Clinicians are raising concerns about “medical emergency kits” containing antibiotics that are being sold for at-home use and promoted by media celebrities like Drew Pinsky, MD, better known as “Dr. Drew.”
One such kit, sold by the Wellness Company, retails for $299 and claims to treat more than 30 illnesses. Pinsky, who works for the company as its chief patient officer, stars in a video breaking down the kit’s various antibiotics. It includes amoxicillin-clavulanate, azithromycin, doxycycline, metronidazole, trimethoprim-sulfamethoxazole, ivermectin, fluconazole, and ondansetron, as well as a “step-by-step expert guidebook” that ensures “safe, effective use.”
“This Kit Could Save Your Life,” says a webpage devoted to the kit, one of several similar products on the market.
For each drug mentioned, the company lists a suggested use, such as “covers [urinary tract infections] and resistant bacterial infections” for trimethoprim-sulfamethoxazole or “treats tick-borne illness and hard-to-reach infections” for doxycycline. For ivermectin — often touted without evidence as a treatment for COVID — the website says “anti-parasitic protection when you need it most.”
Larrie Greenberg, MD, emeritus professor of pediatrics at George Washington University in Washington, D.C., was alarmed when he saw the kit advertised on TV. “They advertise it as an ’emergency medical kit,’ but it is not an ’emergency’ anything,” he said, noting that the ad even says that if you have an emergency you should dial 911. “This is really false advertising. To me, it’s another money-making gimmick to interfere with the doctor-patient relationship.”
Greenberg also panned a study the company linked to which found that the 506 online survey respondents who had purchased a kit “reported high engagement, frequent use for common acute illness, rapid symptom resolution, infrequent and mild side effects, and preparedness benefits extending even to never-users. These findings suggest that pre-prescribed emergency medication kits may represent a practical model for improving timely access to treatment and guided self-management of common acute illness when conventional access is limited or inconvenient.” All of the study’s authors — which included Pinsky — were Wellness Company employees; the study does not appear to have been published in a medical journal.
“This is nonsense research; it doesn’t prove anything,” Greenberg said.
To get the kit, customers must first fill out what’s described as a “brief medical history form.” The site then explains that a “licensed provider will review your information to determine eligibility. Some states require a live video visit with a licensed provider before a prescription is issued. We’ll let you know if yours does.” Once the customer is approved, the prescription is “dispensed by a licensed U.S. pharmacy then shipped free, directly to your door,” usually within 1 to 2 weeks, according to the website.
Although the site says the kit should be used only by the person for whom it’s intended, a customer can order up to four kits at once. The site also lists precautions — under a “Before You Buy” tab that a customer would have to proactively click on — for certain medications, such as not using trimethoprim-sulfamethoxazole if a sulfa allergy is present, or not using doxycycline if the customer has a tetracycline allergy.
The company also says on its website that the medications “are intended only to be used under provider supervision. Should you feel ill, you can make a free, follow-up appointment with one of our providers for a diagnosis and treatment plan.”
However, “Who is to prevent them from using this for another person in the family?” Greenberg said. “How about a child?”
Kits like this are problematic for several reasons, Rita Jew, PharmD, MBA, president of the Institute for Safe Medication Practices said in an email. “Standard of care calls for a doctor to obtain a full medical history, including medication use and allergies and associated reactions, and perform a physical exam on the patient prior to prescribing any medications,” she said. “These kits circumvent that best practice.”
In some instances, medications can be prescribed in advance — such as when a patient is going to an area where traveler’s diarrhea is prevalent and gets an antibiotic through their primary care physician along with instructions on when to take it. However, dispensing a supply of different types of drugs before any illness “and relying on the patient to select the correct medication to take based on specific symptoms is putting a lot of responsibility on the patient who may not have a medical background to self-diagnose, select the correct medication from the kit, and take the appropriate dose for the appropriate duration,” Jew continued. “Misdiagnosis by the patient may result in worsening of their clinical condition due to delay in appropriate therapy. Selecting the wrong medication to take, or taking the wrong dose, may result in adverse drug reactions with varying severity.”
Though some of these products seem to involve some initial screening before sending them out, “the patient may begin to take new medications or be diagnosed with new diseases or develop new allergies that may contraindicate or interact with the medications in the kit,” Jew added. “Without medical screening immediately before use, patients may face serious or even life-threatening adverse reactions from medications in the kits.”
Neither the Wellness Company nor Pinsky’s show responded to requests for comment on the kit.
