Why do pharmacists control access to certain drugs?

I had a student who is diabetic come to speak to me today, and in the meandering way conversations I get into with students go (usually my fault), she ended up asking the rhetorical question “why do I have to get my insulin from a pharmacist?”

It is a good question.  As I noted in the last post, the issue of the “dangerous”ness of drugs drove the construction of control of access to some drugs.  But what about insulin?  It’s not addictive; it’s not really poisonous (at least no less so than non-drugs you could surreptitiously administer and kill someone, like antifreeze) and it’s an essential substance for some people to receive artificially.

To be honest, I’m not sure.  I told the student that she could do a directed reading with me and we could explore the idea. I love it when I have motivated students like that, and questions I can’t answer.

I do have some guesses, though.  They are really nothing more than suppositions based upon my thin knowledge of the process

1. Insulin, when it was first isolated, was relatively difficult to get your hands on.  Controlling access through a pharmacist or doctor would allow its use to be judicious.
2. Controlling access to insulin was easy to justify because diabetes itself had to be diagnosed.  Without such a diagnosis, you’d not know you had diabetes. So there was no real way to self-diagnose, and no need in the market to have it available for over the counter sale.
3. By the time insulin had been isolated and seen to be an important medical tool, the idea of expanding medical jurisdiction over access to such technology was sort of a given. Maybe it was just natural that new important substances like insulin would be available only by prescription.
4. It made it more expensive. Big pharma loves something that makes drugs more expensive (I doubt this was the case).
5. It needs to be injected, which makes the hormone insulin need to be administered by docs.  See #2.
6. None of the above
7. Many of the above.

I really have no idea.  I will look into it though.  It’s a compelling thought, and will fill out the complexity of my narrative on the relationship between legislation that controls access to medicine, and the authority and social role of the medical industrial complex.

Interested in this question?  Have some ideas?  Post a response.  Share thoughts.  I have to come up with a reading list at some point, so you’d make my job a lot easier.

Your responses are copyright: you.

My post is (c) Dan Malleck. 2012.