It wasn’t that long ago when asthma and severe allergies, like anaphylaxis, were treated with fumigating powders, caustic vapors, opium and stramonium cigarettes. Patients were debilitated, unable to work, go to school and many died.
The last 30 years have brought radical advancements in research, technology, medical devices and treatment. Federally funded evidence-based national asthma and anaphylaxis treatment guidelines are shown to prevent needless death and suffering while reducing healthcare costs.
Yet a new paradigm to cut healthcare costs proposed by the Food and Drug Administration threatens to deliver us back to the dark ages.
In the new world, physician visits would be limited only to those who are “seriously ill.” Asthma and anaphylaxis medications would be available without a prescription – a plan that would shift more risks and costs to parents of young children and adults affected by these conditions.
Instead of routine care and monitoring provided by medical care practitioners, patients would be encouraged to seek diagnostic and treatment advice from pharmacists, pharmacy kiosks and online-based algorithms. The special interest groups who would most benefit from this shift are already ringing the cash registers, and representatives from their associations dominated the public hearing held three weeks after the agency announced its proposal in the federal register.
Despite statements about how the FDA’s goal is to free up physician visits for more seriously ill patients, this dramatic policy shift feels more like an attempt to flush patient care and medication costs out of the reimbursement system as rapidly as possible, leaving patients gasping for air and drowning in out-of-pocket health expenses.
Shockingly, not only does the proposal completely disregard proven national treatment guideline and standards for care, it ignores a wealth of federally funded research that shows how solo and substandard asthma and anaphylaxis care is far more costly than strategic physician-directed treatment. In fact, the most expensive part of asthma and anaphylaxis comes when there is a failure to properly identify the cause of the illness or how to efficiently treat it – a likely outcome if the FDA’s proposal gets adopted.
Just days ago, Centers for Disease Control’s latest assessment of asthma and allergies in America advised those with asthma and allergies should work with their doctor to create a plan to control and treat the conditions. With the FDA’s proposal flying in the face of reason and evidence-based research, we’re left wondering what prompted the agency to suddenly abandon its public health, food and drug safety mandate.
Cutting health care costs is a worthwhile objective. However, it should not be done in a way that leaves the more than 24 million Americans with asthma and the millions at risk of anaphylaxis at greater peril. Inevitably, we could all pay the price if patients are left to fend for themselves, potentially trading qualified care for higher priced urgent care and emergency room visits and the suffering and loss of productivity that goes hand-in-hand.
As we celebrate National Asthma Awareness Month in May, it is critical for our country’s leaders to remember the importance of developing policies that protect and respect asthma and allergy patients’ access to evidence-based medicine. And they should start with a critical examination of the FDA proposal.
Sander is president and founder of Allergy & Asthma Network Mothers of Asthmatics (AANMA), the leading national nonprofit dedicated to eliminating death and suffering due to asthma, allergies and related conditions.
First published in The Hill Newspaper’s Congress Blog, May 9, 2012
For more information on this issue and what you can do about it, visit AANMA’s Advocacy page