"An authority directing the whole economic system would be the most powerful monopolist conceivable... not our own view, but someone else's, of what we ought to like or dislike would determine what we should get."

   -FA von Hayek, The Road to Serfdom, 1944

The ambit of Congressional healthcare oversight extended to the lowly bar of soap this week.  In it effort to enforce federal control of soap-threatened public safety Ed Markey (D-MA), the powerful Chairman of the House Energy & Commerce Subcommittee, formally asked the FDA and EPA to clean up its act and that of the purveyors of triclosan (Ciba), a long time antimicrobial ingredient in soaps. The FDA stated it does not have sufficient reason to act at this time and that "triclosan is not known to be hazardous to humans" [http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm].

"Nature...what things again most dear in the esteem, and poor in worth!"

         -Ulysses in Troilus and Cressida, Shakespeare, 1602

Often the value of patents on OTC healthcare products is held in high esteem but experience tells us that more commonly used, but proven, marketing tactics usually win the day.  The fact is that the consumer healthcare market, defined by several measures, is in essence a parity market.  Both share and volume are increased best by first-to-market entry, price/value, brand awareness, promotion and distribution, the blocking and tackling of any good marketer.  Intellectual property, specifically patents and excepting for trademark, know-how and trade dress, is of dubious use in this sector.  The value to both consumers and manufacturers is limited to a few situations.

On March 19 FDA warned consumers and physicians that the risk of at least one statin (Zocor, Merck), when used at higher approved doses, may cause an unacceptably high incidence of a serious side effect (rhabdomyolysis).  Further, they warn of drug and disease interactions at all doses and hint at pharmacogenetic variables, such as race, that may change the risk profile.

Walgreen's announced on 15 March that it has given the State of Washington notice that after 15 April it will no longer honor prescriptions from new patients on Medicaid [http://news.walgreens.com/article_display.cfm?article_id=5288].  Washington has not adjusted up its reimbursements to Walgreens for Medicaid costs.  Branded script reimbursement does not cover Walgreens' costs.  Unlike the private insurers in this case government entities will increasingly seek to undercut the profit motive in healthcare's free enterprise.  The specter of Obamacare's iron-fisted central planning hangs over healthcare pricing and reimbursement.

 "He draweth out the thread of his verbosity finer than the staple of his argument"

     - Holofernes in Love's Labour's Lost, Shakespeare (1598)

Verbose, complex product labeling has increased driven by government regulation, multiculturalism, and tort liability (failure to warn).  Prescription labeling when directed at physicians nonetheless is still arcane.  OTC labeling aimed at the US consumer is more succinct yet now occupies nearly all the package's surface, and then some, akin to creating off-shore "artificial islands" of information.  A recent study of labeling comprehension reminds us what to avoid.