Limiting Access to Antihistamines in Allergic Patients

In response to the availability of one nonsedating antihistamine as an over-the-counter drug, state Medicaid and several large health insurers are considering whether to end prescription drug coverage for all nonsedating antihista-mines. These policies, by their design, would diminish access to recognized standards of treatment for millions of patients with allergic diseases. Professional experience suggests that these actions not only would lower the quality of medial care for affected patients but also would have significant health and safety implications for the general public.

Allergic diseases occur in 10% to 25% of the population, and up to 40% of those affected are children.
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To varying degrees, antihistamines have the capacity to compete with hista-mine for type H1 receptors and to reduce receptor-mediated activation, thus blocking histamine’s adverse effects. Although all of the members of this class of medications are referred to as “antihistamines,” they vary in their pharmacology. Therefore, the selection of any one of these agents should be made in consultation with an experienced health care practitioner, especially for the majority of patients with persistent disease.

One of the concerns created by these policies is the danger associated with self-medication.

Policies that limit patients’ access to appropriate medications impede a physician’s ability to prescribe the best treatment regimens and should not be mistakenly viewed as being endorsed by trained health care professionals.