Access to drugs

We had a couple of prescription drugs that I knew we would need to refill while in India, and I wasn’t sure of the process. Do I need a script from a doctor? Would they simply refill on the basis of the empty vials from CVS Pharmacy, that referred to the medication and doctor’s name?

We went to refill our first prescription a few weeks ago. And the process was….simple. The hardest part was figuring out the generic name for a brand name medication. No fuss, no muss, no insurance, no questions asked. The total cost was something like $5.00.

I asked whether they “recognized” prescriptions that were on a vial from a US pharmacy. It turns out that you don’t need a vial, or the (expired) prescription approved by a doctor. You could, in fact, google your symptoms, determine what meds you *think* you need, and go in to the pharmacy (called “chemist” here) and purchase. Ritalin, Codeine, whatever.

I asked how they manage to avoid abuse and over-use. The pharmacist said that they don’t dispense to everyone; if it is a sensitive substance and they see that you are over-purchasing, they might deny you. Well, THAT must work pretty well….there are 4 “Chemists” in our little local market; the “abuser” can just rotate.

I remember that Amnon needed a refill for allergy medication, back in the US. This was medication that he had been taking for years. When he went to refill the prescription at one point, the pharmacist said that he needed approval from the doctor. Amnon called the allergist, who said that he hadn’t seen Amnon in 6 months and he would not approve without a visit.

Our cynical side can conclude that this is all just a scam; ensuring that doctors are visited and that doctor’s fees are paid. Or, perhaps that level of “control” over dispensing medication is really important, to avoid abuse and misuse.

One could do the controlled experiment here…. When consumers can easily and (relatively) inexpensively walk into a pharmacy and purchase medications of their choice, is there more misuse? Do people purchase and take the wrong medications? Do people take more than they should, because it’s available? Or can you trust people to regulate themselves?