What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

By JoNel Aleccia
Health writer
msnbc.com
updated 8:42 a.m. ET, Thurs., March. 5, 2009


Offering free antibiotics to cash-strapped customers may have seemed like a good idea this dire winter, but supermarket chains are fielding a backlash from health experts who say the promotions may do more harm than good.

Five large retailers have received letters from the federal Centers for Disease Control and Prevention and the Infectious Diseases Society of America cautioning that giving away antibiotics contributes to misuse of medication and the rise of increasingly drug-resistant bugs.

“We were a little alarmed, especially when they suggested they’d be doing it during cold and flu season,” said Dr. Lauri Hicks, medical director of the CDC’s program on appropriate antibiotic use.

“We know that antibiotics aren’t effective for cold and flu. We don’t want to perpetuate the idea that they are.”

But the stores, which include Wegmans, ShopRite, Stop and Shop and Giant Food, contend they’re only filling valid prescriptions written by doctors — and trying to save shoppers a little money in the process.

“We feel like it’s a way to help our customers out during tough economic times,” said Jamie Miller, a spokesman for Giant Food, a 182-store chain based in Landover, Md.

However, offering free antibiotics likely will prompt more patients to ask their doctors for the drugs, experts said. Repeated research shows that doctors often prescribe antibiotics just because a patient asks. A study published last fall in the British Medical Journal showed that some doctors use antibiotics as placebos for patients who insist on medication.

“It’s much easier to give someone an antibiotic than it is to explain to someone why they don’t need it,” said Dr. Ed Septimus, an internist who helped write the letters sent by the IDSA.

Giant Food is one of several retailers that launched free-drug giveaways this winter, providing up to two weeks of the most frequently prescribed antibiotics, including amoxicillin, erythromycin, ciprofloxacin and penicillin. The offer is available to anyone with a prescription whether they have health insurance or not.

A typical round of antibiotics costs $10 to $20, though many stores have started offering $4 generic prescriptions.

Most of the stores planned to continue offering the drugs through the end of this month, if not longer. Some grocery chains, such as Meijer Inc. of Grand Rapids, Mich., and Publix Super Markets Inc. of Lakeland, Fla., have offered the free meds year-round for several years.

‘Well-intentioned but obviously ill-advised’
That worries many infectious disease specialists, who say they’ve been fighting for years to reduce demand for the drugs.

“I was actually driving to work and saw this huge billboard that said ‘Come to Wegmans for free antibiotics,’” said Ann Marie Pettis, director of infection prevention at the University of Rochester Medical Center in Rochester, NY.

“Here we are all working so hard to control the use of antibiotics and then to see something that’s well-intentioned but obviously ill-advised was surprising,” she said.

Other experts contend that the stores’ motives aren’t completely altruistic because they’re using the free drugs as so-called “loss leaders” to attract new customers.

“They’re buying these drugs for pennies and they’re getting people into the store to buy things they can make money on,” said Septimus.

If the stores really wanted want to help, they’d give away free flu shots or free blood pressure medications, services that save shoppers money and don’t compromise their health, he added.

Even when they do need the drugs, the free programs may influence patient demand. When Lisa Samples’ husband, James, needed an antibiotic for a bad case of bronchitis this week, the 42-year-old Dallas, Ga., woman asked the doctor to prescribe something from the free list at her local Publix supermarket.

“It makes a difference right now, definitely, especially because we’re both not working,” said Samples, who called the free drugs “a great marketing strategy.”

“I ended up going in and spending money,” she said, noting that she picked up eggs, milk, bread and lunchmeat.

Stores say they aren't prescription police
But the stores counter that the problem isn’t that they’re providing free drugs, it’s that doctors aren’t prescribing them correctly, said Frank Guglielmi, a spokesman for Meijer Inc., which operates 180 stores in five states.

“The premise that we’re responsible for policing prescriptions? That’s not what a pharmacy does,” he said.

Whatever the source, however, health experts say easy access to antibiotics is at the core of the growing problem of drug resistance. Overuse of the drugs has allowed many bacteria to become increasingly immune to the medications. That has fueled the rise of potentially deadly superbugs such as MRSA or methicillin-resistant Staphylococcus aureus, and C. diff, or Clostridium difficile.

C. diff, a severe intestinal illness that can lead to removal of the colon or even death, often is sparked by recent use of antibiotics such as ciprofloxacin, which is on the free lists.

Even when the problem isn’t life-threatening, antibiotics can cause harm. About 142,000 emergency department visits each year are tied to antibiotic use, mostly allergic reactions, according to a recent study in the journal Clinical Infectious Diseases.

“The fact is that antibiotics are not harmless,” said Hicks, the CDC specialist. “There’s a perception that antibiotics are like candy.”

She has urged stores to help raise awareness of proper antibiotic use by providing information from the CDC’s program, “Get Smart: Know When Antibiotics Work.”

That’s why the agency tried to be diplomatic in the recent letters. “We were concerned if we took a very aggressive approach with them, we would lose any opportunity to get our message out there,” said Hicks.

Stores surprised by strong reaction
That has worked with Wegmans, which may soon stock the CDC literature along with the free drugs. Spokeswoman Jo Natale said the company was surprised at the strong reaction from many health experts after the program began. Some doctors called the company to protest the program.

“Did we go to public health officials and ask their advice? We did not,” she said. “We should have had those conversations.”

As it was, the retailer acknowledged health officials’ concerns by sending out tips to their customers on the proper use of antibiotics.

“Without meaning to,” Natale said, “we did initiate a dialogue about this very topic.”

© 2009 msnbc.com Reprints


Link To Article

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Doctors shouldn't be writing the prescriptions if they aren't needed. I say Free!


ETA: I think they should give free birth control.

Message edited 3/5/2009 4:30:04 PM.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

I blame the MDs for prescribing drugs that they shouldn't be prescribing, not the stores for charging what they think will help their business (free drugs usually mean that people will stay there and buy other items).

The stores aren't doing anything wrong, IMO.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

IMO, the problem isn't that they're free. The problem is that doctors just give them out like candy instead of taking time to explain to the patient that they don't need it.

I should goto the doctor and ask for some Vicoden, maybe they'll give it to me instead of telling me I don't need it!

There are lots of stuff offered for free (or cheap) and you know what? If I don't need it, I don't take it. At my office we often get samples of products - after a while of buildup they will offer these products to employees. People go CRAZY for these things - and they're usually pieces of crap. But just because it's free, they want it - even if they decide to throw it away later. I always say to my coworkers "It's crap. Just because it's free crap doesnt make it any more appealing."

But to some, it does...

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

It's the Dr's who write the prescriptions.
It's not like they are offering these drugs over the counter...

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

antibiotics are going to be the downfall of man.

they are given out too often and UNneccessarily.

I don't know who is wrong or what...but people, including doctors and patients need to understand how antibiotics work, how they DON'T work, and what the repercussions are for overuse.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Posted by dita

Doctors shouldn't be writing the prescriptions if they aren't needed. I say Free!


ETA: I think they should give free birth control.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

If those places are still honoring prescriptions and not just handing drugs out like candy, then free or full price, overuse of antibiotics is the fault of the individuals prescribing them. Nothing wrong with reducing the cost, IMO.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Let them be free but filled only with a legit script.

I work with a woman who won't go to the doc because of the $20 co-pay. She will take her prescription until she feels better and not take the whole thing.

She gets sick again a few weeks later because she never finished her meds.

She thinks this is economical..she then refuses to go back to the doc for a check and takes what's left of the antibiotic from the last time. She doesn't want to spend another co-pay for more meds.

This medicine is serious stuff and people mess around with it.

My doc won't give my anything unless I have a fever or if I don't get better after a while. But I have to be dying, have green stuff coming out of several orifices and begging.

So my co-worker hoards her meds because she doesn't want to have to spend the money again and she continues to be sick. Vicious cycle.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

since the flu is a viral infection, and antibiotics are for bacterial infections, I really dont see the correlation here

I said it was NOT a good idea.

people will end up building an immunity to the AB's and then when they really do need it, it will be useless

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

nm

Message edited 3/6/2009 10:33:50 AM.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

I agree with PP, if they are giving away free antibiotics with valid prescriptions, its on the owness of the doctor to only give antibiotics where needed.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

The CDC is basically trying to determine what supermarkets and pharmacies should charge for their products. It's not up to the CDC to determine the cost of things.

OK, they say free is bad. Is .50 cents OK? Is $1 OK. How about $5? The CDC should watch over medicine, and not how much a company is charging for it....

If a doctor can't say no to a patient who is "demanding" treatment that may potentially cause more harm, then maybe that doctor should have picked a different profession...

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Posted by SweetestOfPeas

since the flu is a viral infection, and antibiotics are for bacterial infections, I really dont see the correlation here

I said it was NOT a good idea.

people will end up building an immunity to the AB's and then when they really do need it, it will be useless

Message edited 3/6/2009 12:26:26 PM.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Drug companies are at fault too....they shouldn't have commercials for drugs, coupons etc--this makes it seem like medicine is a commodity when it they're not!

Not all dr's over prescribe but the ones that do should be looked at--at the same time patients shouldn't be begging for Rx's for whatever they think they need--and this happens a lot--then they just Dr. shop till they get what the want.

Re: What do You Think: Free antibiotics may have high cost later, Stores offer promos, but experts caution about misuse and drug resistance

Drug companies have done an excellent job of undereducating people about their products to create a demand for them. What I mean by that is...think of all the ads out there on TV and in print that say, "ask your doctor about_____". So now you have a whole segment of the population that believe that whatever health problem they have can be cured with some prescription instead of looking at their overall health and adjusting things like diet, exercise, sleep habits, etc.

I think the free drugs are a great thing for people in a financial crunch, but ultimately, the responsibility is with the doctors. They shouldn't be prescribing drugs people don't need. Period.