Australians missing out on pharmacy medicines

15 October 2017

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NZ approved non-prescription access for three times more
prescription medicines than Australia in last five years

Australians are falling behind on access to medicines available via pharmacy - medicines that have been improving health outcomes in other nations, such as the UK and New Zealand.

A new assessment of research by Dr Natalie Gauld, a presenter at the World Self Medication Industry (WSMI) General Assembly held in Sydney this week, shows that, compared to Australians, New Zealanders have more medicines available to them through pharmacy, allowing them to better self-manage health conditions and minor ailments. Australian regulations and approval processes are being questioned based on these findings.

"In New Zealand we are giving people the tools and support to make informed decisions on their health in key areas, however Australians don't yet have the same level of access," says Dr Gauld.

"In the last five years, New Zealand regulatory authorities have received applications to 'down-schedule' twice as many medicines from prescription-only to non-prescription access, and given the green light in three times as many cases," says Dr Gauld.  "This is a significant difference. There is an opportunity for Australia to consider how down-scheduling could be enabled for greater access in terms of a 'wider public health opportunity' and the management of our escalating healthcare costs."

Medications that require a prescription in Australia but can be accessed directly via a pharmacist in New Zealand include the oral contraceptive pill, shingles vaccination, and treatments for migraine, erectile dysfunction, urinary tract infections, psoriasis and acne. In the UK, consumers with high cholesterol or needing antimalarials for travel can head straight to their pharmacist for treatment without a visit to the GP.

Nine out 10 Australians already use non-prescription medicines regularly1, and each $1 spent on the top 8 non-prescription product categories saves the Australian economy $4.2

The assessment and approval process that permits a prescription-only medicine to move to non-prescription access - a process referred to as 'switch' - has been responsible for how we access many of the medicines millions of Australians access every day in pharmacies and grocery stores. These include ibuprofen, antifungal treatments and nicotine replacement therapy - it is estimated that 68,750 premature deaths in Australia were prevented by NRT in the first 10 years after it became available over-the-counter (OTC)3. Figures presented at the WSMI General Assembly will show that nearly 40% of medicines currently available over-the-counter in the USA were previously prescription-only medicines4.

In addition to less access to medicines, most Australians are in the dark about many medicines they can access - but only if they ask their pharmacist for them (known as Schedule 3 medicines).  These medicines are kept behind the counter in pharmacies and many Australians wouldn't know they were available, as they are not allowed to be advertised to consumers. These include treatments for cold sores (famciclovir), thrush (fluconazole) and bacterial conjunctivitis (chloramphenicol).

The risk-benefit assessment process to review access to medicines in Australia is in stark contrast to New Zealand, where the in-pharmacy access to erectile dysfunction medications (e.g. Viagra) has been seen as a positive for men's health - the screening process for these medicines has actually helped catch out previously undetected health issues in men who go to the doctor infrequently.

"Australia needs to adopt a more progressive approach and review how wider access to medicines supported by information/advertising can support improved overall health of the community and reduce the escalating burden on the healthcare system," says Deon Schoombie, CEO of the Australian Self Medication Industry (ASMI), which is co-hosting the WSMI General Assembly.

Under the theme The Health Economics of Self-Care, the WSMI General Assembly brings together 350 attendees and over 30 world-leading experts in consumer healthcare. The conference will address how adopting responsible 'self-care' strategies can help Australia and other nations better manage the significant health challenges and costs associated with an ageing population, the rising tide of preventable disease and the ongoing burden of chronic disease.

"While consumers value the convenience of non-prescription medicines, the potential benefits extend to improving consumer health and increasing the efficiency of healthcare delivery," says Dr Eric Brass, Professor of Medicine at University of California and past Chair of the FDA's Non-prescription Drugs Advisory Committee.

 "Self-care is already well-established in the management of common acute conditions," says Dr Edwin Hemwall, a world-renowned expert in the 'switch' of medicines from prescription-only to OTC access. "Influencing consumer and patient behaviour can reduce costs and better utilise scarce healthcare resources."

Dr Natalie Gauld, Dr Edwin Hemwall and Prof. Eric P. Brass will all present at the World Self Medication Industry (WSMI) General Assembly takes place in Sydney 18th - 19th October and are available for comment. See the WSMI General Assembly schedule here.

 References

1.  Consumer Behaviour Fact Book (March 2015), Macquarie University Centre for the Health Economy

2.  Macquarie University. The Value of OTC Medicines in Australia, March 2014.

3.  Bittoun R. Brain and Mind Research Institute, University of Sydney, Australia. A decade of over-the-counter therapeutic nicotine in Australia. Its contribution to improving quit rates and saving lives. May 2007

4.  Kartha S. et al,Switching Drugs from Rx to OTC status - A Regulatory Perspective. Journal of Young Pharmacists, Jan. 2017.