AAFP Cries Foul Over Prescription Requirements for OTC Medications

Many FPs and their patients were surprised to learn in January 2011 that a provision in the Patient Protection and Affordable Care Act required a physician's prescription to use funds from so-called tax-preferred health accounts to purchase OTC items. Now, the AAFP has joined with dozens of other organizations in calling on Congress to repeal the provision, which "increases costs to the health care system and places a new administrative burden on already overburdened physician offices," according to members of the Health Choices Coalition, of which the AAFP is a member.

In an April 25 letter (3-page PDF; About PDFs) to the House Ways and Means Committee, the coalition said the provision has "resulted in unintended consequences to both physicians and patients."

The coalition sent the letter to the committee as it prepared to hold a hearing on the provision that limits the use of tax-preferred account funds to pay for OTC medications. In the letter, the coalition described the provision as "bad policy" and called on Congress to restore the ability to pay for OTC medicines with tax-preferred account funds.

"Consumers depend on OTC medicines as a first line of defense for their families' health care needs," the letter said. "These medicines save consumers billions of dollars annually through reducing unnecessary doctors' visits, increased productivity at work and the cost advantages of using OTC medicines as a frontline treatment."

According to the letter, a recent study (12-page PDF; About PDFs) "found that OTC medicines contribute a total of $102 billion each year in savings and cost avoidance in the health care system."

"In other words, for every $1 spent on OTC medicines, the health care system reaps $6 to $7 in savings. The availability of OTC medicines off-the-shelf and without a prescription provides medicines for an estimated 60 million people who would otherwise not seek treatment."

Millions of American families rely on flexible spending accounts (FSAs), health savings accounts, and other tax-preferred accounts to purchase OTC medications, according to the letter. "This issue is of critical importance to the estimated 19 million working Americans who rely on voluntary contributions of pre-tax dollars to FSAs to help meet their basic health care needs, including the purchase of safe, affordable OTC medicines."

The letter also stresses that "prohibiting the use of FSA funds to purchase these medicines or requiring documentation from a doctor that OTC medications are being used to treat a medical condition is already limiting access and greatly reducing the cost efficiencies associated with these medicines."