California S.B. 484 is a bill making its way in the California Assembly that would make it necessary to get a doctor’s prescription in order to buy cold and allergy medicines that contain pseudoephedrine. This would eliminate over-the-counter status for such medications as Zyrtec-D, Sudafed, Mucinex D, Claritin-D, and Advil Cold & Sinus. 

The goal of the bill is good: It is intended to crack down on the illegal manufacture of methamphetamine. The bill targets pseudoephedrine because it is a key ingredient in this criminal behavior, along with other such common substances as fingernail polish, paint thinner, table salt, lithium from camera batteries, lye from drain cleaner, vehicle starter fluid, and phosphorus from road flares or matches.   

The consequences of the bill’s passage, however, would be devastating for Californians. Requiring consumers to obtain a prescription to purchase pseudoephedrine products would impose substantial, and unnecessary, new costs on consumers and the healthcare system without making any impact on the availability or abuse of methamphetamines. 

Legitimate consumers are the ones who will be forced to:

• Take time off to see a doctor to obtain a prescription when they need a cold or allergy medicine containing pseudoephedrine, even though these products are approved by the U.S. Food and Drug Administration for nonprescription use;
• Pay a co-pay for their doctor visit or pay out-of-pocket;
• Find a pharmacy, during pharmacy hours, and wait for their prescription to be filled; and
• Pay prescription-drug prices or their co-pay for a nonprescription drug.

Requiring a prescription for an OTC drug will impose direct costs on the state:

• To reimburse physicians every time a Medicaid or SCHIP recipient sees a doctor to obtain a PSE prescription;
• In increased health insurance premiums for state employees; 
• In over $4,460,000 in lost sales tax revenue (based on 2008 sales data, not including Wal Mart) because prescription drugs are tax-exempt while OTCs are subject to sales tax; and
• In added expenses on public hospitals that will be forced to treat the uninsured who can no longer buy these products without a prescription and lack timely-if any-access to a doctor.

Federal law now strictly limits all sales of pseudoephedrine-containing OTCs. These medicines already are sold only behind the counter with maximum daily and monthly sales restrictions. In addition, everyone who purchases a pseudoephedrine medicine must sign a logbook.

There is evidence that the restrictions already in place are helping.

• Meth labs have dropped 61 percent nationwide.
• Meth labs have dropped 86 percent in California.

Rather than shift a law enforcement problem onto consumers and the healthcare system, California should follow the lead of Oklahoma, Kentucky, and Arkansas, and use an electronic logbook to enforce the quantity limits that would prevent the illegal diversion of pseudoephedrine for the production of meth.

Californians, tell Sacramento to keep pseudoephedrine Rx-free.