When the patient is in charge – thoughts at a pharmacy’s OTC shelves

Blogs • 01.11.2019

Customers often head for a pharmacy also in matters not involving prescription medicines; the selection of over-the-counter (OTC) medicines seems dizzying even to a pharmaceutical professional. Besides medicines, products available for self-selection include medical devices, dietary supplements, and cosmetics products. Consumers may truly have a hard time distinguishing between different product categories on the pharmacy shelves.

Surprisingly, a vitamin/mineral supplement previously sold as a medicinal product may now be found among dietary supplements at the pharmacy. It is also confusing that products intended for similar use may be available in several different product categories.

How to recognize OTC medicines?

Compared with medical devices, dietary supplements and cosmetics products, OTC medicines are subject to different and much more extensive requirements. They must have a marketing authorisation granted by drug regulatory authorities. Like prescription medicines, OTC medicines must meet strict quality criteria and be effective and safe. They must be monitored for adverse reactions, and their product information must be approved by the authorities and kept up-to-date together with the rest of the marketing authorisation documentation.

The packs of OTC medicines available in Finland must bear a text indicating OTC status in order to make it easier for consumers to distinguish between OTC products and other products.

The suitability of medicines for self-care is evaluated on a case-by-case basis. The pack sizes of OTC products must not be unnecessarily large considering the duration of treatment. Nowadays, the packs of OTC medicines available in Finland must bear a text indicating OTC status in order to make it easier for consumers to distinguish between OTC products and other products.

What lies in the future of OTC medicines?

In the next few years, there will certainly be new products and possibly new strengths, pharmaceutical forms and larger pack sizes approved for self-care. A large-scale increase in the number of OTC products is not likely, though.

At the moment, there are only a few OTC medicines requiring additional advice (behind-the-counter (BTC) medicines) in the Finnish market. Maybe this product category will grow in the future? The BTC status has worked well with postcoital contraceptives as they must be taken without a delay; a requirement to see a doctor might unnecessarily hinder their use in some cases.

Maybe a new product category could be created between OTC and prescription medicines?

Even today, OTC medicines are useful in relieving the strain on other healthcare services. Maybe a new product category could be created between OTC and prescription medicines which would allow for example pharmacists to dispense certain medicines to patients based on a standardised set of questions?

Pharmacies or grocery stores?

Self-care is a form of drug treatment which puts special emphasis on the role of pharmacy staff. Pharmacy professionals are well equipped to advise customers, which provides a solid foundation for a controlled expansion of the range of self-treatment products available at pharmacies in future.

Nicotine replacement products used to be sold in pharmacies only; now they can be bought in grocery shops and other retail outlets. This development has more than doubled their sales, 86% of these products are now sold at outlets other than pharmacies. There is no data available on the impact of this change on smoking cessation, however.

In public debate, there have been forceful opinions voiced in support of the release of OTC medicines for sale in grocery shops. It is also possible that Parliament will decide on the release of certain products in the near future. It is impossible to predict all the consequences. But one thing is certain: when the time comes, we will face new, different challenges.