The real cost of free antibiotics

More than a few grocery store chains have recently announced that they would provide free generic antibiotics to their customers who present a prescription. Normally Consumer Reports would applaud this kind of price competition, but not in this case.

Inappropriate use of antibiotics in viral infections such as the common cold, bronchitis, and run-of-the-mill sore throat is still much too common. Antibiotics not only don't help those viral infections but can cause serious side effects. In addition, every antibiotic prescribed unnecessarily increases the risk of a future infection from a bacterial mutation that is resistant to antibiotics. Consumer activists supported by Consumers Union have long led a national campaign to raise awareness of deadly health-care acquired infections, such as methicillin- (a type of penicillin) resistant staphylococcus aureus (MRSA) or a super-infection from Clostridium difficile. We expect hospitals and doctors to figure out how to prevent such disastrous infections, but pharmacies and consumers should help too. 

All doctors are human. In my own practice refusal to prescribe an antibiotic was the most common reason patients became upset with me and questioned my advice. I could often see it coming, and to be honest, some days I just didn’t have it in me to get into an argument.

Research focused on drug costs has shown that the price patients pay is an important factor in asking for and filling a prescription. We know from recent evidence that many patients are doing without important drugs in order to get through tougher financial times. The opposite is also true: When drugs are free, consumers want them and use them more. Another possible problem of the giveaway program is that it could lead to stockpiling of antibiotics for a rainy day by patients who see several doctors and receive prescriptions from each. Theoretically, such practices could cause drug shortages.

Why did these pharmacies choose antibiotics and not another class of drugs, such as blood pressure medicines, to give away for free? Considerable research suggests that making the most common high blood pressure drugs free would significantly improve people's health. More people would take these important medicines, reducing heart attack, stroke, and kidney disease. Our guess is that this would not be good business for pharmacies. Antibiotics are typically used for only a short period of time and could be used to lure potential customers into the store.

Pharmacies have a responsibility beyond their market share and bottom lines. Good old American capitalism can work well, but in this case it could help resistant bacteria more than consumers.

—John Santa, M.D., M.P.H., director, Consumer Reports Health Ratings Center

Read our blog on preventing MRSA, learn more about the national campaign StopHospitalInfections.org, and TELL US WHAT YOU THINK about the free antibiotics program.

Comments

[Lisa]

I agree that free is not always better but in this case the Dr prescribing the meds is the check to balance it out. suffering with an infection because you can't afford the antibiotic or treatment can become life threatening. I have a friend with a very bad impacted tooth with infected nerve and she is dependent on the antibiotics being free. she had to borrow money just to pay the clinic 30$ to prescribe it. If the supermarkets are willing to offer free antibiotics to help those who can't afford it, then I don't really care if they profit too. and yes the other meds would be great too probably better. The bottom line is I trust my doctor to say NO if I don't need the meds, I certainly trust my doctor better than supermarkets to regulate if it is needed or not. Don't YOU!

[Bill]

This seems like a two-step process. First, the doctor prescribes the drug(s). Then the pharmacy fills the prescription. Assuming the patient has a prescription from their doctor, I think it is FANTASTIC if a pharmacy chooses to dispense the drugs for free. If the patient doesn't need antibiotics, the doctor shouldn't prescribe them. If the doctor prescribes antibiotics just to keep patients, then the patient is still going to get it filled regardless of whether it is free or not.

*****Unless the original argument is that, knowing the pills would be free, the patient would go to the doctor, or insist on antibiotics, when they otherwise would not (because they couldn't afford antibiotics at full price.)*********

I am not a doctor or pharmacist, and I don't doubt that there are dangers in taking antibiotics unneccesarily or too often. And I agree that free heart medicine would be great too. (I have heart disease.) But I disagree that a pharmacy giving out free medicine is a bad thing. How about people who REALLY NEED antibiotics? Isn't the free medicine a benefit to them? And if it is a good public relations and sales strategy for the pharmacy, then it is a win-win.

SO DOCTORS: ONLY PRESCRIBE ANTIBIOTICS IF THE PATIENT NEEDS THEM!

[Denzil, registered pharmacist]

As a pharmacist, I see how SOME doctors give patients whatever they request, and even compete with other doctors in the area by their freely prescribing pen. Example, one dr in the area does not give refills on controlled medication. Another dr gives 5 refills so that patients will come to him. Many people believe their dr is good because he/she gives them what they want. I propose, that a good dr is one that will listen and maybe say no to your requests, but propose alternatives that will help you solve you medical problem.

[Mary]

I have to agree with David and I'm not sure I say it any better than he did.

[David Drescher]

The problem is with the author's inability to stand up to the patient. He failed to explain the truth and refuse to write a prescription.

[Bill]

Right on Nina. Indiscriminate dispensing of antibiotics at no financial cost to the patient can well lead to serious physical costs later on. Self-diagnosis by the patient of a potentially serious ailment which does not respond to the antibiotic they have in hand can lead to serious complications up to and including death, to say nothing of therapeutic incompatabilities, or allergic reactions that may occur.
And when one may be dealing with MRSA or C-diff infections.....watch out !!!

[Nina]

The antibiotic giveaway is a poor idea. People want what's free whether it's appropriate or not. And please doctors, get a spine! If antibiotics aren't going to help, don't prescribe them to an uninformed patient. That just hurts all of us.