. Which was well and good for many allergy sufferers, but Claritin tends to make me a little drowsy. I much prefer its competitor, Allegra. It was widely expected that Allegra was going to be OTC within another year or two. Here we are, 3 1/2 years later, and there’s no sign of any movement in that direction (the same applies to Zyrtec).

From what I can gather, the delay is the usual American stand-by: greed. Simply put, the makers of Allegra can make more money offering it at elevated prices as a prescription drug than they feel they can in the wilderness known as the free market. What’s fun/aggravating are the excuses:

• Consumers can’t be trusted to diagnose their own symptoms and self-prescribe this strong of an antihistamine.

  Yes…because the rush to emergency rooms of people who have self-prescribed Claritin has been appalling. And what about those poor Canadians, who actually do have OTC Allegra available to them? Clearly it’s a plot against Kleenex to ensure that runny-nosed Canucks don’t use so many tissues.

• These are powerful drugs, and need a doctor’s supervision to use safely.

  You mean the very same drugs that are touted in ad after ad as "safe and effective"? Please. Besides, the FDA has said that there’s no reason Allegra and Zyrtec can’t be moved OTC.

• Without medical subsidies, the higher prices per pill to the poor will effectively be a disproportionate tax.

  This might actually an effective argument if it wasn’t for the fact it’s the drug company that’s setting its own price.

  Amazingly, the insurance companies have been trying to push the FDA to make Allegra OTC. They have to spend millions and millions of dollars to make up the difference between the Rx co-pay the customer shells out, and what the drug company is charging.

  Haven’t I just made their point? It’s cheaper to get Allegra through an HMO/PPO/EIEIO? I know it is for me (based on Claritin’s current low price of $0.75 a dose). Of course, that doesn’t factor in such things as my doctor’s co-pay in order to get the prescription, or the time I have to take to go to the doctor. When you factor all of this in…it’s about a wash.

  Don’t get me wrong…I think the OTC costs of Claritin (and presumably of Allegra, should it ever be there) are higher than they should be, but if I’m in allergic distress, and I’ve just discovered I’m out of Allegra, what do you think I’m going to do? Yup…Walgreens. And the product I’ll buy? Well, there’s really only one choice now, isn’t there?

  But back to the "tax on the poor" the higher OTC cost would be. Have they read the stats on the growing wave of uninsured Americans? The ones who can’t afford the $100-250 premiums each month to stay in managed health care, but who can afford $30 for a couple of months to get through allergy season? Thank heaven the drug companies are looking after them.

It’s time that the FDA show some backbone in this and "encourage" the makers of Allegra and Zyrtec to release their products to the OTC market. There aren’t going to be a flood of overdoses, and the few misdiagnosed sinus infections probably aren’t going to be much different than is the case now. This isn’t about looking after the public good, but lining pockets and war chests.

I want my OTC Allegra, and I want it NOW! Literally…Achoo!