A report published last week suggested that making certain prescription medications available as over-the-counter drugs could save Canadian insurers, employers, governments and patients $1 billion each year.
The report dealt with proton pump inhibitors (which treat gastroesophageal reflux disease), oral contraceptives and erectile dysfunction drugs. Researchers noted making them available as over-the-counter products could lower drug costs and reduce the number of primary care visits, which would both help the public health-care system and increase economic productivity through less time taken off work. They also noted, however, the change could increase the risk of misdiagnosis, misuse and adverse health events. And while insurers, employers and patients with little to no coverage would benefit, those with a robust plan would see their out-of-pocket expenses increase.
Canada, of course, isn’t alone in testing these waters. As of 2014, New Zealand men aged 35 to 70 can access sildenafil (the active ingredient in Viagra) without a prescription from their physician, according to the Pharmaceutical Journal. They can instead visit a trained pharmacist who will screen out men who report heart problems and cardiovascular risk factors such as diabetes. Pharmacists will encourage them to visit their family doctors for a heart health check and will inform the physician of the drug unless the patient requests them not to.
Similarly, as of February 2017, New Zealand women aged 16 and older can buy oral contraceptives directly from their pharmacists, provided their physician had prescribed a similar drug in the last three years and they hadn’t developed any risk factors in the meantime. Again, they’ll be encouraged to tell their physicians about the drug.
In the United States, women in Colorado, Oregon and California can buy oral contraceptives without a prescription, a policy change the American Congress of Obstetricians and Gynecologists supports.
“Despite the safety of OC [over-the-counter] use, one frequently cited concern regarding over-the-counter provision of OCs is the potential harm that could result if women with contraindications use them,” the organization wrote in an opinion paper in December 2012. “However, several studies have shown that women can self-screen for contraindications. In one study that compared current family planning clients’ self-assessment of contraindications with clinical assessment, 392 of the 399 participant (females aged 15 to 45) and health care provider pairs obtained agreement on medical eligibility criteria.”
What do you think? Would making proton pump inhibitors, oral contraceptives and erectile dysfunction drugs available over the counter be a good idea? Have your say in this week’s online poll.
As for last week’s poll, it looked at whether the Canada Pension Plan should provide a dropout clause for people who temporarily stop working. Nearly three-quarters (72 per cent) of respondents thought it should as a way to account for childcare responsibilities and to provide equity. The remaining 28 per cent thought the government had done enough by boosting CPP in the first place.