Canada considering medicines deregulation

In a thoughtful essay Lynd et al, from Vancouver, present some interesting points.

Governments in several countries, including the UK, and in a few provinces in Canada are considering reclassifying some drugs from prescription to over-the-counter status. In a CMAJ essay, Lynd and colleagues comment on the economic effects of such changes.

The drugs being considered are used in a wide variety of chronic diseases. They include proton pump inhibitors, beta-blockers, diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, HMG CoA reductase inhibitors, inhaled corticosteroids, short and long-acting B2 agonists, bisphosphonates and oral contraceptives.

In the UK, 100 drugs are on the RPSGBs' list for conversion to over-the-counter status. In Ontario, 8 of these drugs account for $540 million (27%) of the Ontario Drug Benefit Plan budget. In BC, 49 of these drugs account for $266 million (44%) of total Pharmacare drug expenditures.

If the medicines were deregulated to behind-the-counter status (No Public Access), pharmacists would not just dispense medications, they would have a clinical and consultative role. Visits to physicians for routine control of chronic diseases might also decline.

http://www.cmaj.ca/misc/press/pg775.pdf

For those interested in the UK situation see this article, from last year (when I was at Bradford University). Since then a number of POM to P switches have "gone public", including: simvastatin tablets and chloramphenicol eye drops.

In the MHRAs' approval pipline are: trimethoprim tablets, triptans, topical steroids and topical treatment for fungal nail infections.

http://www.pjonline.com/pdf/agenda/pj_20040424_pomtop.pdf

See also this important BMA report on OTC medications (co-written by Alison).

http://www.bma.org.uk/ap.nsf/content/OTCmedication/$file/OTC.pdf