Saturday, October 23, 2010

Viagra prescribed more safely online than in regular practice?

They looked at records of questionnaires taken and prescribing decisions made by a licensed, regulated online pharmacy called KwikMed — that is trying very hard to establish itself as ethically and legally different from those fly by night guys whose spam comments will rapidly attach to this post! They looked at the various outcomes and end points including safety and level of counseling and found that the online system produced results as good as or better as those found from a big records review in an unnamed (not surprisingly!) large multi-specialty clinic in Salt Lake City, UT.

Now obviously the ability to create an online questionnaire for specific conditions with clear inclusion/exclusion criteria (like ED or hair loss) means that as clear a picture can be gained in most cases from a good history taken online--and probably the history will be given more honestly by the patient. Plus the rigor of the history is probably better than one taken in a rushed office visit. And then it gets reviewed by a doctor who may recommend another approach but most times agrees and sends the Rx on to be filled.

I met with the Kwikmed folks randomly last week (and yes they were excited about the article). They've got a pretty sizable business in terms of ED drugs and hair loss drugs and are keeping quite a few doctors busy. The next question is can this type of study justify more online prescribing in different drug categories, or of course can they extend online visits into other categories, such as allowing people to order their own lab tests.

They of course think the answer is both. 

Of course, the core savings that Kwikmed delivers is that you don't have to pay for the doctor visit and the prescription, as they bundle it together. When it's a cash visit and a cash prescription as many of those lifestyle drugs are, then it makes sense for the patient. Of course the same is true for those paying in a high-deductible scenario.

But the more general point is that it'a another piece of evidence that at least some medical care can effectively go online at a lower price point than traditional care.

And why not? The world's flat, right?

Why shouldn't every benefit, including pricing leverage, wholesale access to provider or supplier services, and user friendly quality "indicia", be accessible to those in need?

As mentioned elsewhere on THCB in the "The Affordability Factor" [which has been met by silence from the author], why not extend the value of group purchasing to the general public and specifically those not represented by third party "aggregators", e.g., health plan, insurance company, TPA, MSO, MCO, PSN, PHO, OWA, etc? Why does one have to be enrolled in a diminishing benefits health plan or variant thereon in order to benefit from market pricing via purchasing entities?

Why are private plans, and the government the sole beneficiaries of paying $.15 to $.30 on the dollar while the uninsured must operate in the world of retail medicine?

If the web can facilitate legitimate pharmaceutical access, and perhaps encourage a greater level of diagnostic honesty then so be it.

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Posted by: Rick | Dec 6, 2009 2:39:05 AM


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