There’s a move afoot to make Sudafed prescription again, in an effort to keep would-be Walter Whites out of business. This sucks for lots of reasons, but at least this writer is thinking clearly about the implications costwise:

What really bothers me is the way that Humphreys [the author of a post to which she is responding] — and others who show up in the comments–regard the rather extraordinary cost of making PSE prescription-only as too trivial to mention.

Let’s return to those 15 million cold sufferers. Assume that on average, they want one box a year. That’s going to require a visit to the doctor. At an average copay of $20, their costs alone would be $300 million a year, but of course, the health care system is also paying a substantial amount for the doctor’s visit. The average reimbursement from private insurance is $130; for Medicare, it’s about $60. Medicaid pays less, but that’s why people on Medicaid have such a hard time finding a doctor. So average those two together, and add the copays, and you’ve got at least $1.5 billion in direct costs to obtain a simple decongestant. But that doesn’t include the hassle and possibly lost wages for the doctor’s visits. Nor the possible secondary effects of putting more demands on an already none-too-plentiful supply of primary care physicians.

Of course, those wouldn’t be the real costs, because lots of people wouldn’t be able to take the time for a doctor’s visit. So they’d just be more miserable while their colds last. What’s the cost of that–in suffering, in lost productivity?

Perhaps it would be simpler to just raise the price of a box of Sudafed to $100. Surely that would make meth labs unprofitable–and save us the annoyance of a doctor’s visit.

They can still buy cold medicine, protest the advocates for a prescription-only policy. But as far as I can tell, there’s really no evidence that the current substitute, phenylephrine, does a damn thing to ease congestion; apparently, a lot of it gets chewed up in your liver pretty quickly, and because the FDA only allows a low dose to start with, the resulting pills don’t seem to be any better than placebo. For people who are prone to sinus or ear infections, that’s no joke; one of the main ways you prevent them is by taking a decongestant as soon as you feel the first ticklings of a cold–not four days later, when your GP can finally see you.

I added the emphasis, since that’s also my own experience with the non-sudafed sudafed.

Here’s the real point:

But no policy question is ever as simple as “How can we stop X”, unless “X” is an imminent Nazi invasion. We also have to ask “at what cost?” and “by what right?”

Exactly. There is no doubt that meth is a scourge. But the societal costs of drastically increasing the effective price of Sudafed are bad, too. Are we sure that’s a good idea? And let’s also be clear about something: some anti-meth crusaders are actively talking about prohibition. Seriously. Fuck that.

(Via Schneier.)