11 ms·
This is amazing, it will help a lot of people have access to a drug that can vastly improve quality of life without being gatekept by their doctor. Just one no
by lalaithion 3y ago
This is amazing, it will help a lot of people have access to a drug that can vastly improve quality of life without being gatekept by their doctor.
Just one note about the phrasing of all the headlines: they’re phrased as if the FDA did a good thing, but it’s better to imagine this as the FDA _stopping_ doing a bad thing. The only reason that we haven’t had over the counter oral contraceptive for the last fifty years is because the FDA _didn’t_ allow it over the counter.
- jokowueu 3y agoWhat's odd is that in most of the middle east all non abusable drugs are over the counter . Not sure why it's not a thing in the US . Insulin was recently non otc because body builders abuse it ( deaths )
- candiddevmike 3y agoThere's a bit more nuance here. There is certainly a political angle, but there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly.
- pyuser583 3y agoWe saw this with Theranos. They lobbied really hard to stop doctors from being gatekeepers to blood tests.
- jrockway 3y agoWhat's the problem? Theranos committed fraud and their founder is in prison. Meanwhile, you can order blood tests. Early in the COVID pandemic I thought I had it at the very start. I got myself an antibody test and found that I didn't. Good data, and I didn't need to go wait in a doctor's office with a bunch of COVID patients.
- runako 3y ago> but there may be risks, especially if folks don't take the medicine correctly. This describes every over-the-counter drug that has ever been sold. Keeping contraception prescription-only has always been about politics.
- candiddevmike 3y agoThere are non hormonal options out there like IUDs (and condoms) that may be a better option though. Speaking as a parent, I would rather have my kids come talk to me /my wife about this stuff and work with us and a doctor to figure out what's best for them long term. I recognize not every kid has that kind of relationship with their parents and would benefit from purchasing it directly.
- odyssey7 3y agoAs much as this is coming from a good place with good intentions, some things are human rights[1] that parents shouldn’t be able to withhold. [1] https://theweek.com/articles/470330/birth-control-human-right https://theweek.com/articles/470330/birth-control-human-righ...
- giantg2 3y agoThat doesn't contradict what the parent is saying. Having access to non-hormonal options still fulfills the UN stance.
- nsxwolf 3y agoThis being a "human right" seems like a matter of opinion.
- Levitz 3y agoYour article talks about an annual report, then links another article written 3 years before the one you link, said article doesn't link to the report. So I search for the report itself: https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%20EN-Final.pdf https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%... And the claim is nowhere near the one you are making. What the UNFPA (who can't even declare anything a human right, by the way) is saying is: >Family planning is anchored in respect for human rights, women’s empowerment, and social justice and quality. And >In October, UNFPA published its annual The State of World Population report, which made the case that family planning is a basic human right that unlocks unprecedented rewards for women in terms of health, economic power and gender equality. Putting medical barriers to access the pill is by no means whatsoever a violation of human rights.
- apsec112 3y agoThe risks of pregnancy are much worse! Pregnancy is really tough and can lead to eleventy zillion health complications
- toomuchtodo 3y agoAlso, ~40% of children born into poverty remain in poverty [1], and it costs $310k per child from 0-18 (excluding daycare and college costs) [2]. Broadly accessible reproductive healthcare is about as impactful as vaccines from a value delivered for the cost perspective. You want to avoid as many both unintended and unwanted pregnancies as possible (which ["unintended"] stands at about half of all US [3] and global [4] pregnancies annually). EDIT (hn throttling, can't reply): People who don't want children should be enabled and empowered to not have them. I am surprised that is a controversial opinion. [1] https://www.pbs.org/wgbh/frontline/article/how-poverty-can-follow-children-into-adulthood/ https://www.pbs.org/wgbh/frontline/article/how-poverty-can-f... [2] https://news.ycombinator.com/item?id=33991744 https://news.ycombinator.com/item?id=33991744 [3] https://www.guttmacher.org/sites/default/files/factsheet/fb-unintended-pregnancy-us.pdf https://www.guttmacher.org/sites/default/files/factsheet/fb-... [4] https://www.unfpa.org/press/nearly-half-all-pregnancies-are-unintended-global-crisis-says-new-unfpa-report https://www.unfpa.org/press/nearly-half-all-pregnancies-are-...
- NoZebra120vClip 3y ago[flagged]
- mrguyorama 3y agoHelping poor people who do not WANT kids not HAVE kids is not Eugenics but rather their basic human rights in a world that invented birth control.
- ToValueFunfetti 3y agoWhen you're doing it explicitly because 40% of their offspring will be poor, I think you've at least entered a gray area. Aligning with the interests of eugenicists is hardly an argument against a policy though.
- sixothree 3y agoI think you would be amazed how many people don't "have a doctor" and simultaneously are the same people who would benefit from this.
- giantg2 3y agoI'm pretty sure you don't have to "have" a doctor for this. MinuteClinics and such can provide this. I would guess there are websites you can get Rx through too.
- 0cf8612b2e1e 3y agoThat’s still a needless barrier. If you are poor every dollar counts and being required to pay for a medical professional to rubber stamp a prescription does more harm than good.
- giantg2 3y agoI'd like see the data that supports that. If true, we would do away with the prescription process altogether for most drugs.
- 0cf8612b2e1e 3y agoThat women find getting birth control a hassle? Ask anyone.
- giantg2 3y agoNo, that the prescription process is providing more harm than good.
- travisjungroth 3y agoHaving a doctor rubber stamp a prescription does more harm than good. If the argument is that getting a prescription is such a simple task it should cost almost nothing and be done instantly, then it likely doesn’t need to exist as a barrier at all.
- donatj 3y agoI think you overplay how much people actually listen to their doctor. I contend people listen to packaging and doctors about equally well.
- dmoy 3y ago> Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly. In related news, it is shockingly easy to get messed up real bad by Tylenol. But you can get it in a 500-pill bottle from Costco.
- Scubabear68 3y agoMy cousin is a toxicologist and he was talking about this in the 1980s - that the public had no idea how incredibly toxic Tylenol is and how easy it is to over dose on it and cause significant damage to your liver and other organs.
- zinclozenge 3y agoThe worst is that if you "OD" on tylenol, you won't die right away, but instead slowly and increasingly painfully over time, perfectly aware of what's going on.
- dboreham 3y agoDepends on the country. In the UK people typically are aware of the dangers of acetaminophen, and you can't buy giant bottles.
- crote 3y agoThat's pretty much a USA thing, though. In Europe you'll usually only come across blister packs, and they don't really go beyond 50 / box. It is a lot harder to accidentally OD when you have to individually remove every single pill from a blister pack, rather than just chugging a fistful straight out of the bottle.
- dmoy 3y agoSure, but the context here is why it took so long for the US to allow otc bc pills, the same country that allows 500 pill bottles of acetaminophen
- Levitz 3y ago
- elijaht 3y agoA lot of that ends up being bureaucratic wastes of time though. My partner was on birth control for years and had to jump through so many hoops - Had to go to yearly appointments to continue receiving it - Could not pick up more than a month at a time, which created logistical issues since they HAD to take it daily - Had to get the prescription renewed every three months or so, which often led to delays filling it It led to a ton of needlessly frustrating situations since the pill is so dependent on taking it daily.
- mustacheemperor 3y agoYou are the first commenter to relate anything like even a secondhand real life experience with oral birth control. This thread (edit: at the time I am posting this) is full of men with little real knowledge of this drug insisting on why it’s reasonable it took 50 years for this to be available OTC. I don’t think the contents of their explanations are likely to be accurate, but I think they still explain why it took 50 years to be approved.
- ModernMech 3y agoYour comment is at the top of the thread, so thank you for pointing this out before I waded further into the comment section. I'm sure you saved me some grief.
- SantalBlush 3y agoThis goes for other things on HN, too. If the topic doesn't involve programming, it's mostly just uninformed people talking shit.
- cudgy 3y agoBecause, naturally, humans can only be informed about a single topic: their career. Therefore, programmers are only capable of being knowledgeable about programming. And doctors are only capable of being knowledgable about medicine. And plumbers are only informed about plumbing topics. Really?
- renewiltord 3y agoWait, what exactly has a zero risk? Drinking water has a non zero risk. Breathing air has a non zero risk. I once looked up at the sky. Pretty sure the risk wasn't zero.
- sonigcgg 3y agoWhat is your point? Eating fast food everyday has a non zero risk. Arguably a really high risk. Do you want a prescription for what you can eat as well?
- TheCoelacanth 3y agoThat's true, but there are also very large risks with becoming pregnant. Historically, I believe it is by far the single largest cause of death for young women. Things have improved, but it is still quite risky. Everything in life involves risks, but I believe on net this reduces risk.
- ramesh31 3y ago>there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Nonsense. I can walk into any store in the country and buy enough Tylenol to kill myself for $5 no questions asked. This is an unqualified good thing.
- extragood 3y agoI agree, and I see a lot of false equivalence comparing BC to the dangers of Tylenol/acetaminophen/paracetamol in this thread. Yes, both are drugs and can be misused with disastrous or even fatal consequences. The important distinction is that you can use oral contraceptives correctly and still have seriously negative, life-altering side effects. There are alternatives which may be preferable and ideally every woman should have access to a medical expert who can guide them to make the best choice. Access to an appropriate medical resource is in the other issue, in the absence of a completely safe and effective option. And that seems to outweigh the risks in the the US. I can only hope that, when given the option, women continue to consult medical professionals even though there is now an over-the-counter option available.
- kodah 3y agoSure, and you can use NSAIDs correctly and experience the same. For instance, if you're taking methotrexate. At some point you need to have a new avenue for disseminating that type of information, especially when doctors visits are becoming more inconvenient and expensive.
- kaitai 3y agoI think that it's really shitty that one can take hormonal birth control with perfect responsibility and encounter negative side effects. I also think it's really shitty that the US has the highest infant and maternal mortality rates in the developed world. I've had to deal with both sides (taking hormonal birth control, with some side effects; having a "high risk" pregnancy and being confronted with forced surgery that would increase my mortality burden, against empirical medical evidence but for insurance reasons). My philosophy is consistent: given that the hand of cards is shitty, I want to choose how I play the cards. Ideally, as you say, folks should have full access to knowledgeable medical experts who can help guide them. Again, our mechanisms for delivery of care in the US don't allow that, and unfortunately our physician and nurse training doesn't facilitate that either. A lot of medical professionals insist that hormonal BC doesn't have side effects, many insurance companies don't cover experimentation to find the best method for a particular person, non-hormonal woman-controlled methods are underused in the US. Since medicine in the US is built around making money & defending against lawsuits, care gets lost.
- jlarocco 3y agoWalking across the street is a risk. Should I be required to discuss it with my doctor first? If you're concerned, you can talk to your doctor first. No need for everybody to live their lives by your whims.
- deleted 3y ago[deleted]
- hunson_abadeer 3y ago> there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. This costs money in the US. And it costs time and effort everywhere in the world, with doctors frequently using this as a hook to force you to visit them regularly and bill you or your insurance for that. And it's just disempowering bureaucratic bullshit when the risk is far less consequential than most other risks we take in life. Do you have a permission slip from your doctor for sitting in front of the computer all day? That's far worse to your health than oral contraceptives.
- Obscurity4340 3y agoThere are a lot of OTC meds that are literally more dangerous or side effect heavy or have objectively worse risks, or are more damaging with long-term use than their superior prescription-only counterparts. Even within prescription medications, it is ironic that they often schedule more leniently based on the potential toxicity+lack of abuse potential (stick+ lack of carrot).
- schoolornot 3y agoMaybe it's time for the FDA to just do quality checks but otherwise screw off. I'm tired of having to order 100% safe drugs from Indian pharmacies. No question they are colluding with Big Pharma. Is there any reason the "Farmacia" model of Latin American countries, where you go in and pay per-pill for whatever you want wouldn't work here?
- sixothree 3y agoOut of curiosity (and ignorance), what kind of things are available in India that are gatekeeped here?
- ultrarunner 3y agoFor the longest time, something as simple as Voltarin was not available OTC in the US, but could easily be obtained from other countries. It's an anti-inflamatory cream used for joint pain that you don't have to eat, so lower risk of side-effects to stomach, liver, and kidneys.
- noodlenotes 3y agoSunscreen! Korea and Japan have great sunscreens that don't feel oily or icky on your skin because they're able to use more modern ingredients. The FDA hasn't approved new sunscreen ingredients since 1999. This is important for people (commonly women) who regularly use skincare treatments that make their skin extra sensitive to the sun. They want daily facial sunscreen that doesn't feel greasy. We end up buying it on eBay because it's not allowed to be sold in the US.
- mastersummoner 3y agoModafinil is one.
- cnelsenmilt 3y agoRegulatory capture is a real problem, but are you suggesting we'd be better off if the same Big Pharma could just market and sell whatever it pleased?
- 3y ago
- giantg2 3y agoWas there really any gatekeeping going on for this in the first place? Seems more like just about everyone who asks recieves it.
- myself248 3y agoSpotted the person who's never been without health insurance.
- giantg2 3y agoYou still require payment for OTC. You can get birth control from places that don't require insurance like MinuteClinics and online for a cost of about $20 for the visit.
- muhehe 3y agoCorrect. We, the high-tech HN crowd, often forget about third world countries with terrible healt care.
- not_the_fda 3y agoIts more about needing the Dr appointment. A Dr appointment isn't cheap if you are poor and lack insurance, and many places have wait time of a year to get an appointment.
- giantg2 3y agoYou can get birth control from places that don't require insurance like MinuteClinics and online for a cost of about $20 for the visit. I'm pretty sure the online option does not have long wait times.
- renewiltord 3y agoThis is 3 hours of minimum wage work to get a rubber stamp to get it. Interesting.
- gwern 3y agoSame story with home pregnancy tests: https://www.nytimes.com/2016/07/31/opinion/sunday/could-women-be-trusted-with-their-own-pregnancy-tests.html https://www.nytimes.com/2016/07/31/opinion/sunday/could-wome...
- bastardoperator 3y agoWe also don't have to worry about pharmacist denying people (mostly women) birth control because they have moral objection to it.
- basisword 3y agoWhen you refer to the doctors as gatekeepers is it because they are doing something other than ensuring you have a safe experience with the drug, or is it more a comment on inability to access doctors due to US private medical system?
- pevey 3y agoYes Both And also the more mundane reason that an extra hoop to jump through is unnecessary and does more harm than good.
- ironcurtain 3y ago[flagged]
- dang 3y agoWe've banned this account for breaking the site guidelines, not just with this personal attack but in plenty of other places. That's not cool. Please don't create accounts to break HN's rules with—it will eventually get your main account banned as well. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html