Nasal Allergies, Self-Care, and Paternalism
The FDA Nonprescription Drugs Advisory Committee voted 10-6-2 Wednesday to recommend that Nasacort AQ nasal spray for nasal allergies be approved for sale in the U.S. without a prescription. Nasacort AQ is one of a group of nasal steroid sprays that experts generally agree are the most effective products for treating nasal allergies with an excellent safety profile.
After reading the briefing materials from the FDA, the outcome was not a big surprise. The reviewers at the agency had clearly concluded that this drug was safe and effective for nonprescription use. The sponsor was well-prepared.
What was surprising was the retro perspective that specialty groups brought to the time set aside for public comments. Allergists, otolaryngologists, and an asthma patients group stood up to warn that the patients who are seeing these specialists are quite happy they way things are and dire consequences will ensue if patients try to treat their own nasal allergies with this stuff. One allergist presenting a forecast of calamity started her presentation by mentioning that her expenses to testify were paid by a company that sells prescription allergy products.
All these people — who are well-connected to medical specialists — seemed quite unaware that most people don’t have the time or money to see a specialist for their allergies. Most people don’t even spend a whole lot of time with a primary care doctor on the subject. Life gets in the way. And even with more serious chronic diseases, most health care experts are saying that more self-care, not less, is the way to get better outcomes for the money we spend.
To their credit, the Asthma and Allergy Foundation of America spoke to the need for better access to better tools for self-care.
Allergists and otolaryngologists have a lot to offer to people who are severely effected by nasal allergies. They don’t need to gin up business for themselves by suggesting that everyone needs to see them for their allergies.
Click here to read more in the Wall Street Journal and here to access the briefing materials for this hearing.
Allergy Season, photograph © AshtonPal / flickr
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