In-store pharmacy health clinics to expand presence, offering "drive-through" disease diagnosis, pharmaceutical sales

(NaturalNews) The number of walk-in health clinics inside retail stores such as CVS, Target, Walgreens and Wal-Mart is set to quadruple by the end of 2008, drawing controversy from physicians' groups. The retail clinics offer certain key advantages over visits to doctors' offices or emergency rooms, including lower and clearly posted prices, shorter wait times and longer hours than a normal doctor's office. However, most of them rely on family nurse practitioners and have no physician on site. In addition, the American Medical Association and other doctors' groups have accused the clinics of a conflict of interest, because they write prescriptions that can then be filled by the pharmacy in the hosting store.

Doctors have also warned that the relationship between physician and patient could be threatened as the retail clinics become more popular.

Big Pharma critic Mike Adams calls the practice, "Drive-By Medicine," and says that such clinics have a clear financial incentive to find something wrong with patients in order to sell them more drugs. "In-store clinics are customer recruitment stations, not health care centers. They exist solely for the purpose of boosting retail revenues by diagnosing more patients with yet more health conditions, then directing them to purchase high-profit prescription drugs all under the same roof," Adams said.

There are currently an estimated 500 walk-in health clinics in the United States. That number is expected to increase to 700 by the end of 2007 and 2,000 by the end of 2008. Approximately seven percent of U.S. residents have visited one of these clinics, according to retail clinics' group Convenient Care Association.

According to Dr. Rick Kellerman, president of the American Academy of Family Physicians, the clinics are indeed a problem, but they are only one symptom of an inherently flawed national health-care system. "The clinics are one response. They are not an answer," he said, encouraging doctors to reevaluate their own practices.

According to Wal-Mart spokesperson Deisha Galberth, approximately 50 percent of those visiting Wal-Mart clinics are uninsured. According to Sandy Ryan, chief nurse practitioner for Take Care Health clinics, 30 percent of Take Care Health's patients are uninsured and 30 percent have no primary care physician.

According to PricewaterhouseCoopers, 20 percent of U.S. residents live in areas without good access to primary medical care. This shortage of doctors is expected to increase to 200,000 by 2020.

Unanswered Questions Remain Regarding BTC Pharmaceuticals

(NaturalNews) Dr. Sidney Wolfe, Director of Health Research at Public Citizen, recently called for more time, research and input regarding the FDA proposal to create a third class of drugs to be sold behind the counter (BTC) by pharmacists. Public Citizen is a national nonprofit consumer advocacy organization founded in 1971 to “represent consumer interests in Congress, the Executive Branch and in the courts”.

The website (www.worstpills.org) is a Public Citizen site devoted to providing unbiased, expert information on prescription drugs.

Dr. Wolfe says that questions remain about the safety, cost and need for a proposed third classification of drugs by the FDA and asks:

• Do pharmacists have the time and training to explain drug use and side effects to customers? If not, who will provide and pay for this training?

• Will pharmaceutical companies pressure the FDA to have some of their prescription drugs reclassified to BTC status to avoid regulation?

• Will lack of physician oversight in the prescribing process turn pharmacies into “drug vending machines” posing increased health risks to the public?

In a notice to its members, the American Pharmacists Association (APA) lists 25 questions that the organization would like input on regarding BTC availability of certain drugs prior to the FDA Public Comment on November 14, 2007. (A link to the full text is provided in the reference list below)

The role of the pharmacist is central to the BTC discussion. The APA list of questions is a thought provoking compilation of topics that need to be addressed if we are to thoroughly grasp the implications of such a ruling by the FDA.

For example, the APA asks “Would special training be needed for other pharmacy staff to aid in managing the work flow (storage, record keeping, distribution) and additional BTC responsibilities of the pharmacist(s) and the pharmacy? If so, what type of training or measures should be put in place? What impact would BTC availability of drugs have on the practice of medicine? ”

These are important questions that require well defined answers if we are to understand who will be accountable for safety issues related to BTC sales of certain drugs. The self prescribing customer may be the one ultimately accountable for requesting a BTC drug. What guidelines can the public look to when they are assessing a need for a drug and require a thorough understanding of both common and infrequent adverse side effects of potential BTC drugs like statins?

Anyone that saw the ABC News 20/20 Undercover Pharmacy investigation earlier this year will certainly want answers to all of the questions the APA poses. It is not unheard of that part time, untrained staff assists pharmacists; especially at busy pharmacy locations across the US.

Canada, the UK, Germany, France, Italy, Denmark, Sweden, Switzerland, the Netherlands, Australia and New Zealand have already reclassified a number of drugs to BTC status. The APA notes that in these countries, “typically, the pharmacist is required to ensure the patient meets certain criteria prior to dispensing, to provide education on proper use, and to monitor”.

Educate, dispense and monitor. Is it realistic to think that these steps can be comprehensively carried out in already busy pharmacies across the US?

28 Senators vote to maintain Big Pharma monopoly over U.S. consumers; Republicans oppose free trade for medicine

On May 3rd, 2007, U.S. Senators voted on an amendment to the 2007 Prescription Drug User Fee bill that aims to reform the FDA and enhance drug safety. This amendment, known as the "Dorgan Amendment No. 990," threatened to break Big Pharma's monopoly over pharmaceutical sales and allow U.S. consumers, cities, states and businesses to purchase their pharmaceuticals from safety-certified pharmacies located in Canada, Japan, the U.K. and other nations.

Americans currently pay the highest prices in the world for prescription drugs. Canadians, Europeans, and even citizens of Mexico pay only about one-half to as little as one-tenth the price paid by Americans for the very same chemicals. Drug companies actually import many of the raw materials used in pharmaceuticals from other countries, meaning that some U.S. medicines are already sourced from countries like the U.K. and Germany.

Drug companies mark up their prescription drugs as much as 569,000% over the price of the raw materials. (A typical markup is more in the 30,000% - 50,000% range.) Retailing pharmaceuticals is hugely profitable. There is no business in the world with more profit built in to the retail price of the product. The purpose of restricting Americans from buying drugs from other countries is to enforce a medical monopoly in the United States, forcing consumers to purchase drugs at the highest prices in the world, further padding the profits of powerful and influential pharmaceutical corporations who exert strong influence over the Bush Administration and Republican lawmakers.

The FDA has, over the past several years, colluded with drug companies to maintain a monopoly market in the United States in order to protect those profits. It has taken actions such as raiding a bus load of senior citizens returning to the U.S. from Canada, searching the elderly for legal drugs. The FDA has gone to great lengths to pressure U.S. customs to seize pharmaceutical shipments being imported for sale to individual consumers in the United States, and it has even invoked the fantasy-based fear tactic of suggesting that terrorists might adulterate pharmaceuticals coming to the U.S. from Canada (and therefore we should all buy our drugs only from U.S. monopoly-controlled pharmacies because of "terrorists").

Dorgan amendment proposes free trade for medicine

The Dorgan amendment, entitled, "Pharmaceutical Market Access and Drug Safety Act of 2007," proposes what is essentially a free trade policy on prescription medications. It would allow Americans to buy their drugs from certain certified organizations registered as valid importers or exporters. The bill states, "...a prescription drug is neither safe nor effective to an individual who cannot afford it," and goes on to describe rigorous safety requirements that would be required by the amendment, including safety inspections and registrations as well as funding efforts to locate and shut down fraudulent internet sales of counterfeit prescription drugs.

If passed into the law, this amendment would save U.S. citizens, businesses, and government entities (local, state and federal) billions of dollars each year by allowing them to source medications in a price competitive environment. Many cities and states are right now facing the very real possibility of bankruptcy due to health care costs (providing benefits to current and former government employees). A large percentage of those costs are spent on monopoly-priced pharmaceuticals. This Dorgan amendment would set city and state governments free to finally engage in fundamental free market price comparisons and save substantial sums of money in sourcing the very same chemical medications for their employees and retirees.