Prescription for controversy

DO to Congress: OTC rule ‘significantly’ cuts into time for sick patients

Joel M. Feder, DO, told a House subcommittee of the burdens of the new rule that expands the need for prescriptions for OTC medications.


Taking aim at the new rule expanding the need for prescriptions for over-the-counter medications, an osteopathic physician testified before Congress in late April. The recently enacted provision of the Affordable Care Act reduces patients’ access to medication while increasing physicians’ administrative burden and liability, family physician Joel M. Feder, DO, told members of the House Ways and Means Committee’s Subcommittee on Oversight.

“This new restriction on the purchase of over-the-counter medications has necessitated changes in how I am able to treat my patients on a daily basis,” said Dr. Feder, testifying on behalf of the AOA on April 25. “I have been forced to make decisions regarding whether or not to charge patients a co-pay if they wish to obtain a prescription. I have also struggled to best determine how to make the time in an already fully scheduled day to fulfill these requests from multiple patients who previously did not require a face-to-face visit.”

The provision, which went into effect Jan. 1, requires prescriptions for most OTC medications purchased with funds from flexible spending accounts and health savings accounts.

Dr. Feder noted that three to five of the approximately 25 patients he sees per day just ask for OTC prescriptions, mostly for simple colds and allergies. “As a result, my time available to address patients with more substantive health care needs has been reduced significantly,” he said.

In addition, the need to schedule appointments and process paperwork for the patients seeking OTC prescriptions has been burdensome for Dr. Feder’s five-physician group practice in Overland Park, Kan., he said.

Dr. Feder pointed out that the provision also adversely affects the physician-patient relationship and increases physician liability. Patients feel inconvenienced by having to see a physician for OTC drug prescriptions, while physicians feel uneasy writing such prescriptions. “I am potentially placed in a difficult and uncomfortable situation with a patient by possibly refusing to provide a prescription, charging for that service or recommending that the patient purchase a higher-cost alternative,” Dr. Feder said.

Dr. Feder noted that physicians who write prescriptions for OTC medications potentially could be held liable for adverse interactions with other such medications.

The AOA supports legislation that would restore consumers’ ability to use flexible spending accounts, health savings accounts and other tax-advantaged accounts for the purchase of OTC medications without a physician’s prescription. In most cases, the U.S. Food and Drug Administration has determined that these products are safe for broad distribution and therefore do not require a prescription.


  1. Michael Mank

    What about the new proposed legislation that will make more medications available OTC by being classified as “safe use” drugs? Seems like the FDA was first trying to limit patient access and now they are looking to excessively expand it. Seems conflicting…

  2. Andrew

    It was a poorly thought out idea to reduce the amount of money in tax-free accounts, but FSA and HSAs are only increasing in popularity with rising health care costs and the down economy. With less money in the household people are looking for more ways to save. So FSAs and HSAs are increasing and so are the complaints.

  3. Chris Burritt D.O.

    This is an example of how the Government interferes with the patient physician-relationship and proof that the ACA “Obama Care” is not about helping patients or physicians but about destroying what good is left in American Medicine. HSAs and FSAs (couple with true insurance) are part of a solid plan to improve care and bring health care decisions back to decisions between patients and their doctors and to lower costs. The current administration wants to destroy patient and physician autonomy; we must understand the bill, then repeal it.

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