At a time of almost universal anxiety about the state of the economy and rising unemployment rates, a local grocery store chain is making an effort to ease their customers’ burden. The consequences of their generosity may not be as noble as the intent, however.
Stop&Shop grocery stores recently announced a new promotion in which their pharmacies will dispense a 14-day supply of generic antibiotics (with a valid prescription) at no charge, through March of this year. The tag line for this promotion: “You didn’t pay for the germs, why pay for the antibiotics?”
Photo courtesy of Wikimedia
At first glance, this seems great. Makes sense, right? Reducing the cost of healthcare is always a good thing. There is more to cost than money, however, especially in this case. The “free antibiotics” promotion brought up all sorts of ethical, epidemiological, and sociological questions in my mind (and not only mine. Doctors have already spoken up against this promotion).
First off, who is this promotion supposed to benefit anyway? Technically, there are not supposed to be any more people in Massachusetts without health insurance. Technically. Those who remain without health insurance (and I am willing to bet there are more than a few), would still need a doctor’s prescription to take advantage of the promotion – a prescription they are going to have trouble getting. Secondly, antibiotics are already massively over-prescribed in this country. Will this “free antibiotic” promotion push doctors to prescribe them even more? Especially when facing pressure from the patients who want a “cure,” some pill to take that will make them feel better, even if a bacterial infection isn’t the culprit? Will the patients be less likely to take the full course of antibiotics if they feel they are no longer a precious, expensive commodity, thus promoting the emergence of resistant strains?
I do feel bad looking a gift horse in the mouth, but I think there are bigger issues at stake than simply making every day life affordable. Making it easier and cheaper to acquire antibiotics may cost more in the long run. Am I just being cynical and a curmudgeon (I have been called worse, by the way)? What do y’all think?
Will this “free antibiotic” promotion push doctors to prescribe them even more? Especially when facing pressure from the patients who want a “cure,” some pill to take that will make them feel better, even if a bacterial infection isn’t the culprit?
This happened blatantly in France and is only slowly waning after a recent two-year government effort to educate the public, who indeed put a lot of pressure on their doctors and pediatricians in particular. But it seems much more difficult to change primary care doctors in the U.S., firstly because the visits are so incredibly expensive that there is little incentive to move around.
I contracted a sinus infection, perhaps my twentieth, immediately after a flight to the States one Christmas for a three-week vacation. I knew exactly what I needed. I finally negotiated a doctor’s visit to examine ONLY my head, because not being insured in the U.S. there was no way I would shell out $125 for a visit to tell me what I knew, so I got a $25 visit instead for her to tell me what I knew. Armed with a prescription for generic amoxicillin-clavulonic acid, I was shocked to discover that the full price generic was only $10 less than the name brand version. So I made the grumpy pharmacist call the aggrieved doctor who prescribed (a generic and far more inexpensive) amoxicillin only, and (luckily) recovered, though it was not the most appropriate formulation in theory.
My point is, Anna, that anyone who would be attracted into S&S by free antibiotics, might therefore go see their doctor when they otherwise would not, to get an examination if they know they might be able to afford a prescription. And S&S attracts themselves some business for all the other stuff they sell. But bullying doctors does indeed happen.
I think you’re spot on with this issue actually. As you note, nothing quite comes for free – yes, the antibiotics themselves are free but patients still need a prescription from a doctor, so those without insurance, i.e. the most needy, are unlikely to benefit from this initiative.
In addition, the overprescription of antibiotics is a serious problem. The S&S offer is likely to make the ‘worried well’ press for drugs they don’t need and probably wont finish, increasing the chance that drug-resistant strains will develop.
So ‘cynical’? Maybe. But it’s important to look closely at deals that seem too good to be true, as there’s often a catch.
Heather – It’s so nice to hear that the French government has actually done something to educate people about the potential harm of antibiotics. I am not aware of any large scale campaign to do the same in the States. There should be one, clearly. And I think it should educate doctors as much as it aims to educate the general public. And the other thing you mentioned – that S&S attracts customers… they also make themselves seem all holy and do-gooder-like. Which they aren’t, really, in the long run.
Helen – Whew, glad I wasn’t off base. I am just surprised that S&S is concerned more with their image than the effect on public health. Wait. I take that back. my cynicism tells me I am not at all surprised.