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Should the sale of antibiotics be restricted?

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I live in Mexico and I can assure you that's not quite the case.

Many pharmacies give discounts to drugs purchased through insurance or corporate plans. To buy them those in the plan must present a card from their insurer or employer and a medical prescription (most plans don't cover self-medication). I've bought plenty of drugs, prescription and over the counter, and I've never had a discount merely for presenting a prescription.

I think that must have been what I saw during one visit a few years back. I noticed that there were two prices on a box of Picot (an OTC antacid) and some Naprosyn I was buying before it was available off the shelf here. The pharmacist asked us if we had a "receta," which for me (my family is from Spain and Cuba) always meant prescription.

I ran into this same scenario in Spain, where my cousin told me after I bought some meds on my own that it woud have been cheaper with a prescription. Presumably, that means either that a private or state-run health plan would then subsidize or control the price. In my own health plan, a medicine that I take ends up costing me less than the minimum copayment because the negotiated price between my Rx plan and the drug store chain is lower than the cash price. If I'd pay cash, this medicine would cost me about $16, where it's just over $10 for me, even though the health plan is paying zero.

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I think that must have been what I saw during one visit a few years back. I noticed that there were two prices on a box of Picot (an OTC antacid) and some Naprosyn I was buying before it was available off the shelf here.

When and where was that?

Medicine boxes are usually marked with a maximum retail price by the manufacturer. Most pharmacies will respect that, but some don't. Back in the hyper inflationary period of the mid 80s, though, the max price was a joke no one took seriously.

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First, not helping someone is not a crime. Even if they die. Even if you could have saved them. If someone creates an antibiotic or antiviral, they are under no moral obligation to give it to anyone. Thus the whole discussion is moot, the creator of the drug owns it and should be free to do with it whatever he wants. If he makes it available in such a way that resistant strains become common, he has just destroyed the value of his creation. No one is worse off than before he created it.

That is the principled argument. Now for a little conjecture (the example only illustrates the point, the above argument is true in itself):

I manage a drug company. I have just spent 10 billion dollars of my shareholder's money to create "murderallbacterioxicin" of which a proper dose is 99.99% lethal to all existing strains of bacteria. Do I:

1. Distribute it freely so every Tom, Dick and Harry can buy it at a street corner and take it as he pleases thus promoting the rise of bacterial strains resistant to my (ex-)wonder drug and destroying my product's market value;

2. Create a system of distribution that guarantees (by contract) that patients who use my drug will take the full course of medication thus killing off the damn bugs and preserving the medicine's potency.

Hmm, tough choice...

As expected, with the proper system in place (individual freedom of action, property rights), the good is promoted. The moral is the practical.

Edited by mrocktor
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  • 2 weeks later...

Today, the BBC has a story related to antibiotic resistance. Scientists have discovered the specific mechanism by which Streptococcus pneumoniae, become resistant to penicillin. (The article says this bacteria kills 5 million children each year.) Having discovered the specific mechanism, scientists hope they can develop a means to disrupt it.

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