No Professional Oversight With OTC Drugs

March 14, 2008

Recently, the FDA has held hearings on a proposed BTC (Behind the Counter) class of drugs. This class will be kept behind the pharmacy counter and be sold only at the discretion of a pharmacist.

Recently, the FDA has held hearings on a proposed BTC (Behind the Counter) class of drugs. This class will be kept behind the pharmacy counter and be sold only at the discretion of a pharmacist. Currently, there is statutory support for only two classes: Rx Only and OTC (over the counter).

There can be no professional oversight with the OTC class when the drugs are sold at grocery stores, convenience stores or truck stops. It is reasonable to presuppose that there have been medical catastrophes. How many Circle-K cashiers know enough to suggest the possibility of a vaginal bacterial infection to a woman putting money down for a package of Monistat-7? How many young women never get a chance to bear children because of the willy nilly nature of diagnosis with regard to the OTC class? A truck stop worker’s anecdotal diagnosis can and does cause harm.

Some are against the BTC class. One group is the manufacturers. It is all about the Benjamins for them. Patient care is NOT a consideration. They will make gobs more money if their products are placed in the OTC class where they can be sold at truck stops.

The other group has been obstructionist regarding pharmacists for decades. It does not seem to want to “allow” pharmacists to step out of the time-honored dispensing role no matter how advanced the training has become. The AMA says that “pharmacists lack the education and experience in patient evaluation, clinical diagnosis and prescribing for the individual.” Come, think about it. Does the grocery clerk possess these skills? Who would you rather your college student daughter go to for advice on her non-prescription drug choice… the pharmacist or the check out girl at the Jiffy Mart?

My contention is that the system is over-burdened. We need every educated, professional hand we have put to work. At the very least, the pharmacist will ask questions. When did the stomach pain start? What have you been eating? Is the discharge brown or white like cottage cheese? Is there an odor?

As far as the system giving better patient care, this one seems like a no-brainer to me. But, when it comes to money and “turf,” all bets are off.