Slow to switch

Australia is lagging in “switching” medicines to over-the-counter schedules, which misses a significant public health opportunity

Switching is a vital enabler of self-care, according to Dr Edwin Hemwall, a global expert on the issue who will present at the upcoming World Self Medication Industry conference in Sydney.

Dr Hemwall describes this as the logical first step in “the healthcare continuum” to be integrated with professional medical care in order to reduce costs and better utilise scarce healthcare resources.

Enhanced self-management of health conditions through switch has the potential to send more engaged patients to physicians and other healthcare professionals, he says.

Writing in Clinical Pharmacology and Therapeutics, Dr Hemwall explained that facilitating a greater rate of switch requires industry, regulators and consumers all fulfil a responsibility:

Industry is required to develop and demonstrate the utility of safe and effective products with educational self-support programs.

Regulators need to overcome their well-intentioned scepticism and narrow interpretation of laws and guidelines governing labelling and mode of sale, he says.

And consumers must be held responsible for adhering to balanced informative labelling and utilising accompanying support programs providing direction as to when to seek professional counsel.

ASMI says that there will also be an onus on pharmacists, because they will be the point of consumer contact for medicines switched from prescription-only to OTC.

Prescription to OTC switch has already been successful in terms of analgesics such as ibuprofen; antihistamines and intranasal corticosteroids; H2RA and PPIs; smoking cessation products and antifungals.

It says an estimated 68,750 premature deaths in Australia have been prevented by switching NRT to OTC.

“However, while other nations with similar health systems have forged ahead with switch, Australia has fallen behind,” says ASMI.

“In New Zealand, specially trained pharmacists can supply sildenafil under strict criteria to men aged 35-70 with erectile dysfunction. In Australia, sildenafil medicines remain prescription-only.

“Three years on from prescription-free access to sildenafil (the active ingredient in Viagra) in New Zealand, Natalie Gauld and Alison Van Wyk will explain to WSMI delegates how this ‘switch’ was a positive for men’s health issues, as the pharmacy protocol for supplying the medicine identified men suspected of having possible underlying health conditions.

“In Canada, Consumer Health Products Canada (CHPC) has conducted research that shows that switching just three specific drug categories – erectile dysfunction medicines, proton pump inhibitors and oral contraceptives – has potential savings of $1 billion per year.

“CHPC President Karen Proud’s presentation will show how the majority of savings are from lower drug costs, followed by increased efficiency, and productivity gains from reduced physician visits without compromising healthcare outcomes.

“This research uses the same methodology used in similar studies in the USA, Mexico and Australia, which all reached comparable conclusions and figures on cost benefits. In Australia, research from Macquarie University Centre for the Health Economy (MUCHE) demonstrated that switching 11 prescription-only medicines produced total cost savings to the Australian healthcare system of $2.3 billion.”

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