February 19, 2007
What is the OTC World Coming To?
By Bernice Hurst, Managing Director, Fine Food Network
Is it really all about sex? In the U.S., the so-called “morning after pill” can now be obtained over-the-counter (OTC) by certain women, although some pharmacists are taking exception to supplying it.
In the U.K., Viagra will now be available OTC but only after a lengthy interview between customer and pharmacist. More and more retailers are offering medical advice and treatment, leaving decisions about who should be given what medications in the hands of a whole different type of professional who may or may not let their own consciences affect their recommendations.
Boots, a nationwide chain of pharmacies in the U.K., loudly broadcast its status as the first to be selling Viagra OTC. Only when the first customers arrived were they greeted with the news that they had to read a leaflet and make an appointment with the pharmacist before being allowed to hand over their cash in exchange for the pills.
As a spokesperson for the chain told The Guardian, “The Boots erectile dysfunction program involves a detailed hour-long consultation which means customers need to book an appointment with the pharmacist. As planned, the service launched in Manchester stores when all the information leaflets and signage went up announcing availability of the new service and how to book an appointment.
“This is a sensitive condition which needs the appropriate time devoted to it by a pharmacist, and we’re sorry if some customers have got the wrong impression from recent media coverage.”
Regardless of where the lack of communication took place, the process was certainly not what customers expected and not necessarily a choice they would have made had they known they would be discussing intimate details with a pharmacist rather than a doctor presumably well acquainted with their history and circumstances.
As more American retailers introduce in-store clinics and pharmacists play more active roles in dispensing medication previously available by prescription only, relationships between individuals and professionals are changing.
The idea seems to be to keep costs down for consumers and reserve doctors’ time for consultations requiring a higher level of medical expertise. It also, theoretically, takes advantage of pharmacists advanced understanding of drug interactions to help consumers manage their prescription medicine regimens effectively. It may also help to avoid life-threatening consequences as the result of a doctor either not having a full history on a patient or simply making a mistake for one reason or another.
Discussion questions: Should a consumer have to divulge the type of personal information they share with a doctor with a pharmacist to obtain an over-the-counter remedy? What are the implications for pharmacists, their employers and consumers?
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Once again, UK retailers, representing about .01% (.001) of the global population and an insignificant portion of the world’s purchasing power, share their visions and enduring truths with the rest of us. Thanks, blokes, and good luck with that “Commonwealth” thing.
HIPAA is the Health Insurance Portability and Accountability Act here in the Colonies (many people acronym it as “hippa,” and most misspell it that way, too). It protects, among other things, the privacy of patients’ medical histories because that info has been grossly misused in the past.
Grown adults purchase OTC products for their health. Why make it difficult? Are they manufacturing crystal meth in their garages with the stuff? (That’s for law enforcement to track backwards from user-to-supplier-to-manufacturer to figure out.) In the meantime, sell people what they are convinced will help them, provide all of the appropriate written warnings about mixing and matching medications, and quit assuming that people are stupid.
It’s worth pointing out that the definition of “OTC” is somewhat different in parts of the EU than in the U.S. Still, it seems that Boots has gone to extreme lengths to gain permission to advertise itself as a Viagra vending machine? What are other retailers doing? Presumably OTC for Boots means OTC for all? Bernice?
That aside, reducing healthcare costs by having functions not generally requiring an M.D. skill level perform them just makes good economic sense to me. the idea of having nurse practitioners staffing in-store clinics to diagnose and prescribe minor illness is a great example.
Drug interaction could certainly be the purview of the pharmacist, but I’m unclear why that would take a one hour interview. If the pharmacist is being asked to evaluate medical necessity based on either physical or psychological condition, then the drug really isn’t “OTC” in the U.S. sense at all. All that has happened is the “prescribing party” has changed from MD to pharmacist. That doesn’t sound so good.
Privacy is not the issue. The physician lobbyists have been very tight about letting individuals buy their own drugs. Drug company lobbyists are the opposite. As a consumer, I would just like to know the truth, without any spin. Viagra is the appropriate drug for this discussion. Personally, I’d just like to get it out of my face.
We are all concerned about the rising costs of healthcare and this should be a small way to lower these costs. If the patient is averse to sharing private details with a pharmacist then I would assume they would still have the option to have their doctor prescribe it as before. However this most likely would effect whether the insurance company would reimburse them. When name brand drugs become available as generics, people and their insurance companies save money. When a drug becomes available OTC, the price usually drops but the insurance company no longer pays, resulting in a higher out of pocket cost to the consumer. Some days it seems like you just can’t win.
No, customers should not have to divulge this kind of information. Most likely they will just say what they think the pharmacist wants to hear anyway. Now I know why there are so many pharmacies along the Mexican border. They know how to move the product without inconveniencing the customer.
A man goes into a bar, asks for a shot, and the bartender explains that all customers have to engage the bartender in a 1 hour alcohol consultation before being served. After all, the bartender doesn’t know the man’s alcohol history, personal circumstances, or medical issues. When will the Mandatory Bartender Consultation Law take effect?
I also agree that the pharmacist is the wrong person to consult with. There seems to be a blurry line here and I have a feeling that the large pharma companies are exerting plenty of pressure for this type of consultation. After all, this makes it easier to sell more meds and, in many cases, their interest is in volume sales rather than resolving medical ills.
Medications are needed as a result of a physical–or mental–condition. We as a society are becoming too used to the quick fix while not always paying attention to the potential issues causing the symptoms. If someone needs an hour with a pharmacist, it seems that an hour with their doctor is better spent. If the doctor isn’t available, there’s also a physician’s assistant or someone trained to deal with the issue at hand.
Finally, common sense says that if an hour consult is needed to make a drug OTC, it shouldn’t be OTC.
OTC could almost be redefined as “occasionally treats conditions.” Despite the differences in definition between P-medicines (P-meds), Prescription-only-medicines (POMs) and General Sales Listed items (GSLs) in the UK, dispensing this drug as an OTC is a slippery slope. We must also bear in mind that the UK does allow for “prescribing pharmacists,” but Viagra??
My view is that helping consumers make the most informed health decision possible is a good cause. I also contend that the pharmacist is by far the most accessible healthcare professional. However, there needs to be a line of distinction drawn between pharmacists, nurse practitioners, physicians and alternative therapy providers. This is all getting far too fuzzy for me … and I’m in the industry!
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Once again, UK retailers, representing about .01% (.001) of the global population and an insignificant portion of the world’s purchasing power, share their visions and enduring truths with the rest of us. Thanks, blokes, and good luck with that “Commonwealth” thing.
HIPAA is the Health Insurance Portability and Accountability Act here in the Colonies (many people acronym it as “hippa,” and most misspell it that way, too). It protects, among other things, the privacy of patients’ medical histories because that info has been grossly misused in the past.
Grown adults purchase OTC products for their health. Why make it difficult? Are they manufacturing crystal meth in their garages with the stuff? (That’s for law enforcement to track backwards from user-to-supplier-to-manufacturer to figure out.) In the meantime, sell people what they are convinced will help them, provide all of the appropriate written warnings about mixing and matching medications, and quit assuming that people are stupid.
It’s worth pointing out that the definition of “OTC” is somewhat different in parts of the EU than in the U.S. Still, it seems that Boots has gone to extreme lengths to gain permission to advertise itself as a Viagra vending machine? What are other retailers doing? Presumably OTC for Boots means OTC for all? Bernice?
That aside, reducing healthcare costs by having functions not generally requiring an M.D. skill level perform them just makes good economic sense to me. the idea of having nurse practitioners staffing in-store clinics to diagnose and prescribe minor illness is a great example.
Drug interaction could certainly be the purview of the pharmacist, but I’m unclear why that would take a one hour interview. If the pharmacist is being asked to evaluate medical necessity based on either physical or psychological condition, then the drug really isn’t “OTC” in the U.S. sense at all. All that has happened is the “prescribing party” has changed from MD to pharmacist. That doesn’t sound so good.
Privacy is not the issue. The physician lobbyists have been very tight about letting individuals buy their own drugs. Drug company lobbyists are the opposite. As a consumer, I would just like to know the truth, without any spin. Viagra is the appropriate drug for this discussion. Personally, I’d just like to get it out of my face.
We are all concerned about the rising costs of healthcare and this should be a small way to lower these costs. If the patient is averse to sharing private details with a pharmacist then I would assume they would still have the option to have their doctor prescribe it as before. However this most likely would effect whether the insurance company would reimburse them. When name brand drugs become available as generics, people and their insurance companies save money. When a drug becomes available OTC, the price usually drops but the insurance company no longer pays, resulting in a higher out of pocket cost to the consumer. Some days it seems like you just can’t win.
No, customers should not have to divulge this kind of information. Most likely they will just say what they think the pharmacist wants to hear anyway. Now I know why there are so many pharmacies along the Mexican border. They know how to move the product without inconveniencing the customer.
A man goes into a bar, asks for a shot, and the bartender explains that all customers have to engage the bartender in a 1 hour alcohol consultation before being served. After all, the bartender doesn’t know the man’s alcohol history, personal circumstances, or medical issues. When will the Mandatory Bartender Consultation Law take effect?
I also agree that the pharmacist is the wrong person to consult with. There seems to be a blurry line here and I have a feeling that the large pharma companies are exerting plenty of pressure for this type of consultation. After all, this makes it easier to sell more meds and, in many cases, their interest is in volume sales rather than resolving medical ills.
Medications are needed as a result of a physical–or mental–condition. We as a society are becoming too used to the quick fix while not always paying attention to the potential issues causing the symptoms. If someone needs an hour with a pharmacist, it seems that an hour with their doctor is better spent. If the doctor isn’t available, there’s also a physician’s assistant or someone trained to deal with the issue at hand.
Finally, common sense says that if an hour consult is needed to make a drug OTC, it shouldn’t be OTC.
OTC could almost be redefined as “occasionally treats conditions.” Despite the differences in definition between P-medicines (P-meds), Prescription-only-medicines (POMs) and General Sales Listed items (GSLs) in the UK, dispensing this drug as an OTC is a slippery slope. We must also bear in mind that the UK does allow for “prescribing pharmacists,” but Viagra??
My view is that helping consumers make the most informed health decision possible is a good cause. I also contend that the pharmacist is by far the most accessible healthcare professional. However, there needs to be a line of distinction drawn between pharmacists, nurse practitioners, physicians and alternative therapy providers. This is all getting far too fuzzy for me … and I’m in the industry!