Missouri legislator proposes moving PSE Rx-only

Issue: How do you stop meth addicts from circumventing current pseudoephedrine purchase restrictions by buying their respective PSE limits across several area pharmacies, a practice that’s been dubbed “group smurfing”? Answer: Create an electronic real-time logbook database so that law enforcement can catch these “smurfers” in the act.

Or, if you’re in Missouri, you can take the cost associated with creating such a database and shift that cost right onto the backs of your constituents, by requiring them to get a prescription for PSE first. That’s really what the Missouri legislator is proposing. Rep. Jeff Roorda, D-Barnhart, who sponsored the bill in the House, even said as much. The prescription requirement would prevent the state from "dumping money into a database that we don't know will work,” he said, according to published reports.

The bigger issue is appropriate access to healthcare. Reverse-switching PSE limits that access — and forces consumers to go through the added hassle of making a doctor’s appointment, taking time off from work to see that doctor, and filling a prescription for PSE, all within the seven days the average cold lasts. To be sure, PSE isn’t the only cough-and-cold relieving ingredient in town. But while there are other options on the shelf, there are also consumers who are loyal to their PSE products. And it’s these consumers who would pay the price. And if not them, then their healthcare payors. How much more would it cost to treat a Medicaid recipient with prescription PSE versus maintaining their ability to buy that product from their pharmacist?

On the other hand, the electronic logbook solution — incidentally, Missouri lawmakers authorized a statewide electronic monitoring system for PSE-based drugs last year, it just hasn’t been funded yet — is not necessarily a panacea. The cost associated with becoming a part of such a database could be prohibitive, especially if that cost is actually borne by retailers. That cost is compounded for national retailers, who might have to conform to disparate systems across state lines. There is also a concern that pharmacy personnel might be placed in danger if they’re required to refuse a PSE sale because their customer reached their limit at the pharmacy down the street five minutes ago. Meth addicts, after all, aren’t the most law-abiding citizens and might be prone to violence.