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A Prescription That No Pharmacist Ever Sees | Commentary

Secretary of Health and Human Services Sylvia Mathews Burwell recently said the administration wants to address difficulties faced by consumers following the implementation of the Affordable Care Act. A good starting point is a provision that’s costing consumers and needlessly burdening doctors, which has received bipartisan support for change.

A provision of the ACA eliminated over-the-counter medicines as eligible reimbursable expenses under flexible spending arrangements and health savings accounts. Given that OTCs are the first line of treatment for most Americans, this provision seems to contrary to the intent of the act.

Clearly, the OTC prescription requirement is creating unforeseen consequences. But it can be easily corrected with passage of the Restoring Access to Medication Act, commonsense legislation that would repeal that provision of the Affordable Care Act and has bipartisan support in both the House and Senate.

For those unfamiliar, FSAs and HSAs are voluntary plans self-funded by consumers with pre-tax dollars. The funds can then be used to pay for qualified medical expenses, up to specified limits, reducing taxable income by the same amount. Prior to 2011, OTC medicines could be freely purchased using funds from these accounts. That’s no longer the case.

The Affordable Care Act included a provision stipulating that OTC expenditures would still be eligible for reimbursement — but only if a doctor first issued a prescription for a nonprescription medicine. In other words, medicines readily available over-the-counter could be purchased with pre-tax dollars after a consumer had taken the unnecessary time and expense to visit a doctor and get a prescription solely for the IRS and individual tax returns.

A number of physicians have told us they’re routinely asked for prescriptions for OTC medicines solely to enable patients with FSAs or HSAs to get reimbursed for such expenditures.

For patients with chronic conditions that can only be treated with OTC medicines, this provision can be a significant burden.

Sjögren’s disease, for example, is a common autoimmune disorder that destroys tear ducts and salivary glands, causing dry mouth and eyes and, if untreated, more severe health complications. It affects about 4 million Americans, 90 percent of them women, who rely on OTC products such as eye drops and mouthwashes to treat their condition.

Without passage of corrective legislation, the Restoring Access to Medication Act, the costs and burden on consumers, physicians and the health care system will only continue to grow and be exacerbated for years to come amid the growing number of prescription medicines being approved by the Food and Drug Administration for over-the-counter sale. Over a hundred popular medicines have already made this transition, including medicines for allergies and acid reduction, as well as nicotine-replacement therapies to help smokers kick the habit.

With cold and flu season upon us, millions of Americans susceptible to colds will yet again be blocked from using funds they’ve diligently saved in FSAs or HSAs to pay for cough medicines and nasal sprays — forcing them to trek to their doctor to get a prescription, further burdening the system.

According to Consumer Health Products Association research, every dollar spent by consumers on OTC medicines cuts the U.S. health care system’s total costs by $6 to $7. More striking still, a 2012 study found that OTC medications create health care savings of some $100 billion a year by eliminating unnecessary doctor’s office visits and reducing use of more expensive prescription medicines.

Let’s once and for all eliminate needless roadblocks that hinder the ability of Americans to take more control of their personal health and wellness. If the FDA deems a drug to be safe for direct sale to consumers, then its sensible use and affordable access should be fostered, not discouraged by an onerous provision of health care reform.

Steven Taylor is CEO of the Sjögren’s Syndrome Foundation. Scott Melville is president and CEO of the Consumer Health Products Association.

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