First of all: people are starving and being tortured and killed for no reason the world over, so what I'm about to say does not much rate, but I'll just give it a go anyway.
So I go to the acne doctor this morning. I am 33 and got acne about two years ago. I did nothing about it for the longest time, because it's just acne, and who cares, and then I finally went to the dermatologist, who put me on antibiotics that I'm supposed to take for six months, and this was my six-week checkup. The acne is mostly gone but not all gone. The doc says: If you want it completely gone, the only thing that makes a permanent difference is Accutane. Accutane, evidently, is the wonder drug of the acne world. (Or maybe it isn't, but this is how it sounds when I'm sitting there.) She says it will actually change my glands, or somesuch, and that I have to take it for six months. She says it is essentially a huge blast of vitamin A.
The only twist is that in order to take Accutane, you have to join an FDA program called "I Pledge," which sounds creepily like an abstinence cult—and actually isn't all that far off from an abstinence cult. Before you can get the drug, you have to take not one but two pregnancy tests. The dosage is six months. Every month you have to take another pregnancy test. The reason is that Accutane causes severe birth defects, she says. The way she rests on the word "severe" makes me think it causes babies not to have faces, not just miss a finger or something. Then she tells me that in addition to the tests, you also have to prove that you are on not one but two forms of birth control. "We prefer a hormonal course," she says, meaning the pill, along with condoms. I am not accustomed to being told what other people prefer I do with my uterus quite so starkly. Evidently you sign something saying you're using the condoms and the doctor prescribes you the pills, too. Or you get an IUD implanted. I didn't get the sense that, say, pledging to use condoms and a diaphragm would be sufficient.
I have to admit that I was offended. On the other hand, I don't take babies without faces lightly. I couldn't help but wonder: Are there lots of drugs out there that have this kind of FDA pledge program for women attached to them? (The vitamin A doesn't touch sperm, the doc said, so men can do what they want with Accutane and sex.) Or is Accutane singled out because acne commonly appears in horny and irresponsible teenagers?
4) I'll give them a little bit of a pass on the grounds that they are probably trying to avoid a costly lawsuit, but I think you should have to sign a form only saying you're aware of the birth defect issue and have been advised that you should be on birth control. That's enough to cover their asses. This pledge stuff is creepy and offensive.
And really, do you want to wait for the government to rubber stamp every refill?
how do they get away with it?
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