Why Use an Online Pharmacy?

Why buy from an online pharmacy when there are many local places to purchase medication? Are online pharmacies unethical? This article will attempt to discuss these questions and hopefully provide some conclusive answers. Since the beginning of online pharmacies there has been ongoing discussion and some action as to banning the use of online pharmacies altogether in the United States from both people using them and also for the online pharmacies, by implementing harsh fines and punishments.

Unfortunately for the online pharmacy industry there are some online pharmacies that are complete frauds which sells who knows what as medications to make steep profits for themselves. For the most part though there are many legitimate online pharmacies that sell the highest quality FDA approved medications, a careful online search done on the pharmacy you are considering buying from is an excellent idea so you don’t get ripped off. There is a particular usefulness of an online pharmacy that should be considered and examined before a wholesale banning of online pharmacies, either governmentally or personally. Before making an uneducated decision a person should critically examine both sides of the arguments of both the pros and cons of an online pharmacy.

Some pros of an online pharmacy are the following:

– A person suffering from embarrassing ailments such as erectile dysfunction for example, can receive proper drug treatments without the embarrassment of a local doctor and pharmacy visit

– In our extremely busy lifestyles the ease of buying from an online pharmacy is a huge benefit in saving time, effort and money, the relative speed and ease of ordering needed medications online are second to none

– Along with the above point purchasing medication online is able to be accomplished at anytime during the day or night, 365 days a year, you can buy your medications when you have time to do so

– If carefully planned, buying medications online are the most cost effective ways to purchase medications

– A shut in or disabled person requiring medications is able to order their needed drugs online when it is far too much effort or far too costly to make a personal visit to a doctor for a prescription

Some cons of an online pharmacy are the following:

– Government authorities like the FDA have a very difficult time regulating and checking up on the amounts of certain restricted medications being sold to individuals

– Government authorities like the FDA have a very difficult time discovering where an online pharmacy is receiving its source of medications from and whether or not these sources are pure

– If the proper research is not done an online pharmacy could be selling impure medications or even sawdust packaged as a certain approved medication and thus ripping off its customers

– An online pharmacy if left unchecked and unrestricted could be shipping out medications that are possibly restricted or dangerous without a proper prescription

A person deciding to purchase medication from an online pharmacy can take several precautions to help to insure a safe, honest and positive experience using an online pharmacy and minimize the risks of ordering from an online pharmacy.

Some precautions to take are the following:

– Search online forums and consumer review sites discussing the particular online pharmacies that you are considering making a purchase from

– One idea in safety is obtaining a prescription from your doctor before ordering from an online pharmacy, and then you have some assurance that you are receiving the correct medication for your ailment

– Always examine carefully the privacy policy and the legal terms and conditions of the online store that is selling the medication before ordering

– Be positive that online pharmacy’s credit card transactions are SSL secured (the lock on the bottom of the screen is there when ordering) before ordering

– If the site you are visiting seems to have lots of missing web pages, errors, etc. this could be a sign that this site is not the most reputable for ordering medications from

– If you have a funny unsafe feeling when going through the ordering process from a particular website perhaps decide on another and/or perform some of the above tests on the site

Now it is up to you, the consumer as to whether or not you will purchase your medications from an online pharmacy or purchase your medications from a local drug store. Considering all the pros and cons a person can easily make up their minds as to which route is the best to choose. Remember precautions always minimize the risks.

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Online Pharmacies and Telemedicine

Not a day goes by when our email inboxes do not fill with advertisements for prescription drugs. Many of these emails promise to deliver drugs of all classes by overnight courier without a prescription. While there are legitimate online pharmacies, and the practice of telemedicine or cyber-medicine is gaining acceptance, this change in the way medicine is being practiced is rocking the foundations of the medical establishment. Being able to consult a doctor online, and obtain prescription drugs delivered to your doorstep by UPS has broad social and legal implications. The Internet facilitates making drugs available to those who may not be able to afford to pay US prices, are embarrassed to see a doctor face-to-face, or are suffering from pain, the treatment of which puts most doctors in direct conflict with the ‘war on drugs’ but on the other hand there is the question whether these pharmacies make drugs available to recreational drug users without the oversight of a licensed medical practitioner.

The Need for Alternatives

Medical care in the US has reached a point where it is expensive and impersonal which has caused the consumer to become generally unsatisfied with the medical establishment as a whole. Examples include the huge differences between the cost of drugs in the US and Canada, long wait times in US pharmacies, and poor service in general. Perhaps realizing this, US customs appears to tolerate the millions of Americans that visit Canada every year to buy their medications, as for the most part, these ‘drug buyers’ are elderly American’s that can’t afford the high cost of filling their prescriptions in the US.

Rather than to travel to Canada or Mexico millions of Americans are now turning to the Internet for both their medical needs. Telemedicine (or cyber medicine) provides consumers with the ability to both consult with a doctor online and order drugs over the Internet at discounted prices. This has resulted in consumers turning to online pharmacies for their medical needs, and in particular pharmacies with a relationships with a physician, which allow the consumer to completely bypass the traditional brick and mortar pharmacies, with the added benefit of having their physician act as an intermediary between the consumer and the pharmacy. According to Johnson (2005) this is as a result of consumers becoming very dissatisfied when it comes to dealing with both brick and mortar pharmacies and medical practitioners. As Johnson, notes, “Consumers are more likely to know the name of their hairdresser than their pharmacist.” When Johnson (2005) rated the various professions within the health care system, he found that pharmacists had the lowest interaction with their patients than did any other group. Today, as a result of this “consumers are buying 25.5 percent of their prescriptions online, opposed to 13.5 percent of which are picked up at a brick and mortar pharmacy” (Johnson 2005).

Drugs and Society

What has brought so much attention to online pharmacies is that it is possible to obtain just about any drug without a prescription online. Many of these prescriptions are for legitimate purposes purchased through an online pharmacy because the buyer is too embarrassed to visit the doctor or for other reasons including the unavailability of FDA approved drugs to the consumer. These drugs may include steroids that due to their misuse and being classed as a classed a category three drugs, are seldom prescribed by physicians. These drugs have a useful purpose to those suffering from any wasting disease such as AIDS, they also play a role in ant-aging (FDA, 2004).

The Doctor Patient Relationship

Today a visit to a doctor is generally brief, much of the triage it is done by a nurse or a nurse practitioner with the doctor only dropping in for a few minutes, if at all. In many cases the patient is seen by a nurse practitioner. One of the arguments against telemedicine or perhaps a better term is cyber-medicine, is that the doctor does not have a physical relationship with the patients and thus is in no position to make a diagnosis, and thus can not legally prescribe drugs.

Ironically when one compares the work up that one has to go through to consult with an online physicians and compares this to a face-to-face visit with a brick and mortar doctor, one finds that the online physician, in many cases, has a better understanding of the patient’s medical condition than does the doctor who meets face-to-face with the patient. In most cases before an on-line a doctor prescribes any type of medication they insist on a full blood workup they may also require that one has additional tests performed, for example.

The AMA, the federal government, and various states claim, however, that it is illegal for a doctor to prescribe drugs without a valid doctor-patient relationship. While there are no laws at present that outlaw online pharmacies, various states have enacted legislation, or are in the process of enacting legislation to prohibit a doctor from prescribing drugs to a patient that they have not seen face to face. Some states also require that the doctor that prescribes the drugs be licensed in their state. This alone could hamper the development of cyber-medicine. According to William Hubbard (2004), FDA associate commissioner “The Food and Drug Administration says it is giving states first crack at legal action, though it will step in when states do not act” (FDA, 2004).

Internet Pharmacies

The reason that email boxes around the country fill up with offers to supply drugs of all kinds, at reduced prices, without prescriptions, and more is because people buy them as the billions of dollars the drug companies are making each year attest to. The Internet has become the drug store of choice for many.

Categories of Internet Pharmacies

Internet pharmacies are generally acknowledged to be comprised of the following five categories:

Internet pharmacies can be divided up into five different categories, as follows:

Licensed online pharmacies with a no medical affiliation.

Licensed online pharmacies with a medical affiliation

No record online pharmacies (NRP)

International online pharmacies (IOP)

Licensed compounding pharmacies

The licensed online pharmacies with a no medical affiliation are of course Drugstore.com, CVV, and others. They all require a prescription from a licensed doctor that the patient has a doctor patient relationship with. The prescription can be called in by the doctor.

The licensed online pharmacies with a medical affiliation often depend on a broker. The broker collects your medical information, and then assigns your case to one of their networked physicians. Many of these networked physicians are willing to prescribe pain killers as they believe that it is only through the use of these drugs that some people can live a harmonious life.

A Government Accountability Office (GAO) Committee on aging held in June 2004 found that “Unlicensed international pharmacies do not require a prescription, and are generally located off shore.” No prescription pharmacies can be found all over the world. Many of these sites have come under controversy as in some cases all it takes to have that prescription delivered to you by next day air, is to fill out a questionnaire online.

A study conducted by Henkle in 2002 to ascertain how easy it would be to obtain drugs over the Internet found that “37 of the 46″ pharmacy required a prescription from a licensed doctor. The emphasis was on the prescription and not on the doctor. Henkle (2002) in fact notes that some sites offered to recommend a doctor.” Henkle (2002) was able to obtain prescription drugs from nine sites outside the US during the study, without a prescription.

Online pharmacies with a doctor affiliation

There are a number of online pharmacies, with a medical affiliation is that take great pain to differentiate themselves form unlicensed overseas pharmacies. These pharmacies, stress that they are “American based companies that provides consumer’s easy access to FDA approved online prescriptions over the Internet and are quick to point out that “An online consultation can be just as relevant as an in-person consultation.” It is interesting to note that many of these online pharmacies also point out that “While they are committed to making access to online prescriptions easier, they believe that the Internet can not replace the importance of regular doctor visits to fully evaluate your health and any medical conditions.” Many of these online pharmacy sites also makes a wealth of drug information available on its web site that enables the consumer to educate themselves on drugs that may have been prescribed. The Internet has for all intensive purposes is quickly replacing the brick and mortar base physician as a patient’s primary health care provider.

A sales pitch, of course, or is it? Most of the legitimate online pharmacies ensure that they comply with state and federal regulation. The doctors are licensed in all 50 states and their pharmacies are too. These legitimate Internet pharmacies cater to those that are looking for a better price; for some it comes down to making the choice of eating cat food on crackers in order to afford their medications because of the high US drug prices. In other cases patients resort to cyber-medicine to avoid the embarrassment of having to deal with a physician or pharmacy that may be judgmental. Many of these online pharmacies will arrange a consult with a licensed, medical doctor over the phone and will then fill the prescription accordingly.

According to Henkel (2000) “More and more consumers are using the Internet for health reasons” and references a study carried out by a market research firm Cyber Dialogue Inc., “that found that “health concerns are the sixth most common reason people go online” (Henkel 2000).

For many people a trip to the pharmacy is an ordeal. In some cases the local pharmacy may also be located in the closest town which may mean a long drive if one lives in a rural community. Online pharmacies provide a means through which their prescriptions can be delivered conveniently and quickly. Being online also allows the consumer to shop for the best prices, an important factor if one is living on a pension.

The Internet has also created a more aware user. It is not unusual for a consumer to research drugs on the Internet. A consumer may have seen a TV or magazine advertisement advertising a new drug. Ultimately, the Internet also provides the consumer the opportunity to enter into a doctor patient relationship that may in fact be more legitimate than the doctor who makes a physical appearance. Further information on doctors that practice telemedicine can be found at: http://www.becomeone.com

It is interesting to note, as discussed previously, that consumers are becoming dissatisfied with the care and treatment they receive from both brick and mortar physicians and pharmacies. Zanf (2001), references a study by Lang and Fullerton that “Identified four factors related to outpatient pharmacy services: professional communication, physical and emotional comfort, demographics, and location and convenience.” All of which are contributing factors as to why more and more consumers are resorting to cyber-medicine.

The Dark Side

There is also a dark side to the Internet pharmacy, as previously discussed, spam email touting the availability of any prescription drug one could want, without a prescription, is something everyone is familiar with has reached epidemic proportions.

From Ambien, and of course Viagra to more powerful drugs such as Oxycontin, you can have it all. Over night shipping is available in most case, or so these emails proclaim.
In some instances this pharmacy spam originates from unscrupulous individuals who have no intention of delivering the drugs, realizing that very few people, if any, will complain about the non delivery of an illegal drug through the mail.

In other cases the drugs are sent without a prescription from countries where that particular drug may legally be sold without a prescription, or at least the laws are more relaxed. Valium, for example, is sold over-the-counter in Taiwan.

According to Crawford (2004) “Consumers who purchase drugs online thinking that they are they are getting the same drugs as they would from their local brick-and-mortar pharmacy are being misled, and as a result are putting their health, and eventually their lives at risk” Crawford cites examples of Internet pharmacies supplying drugs that were under strength, contaminated and mislabeled (Crawford 2004).

According to Won (2005) Drug-industry executives think the Internet and mail-order operations will be the biggest source of counterfeit drugs over the next five years, according to a report released today by Ernst & Young. According to James G Dickinson (2005):

The federal government in July shut down an alleged illegal Internet pharmacy for selling counterfeit drugs and issued a warning on other counterfeits found to have been sold in Mexican border pharmacies to individual patients from the U.S. The Internet pharmacy had sold more than $7 million in counterfeit Viagra and other prescription drugs over the past five years, according to the San Diego Union-Tribune. The San Diego-based operation required individuals to complete a $35 “doctor consultation” survey before receiving the prescriptions, but the survey was never shown to a health professional to evaluate whether a safety risk existed, the paper says (Dickson, 2005).

In a separate action, the FDA warned Americans about counterfeit versions of Merck’s cholesterol drug Zocor and generic Carisoprodol – used for treating musculoskeletal conditions – that had been imported from Mexico by individual Americans (FDA, 2005).

Over the last year patients suffering from pain, and other conditions that they are reluctant to see a doctor face-to-face, have had the option of consulting a doctor online. The ability to consult with a doctor online, and then to receive drugs as a result has come under much controversy. This has for the most part been as a result of not adequately screening patient’s records, or ordering from unregulated overseas pharmacies.

The Internet – a new way of marketing

Not all Internet pharmacies are illegitimate, however, and there are many pharmacies that provide the consumer with a legitimate prescription by overnight service. My last prescription came by mail. The whole transaction was completed over the Internet. It was a prescription that my doctor had given to me personally, however. As discussed, what constitutes a doctor patient relationship is at the crux of the online pharmacy debate. This of course has implications as to what constitutes a legitimate prescription. What constitutes a legitimate prescription is a hotly debated topic.

The Future

As noted, being able to consult a doctor over the phone, and then have one’s prescription filled by an Internet pharmacy is convenient for many people. As the American population ages, more and more people will have trouble getting to the doctors office, not to mention driving to the pharmacy. Clearly safeguards are needed if cyber-medicine is to raise the quality of medical care available to Americans. The online pharmaceutical industry has taken a number of steps to ensure that consumers are protected against unscrupulous online pharmacy operators including the certification of online pharmacies.

According to Henkel (2000) “One way consumers can ensure the quality of an online pharmacy is to look for the Verified Internet Pharmacy Practice Sites (VIPPS) seal.” According to Henkel (2000) any site bearing this seal has gone through a rigorous series of quality checks which are part of the Verified Internet Pharmacy Practice Sites program. Unfortunately as Henkel (2000) notes, “Because VIPPS certification is fairly new and voluntary, only a few sites have been certified so far.” Recognizing the problem of ‘rouge’ pharmacies, SquareTrade, has also implemented a program to protect consumers from ‘rouge’ pharmacies. According to SquareTrade, “The Licensed Pharmacy program verifies that your business is a pharmacy in good standing. Verified pharmacies can display the Licensed Pharmacy Seal on their websites – distinguishing themselves from unverified and rogue pharmacies.”

If these safe guards are not put in place, and legislation is enacted that makes it illegal to obtain a prescription from an online pharmacy based on an online consult, the black market for drugs will continue to thrive. Customs by its own admission only catches approximately 2% of all illicit prescription drugs that enter the US.

Negating the fact that through technology, one could enter into a doctor patient relationship that may be affordable. Security, as some have suggested could be accomplished through the use of video cameras and biometric scanners which would cut down on the number of fraudulent prescriptions written. Measures like these would put the convenience of using an online pharmacy out of the reach of those without the technology. One could also not prevent consumers from using off shore online pharmacies. While the FDA is presently trying very hard to get the Canadian government to enact legislation that would prohibit the export of drugs from Canada by mail it appears that the profit that results from the sale of drugs is causing the legislation to stall. As one Canadian pharmacy owner noted, however “We will just move to the UK.”

Ironically, the Canadian’s are offering to crack down, not because of any concerns relating to the sale of drugs online, but because Canada controls drug prices, making them far cheaper than the same drug in the US. The Canadian authorities are planning on cracking down “arguing that the system was created to help Canadians, not Americans.” The drug industry itself has gone so far as to black list Canadian pharmacies that sell to American customers over the Internet. With all the paranoia relating to terrorism there is a concern that any drug coming in from another country may be contaminated. There are no instances on record of a consumer having received a contaminated drug from Canada (Matthews, 2003).

Even more ironically with all the talk about the dangers of drugs purchased from overseas, some legitimate companies are now being forced to buy from other than US sources because they have been black listed by US drug manufactures (Matthews, 2003). Mathews (2003) goes on to illustrate this by pointing out that “Canadian suppliers, in particular, that have been blacklisted, are now turning to sources in Europe.” Mathews (2003) notes that while for the most part these European sources are legitimate and make a high quality drug. In some cases, however Mathews et al. (2003) note that the pharmacies are having to go ‘farther a field’ to find product.

Conclusion

While there need for controls to be put in place to regulate the practice of both medicine online and Internet pharmacies, we also need to acknowledge that science and technology has furthered the practice of medicine, and that the Internet will further it yet.

The Internet has the potential of expanding medical care to those that may not routinely seek it, or are too infirm to travel to the doctor’s office. While the present trend appears to be to make it illegal for a doctor to prescribe drugs without seeing the patient face-to-face there is also a move to establish rules and regulations that ensure that patients receive quality care over the Internet. Unfortunately medicine and politics have become so intertwined and doctors have inadvertently become unwilling agents in the war against drugs.

One can’t turn back the clock though, and according to Larkin (1999) “At a July 30 US Department of Commerce hearing on the benefits and risks of ‘drugstores on the net’, the question was examined.” The main issue was how to shutdown the online pharmacies run by unscrupulous individuals, while still fostering the legitimate online pharmacy business in order to both promote commerce and still protect the consumer (Larkin, 1999). According to Larkin (1999) “What’s new here is not the practice of pharmacy, but the way we communicate with and inform customers.”

Article Source: http://EzineArticles.com/80740

Online Pharmacy is Best Place to Buy Pharmacy Products

vitamins, over the counter medicines, weight loss products, diabetic supplies, and much more. Also, at an online pharmacy, you have a choice to either visit the pharmacy (store) or have vitamins, over the counter medicines, weight loss products, diabetic supplies, and much more.

Also, at an online pharmacy, you have a choice to either visit the pharmacy (store) or have the online pharmacy fill and send your prescription through the mail. When you have your prescription drugs mailed, various pharmacies have to follow particular steps and special rules to check, fill and send your prescription drugs.

When you are at the online pharmacy website and filling out the forms with your name, address, etc. and your doctor’s prescription information, they will also need a payment method to finalize the prescription order, plus any insurance payment information or medical plan you are using. Depending on which online pharmacy you use, they will either accept a payment online for delivery purposes or you will have to visit the actual store to complete the prescription payment process.

Also, one very important thing to consider at the online pharmacy your are using is that they have a secured checkout, payment system! In future, any sites where you purchase items online make sure that this “https” configuration is in the website address, anything else can be hacked and your address, payment, and medical information stolen by Internet criminals.

Online pharmacy is the next generation of pharmacy, with the explosion of the worldwide web, every land based pharmacy will have a web presence, website, if they want to stay in business and be competitive in the pharmacy industry. When you finally select an online pharmacy website that you would like to do business with, check their site credentials, make sure that they are a “Verified Internet Pharmacy Practice Website” defined by the “National Association of Boards of Pharmacy.” If you are concerned about the online pharmacy site and they aren’t answering all your questions, there are many other sites on the Internet to choose.

One good tip about choosing online pharmacies is to select one that is associated with a large pharmacy chain, a well known pharmacy group. This way, you know the large pharmacy or someone else you know and have dealt when them before. The trust factor is minimized and your securityScience Articles, bank and credit information will be kept secured. “The Online Pharmacy” is the future of Pharmacy!.

Buy Medicines from an Online Pharmacy

Online pharmacy is considered as next generation of pharmacy. With this revolution, every land based pharmacy must have a web presence.

In this competitive business, if they want to stay alive, they must need these online pharmacy web sites. Before selecting the online pharmacy web site, which you want to business with them make sure that they are Verified Internet Pharmacy Practice Website defined by the National Association of Boards of Pharmacy.

There are lots of valued online pharmacy web sites are providing the services to their loyal customers in a professional way. For these services, you need to fill the form with your name, mailing address and doctor’s prescription information. After that you need to finalize the order, you need to select the payment mode or medical plans using. You need to pay the amount either online, or you have to visit the original store to complete the process for payment depends upon the stores you have selected.

There are lots of main things to be considered before ordering the pharmacy. The main thing is the online pharmacy store website, which you have selected has a secured checkout and online payment system. And also this web site must have the configuration http in the website address or not. Because now a day lot of websites is hacked and your address, payment and medical information will be stolen by any internet criminals.

Here is a suggestion that you need to select the best one that is associate with a large pharmacy chain. And also it should be a well known pharmacy group.

Always check to see that the online pharmacy is staffed by fully licensed professional pharmacists.

Watch out for counterfeit drugs. There have been numerous cases where online pharmacies have sold counterfeit or fake drugs. These are often ineffective or dangerous to your health. When you receive your online prescription, check the delivery carefully to ensure that the package appears genuine and has not been broken or tampered with.

There are lots of advantages while selecting the trust oneFind Article, because they will keep your bank and credit information as a secured factor. Here one thing to remember that this online pharmacy is the easy way to purchase medicines.

Pre-paid health care on a mobile

South Africans used to pay-as-you-go cellphone airtime can now use their mobile to purchase healthcare services for use in times of need from Yarona Care.
Pre-paid health care on a mobileThe concept, from Bradley Soll, MD of Yarona, one of the largest independent healthcare provider networks in South Africa, has been partnered with Makhonya Investments, a Congress of Traditional Leaders of South Africa (Contralesa) led investment company, which has a 26% shareholding.

The new healthcare products allow patients to see a doctor or dentist and to buy medicines when needed. According to Nkosi Phathekile Holomisa, president of Contralesa, “The healthcare voucher is purchased and loaded onto a cellphone and can be used when and where needed. The pre-paid voucher can be kept on a cellphone for as long as a year and can be used or transferred to a family member or friend in need of healthcare services. That is how easy it is to access healthcare when you need it the most.”

Soll explains that there are now nine products on offer, which will be gradually rolled out across South Africa over the next twelve months. “The pre-paid voucher allows patients to see participating doctors or dentists who will then redeem the cellphone voucher and provide the necessary healthcare services.”

The company decided to use the cellphone as a means of delivering its product because of its growing popularity. There are at present more than 40 million cellphones users in the country and the technology is well understood and fully embraced by young and old alike.

Kenya: Healthcare hurdles in Nairobi’s slums

Quality healthcare is a luxury often beyond the reach of those who live in Nairobi’s slums, such as mother-of-seven Grace Awour Opondo.
NAIROBI, 11 July 2008 (IRIN) – When you are sick you buy medicine from the local shops,” Opondo told IRIN. “If you are lucky you recover because the medicine is not usually the right one.

“Sometimes there is no medicine even in the hospitals, so they send you out with a prescription,” she said. “Then the chemists are expensive so often one has to make do without the medicine.”

According to Sakwa Mwangala, a programme manager with the African Medical and Research Foundation (AMREF), the fact that people are squatting on government land often prevents them from accessing essential services. Slums are regarded as informal illegal settlements, which means they are underserved in terms of infrastructure development and access to basic amenities.

“Government health facilities are also not easily accessible for most slum residents,” said Mwangala, who heads AMREF’s Kibera integrated healthcare programme. Kibera, on the southwestern edge of central Nairobi, is one of the largest and most densely populated slums in sub-Saharan Africa.

Most people operating health “facilities” in the slums are quacks, he said. “There is a lack of quality control, with the people in most of these clinics lacking skills.”

The urban poor fare worse than their rural counterparts on most health indicators, according to a report, Profiling the burden of disease on the residents of Nairobi slums prepared by the African Population and Health Research Center (APHRC).

Pneumonia, diarrhoeal diseases and stillbirths account for more than half the deaths of children under-five, while HIV/AIDS, tuberculosis, interpersonal violence injuries and road traffic accidents account for more than two-thirds of deaths among people aged five years and older, stated the report.

The poor health status of slum children is in part due to continuous exposure to environmental hazards coupled with a lack of basic amenities.

“The chances of one becoming sick are high because of the poor sanitation; most of the houses are also poorly ventilated,” according to Leonard Wawire, a teacher in the Mathare slum.

“Here, there are no trees to clean the air; any plant growing is usually growing out of waste,” Wawire said.

Changing the way we buy medicines

Researchers in the United States propose consumers buy yearly ‘medicine licenses’ as new way to pay for prescriptions.
Changing the way consumers pay for prescription medicines so that the system more closely resembles paying for cell phones or computer software could increase medicine use without altering patients’ out-of-pocket spending, health plan costs or pharmaceutical company profits, according to a new RAND Corporation study.

Researchers propose that consumers pay an annual “license” fee that would entitle them to a year’s worth of medicine for each prescription they take on an ongoing basis, with a very small or no co-payment for each monthly supply.

Such a system could be used to pay for medicines that treat chronic conditions such as high cholesterol, diabetes or asthma without increasing the cost to consumers and may reduce the periods when patients go without such medicines because of the cost, according to a study published in the journal Health Affairs.

A new way

“We propose a fundamentally new way for consumers to pay for medicines that are taken for long periods of time to treat chronic health conditions,” said Dana Goldman, corporation chair in health economics and director of the Bing Centre for Health Economics at RAND, a non-profit research organization. “We believe this approach can help improve patient care without costing anyone more money.”

Researchers suggest that a pilot study be organized with the cooperation of health insurers and medicine manufacturers to test the benefits of the proposal.

The “two-part pricing” scheme outlined by researchers is used to pay for products in many areas outside the medical world. Payments for Internet service, cable and satellite television, all-you-can-eat buffets and country club memberships are all examples of the pricing plan. Consumers pay a set fee to cover a period of time, with unlimited access to the services. Consumers can use as much or as little as they need.

Maybe the best example of the pricing plan is computer software, researchers say. Instead of paying a fee every time a computer is turned on, consumers pay a one-time fee to buy a license for unlimited use of a company’s computer software operating system, for example.

Low production costs

What makes pharmaceuticals similar to these products – and different from other health services – are the very low costs of production and the existence of few good substitutes, researchers say.

The article in Health Affairs outlines how a medicine-licensing system might be used to pay for statin medicines – the most-popular form of prescription medication used to treat high cholesterol. Researchers examined the current costs of the medicines and how the new pricing plan might affect patient compliance – whether patients are taking medicines as prescribed by their physicians.

Researchers propose that consumers pay a $195 fee for an annual license for the statin medicines – equal to what most consumers now pay out of their own pockets each year if they have insurance plans that require $25 per-prescription co-payments. Insurance companies would pay an additional $374 to pharmaceutical companies for each statin license.

Because there would be no monthly out-of-pocket payments for consumers, researchers suggest that patients would be more likely to take their prescriptions. Analyzing past research about the impact of rising co-payments on patient compliance, researchers suggest the average annual use among patients taking statins would climb from 7.8 months to 9.8 months under the new pricing plan.

The increased use of the medication among patients may result in fewer long-term health problems and lower overall costs to insurance providers, according to the study.

Make it easier to pay

“The up-front cost may discourage some patients from starting medicines, but that could be overcome by allowing monthly payment plans,” Goldman said. “Research suggests that eliminating or greatly reducing co-payments for individual prescriptions will encourage patients to stick with their medicine regimes and that will improve the quality of medical care.”

Spending on prescription medicines has outpaced the growth in total spending on health care in the United States, growing 10% from 1998 to 2003 compared to 5% growth in all health care costs.

Rising medicine costs have caused many insurance plans to increase the co-payments made by consumers, leading to greater concerns about patients skipping medications because of cost. Physicians regularly distribute free samples to patients and some insurance plans have even begun requesting that enrollees engage in pill splitting – dividing higher-dose tablets to avoid buying additional prescriptions.