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The Role of Self-Medication in Cost-Containment in the United States

Published by: Decision Resources

Published: Apr. 6, 2005


Table of Contents


Overview

Stakeholders' Perspectives on Self-Medication

Key Drug Classes

Outlook and Implications for the Pharmaceutical Industry




Table 1. Number of Active Ingredients Available Over the Counter in Each Major Drug Class in the Leading Pharmaceutical Markets, October 2004

Table 2. Retail Prices of Select Nonsedating Antihistamines at a Leading Internet Pharmacy, March 2005

Table 3. Effect of Various Health Plan Responses to the Switch of Loratadine to OTC Status

Table 4. Retail Prices of Select Proton Pump Inhibitors at a Leading Internet Pharmacy, March 2005

Table 5. Impact of the Launch of Prilosec OTC on the Status of Proton Pump Inhibitors in the Arkansas State Employee Health Plan Formulary




Figure 1. Number of WellPoint Health Networks Plan Members Who Filled Prescriptions for Nonsedating antihistamines in the First Five Months of 2002 and 2003

Figure 2. Proton Inhibitors’ Prescription Shares Before and After the introduction of Coverage of OTC Omeprazole in the Arkansas State Employee Health Plan

Abstract

With sales in 2003 estimated at $17.5 billion, the U.S. market for over-the-counter (OTC) drugs is by far the largest in the world, but it is arguably far from being the most dynamic self-medication market. The U.S. market's sluggish performance is attributable in part to the very cautious attitude of the FDA toward the reclassification of prescription drugs as nonprescription medicines, a process known as "Rx-to-OTC switching." However, recent statements made by the FDA indicate that its attitude toward Rx-to-OTC switching is about to change. We begin this report by considering the perspectives on self-medication of three major stakeholder groups: consumers, payers, and manufacturers, plus the position of the FDA. We then examine the cost-containment implications of Rx-to-OTC switching in two drug classes that have had recent switch approvals (nonsedating antihistamines and proton pump inhibitors) and two classes that may see switches in the near future (statins and obesity therapies). We conclude with a brief assessment of the outlook and implications for the pharmaceutical industry.

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