Shopping for Drugs: 2004
Table of Contents
- Executive Summary
- Introduction
- Comparing Prices
- Therapeutic Drug Substitution
- Bulk Buying
- Pill Splitting
- Generic Drug Substitutes
- Switching to Over-the-Counter Drugs
- Weighing the Cost and Benefits of a Drug
- Case Studies: Price Comparisons for Specific Drugs
- Buying Drugs Abroad
- Special Opportunities for Seniors: Medicare Discount Drug Cards
- Financial Assistance to Lower Drug Costs
- Conclusion
- Notes
- Appendix
- About The Author
Switching to Over-the-Counter Drugs
About 80 percent of the time, patients initially treat their medical problems with OTC drugs. Americans buy OTC drugs more than 5 billion times each year. 59 Today consumers can choose from among more than 100,000 different OTC drug products. 60 Physicians recommend them more frequently than in the past. 61 According to Ipsos PharmTrends, more than half of doctors recommend OTC products to their patients when appropriate. In fact, in the first six months after Claritin was switched from a prescription drug to OTC status, 42 percent of those purchasing it had been advised to do so by their doctor. 62 More than 600 OTC drugs were previously available only by prescription. 63 For example:
- Over the past few years, such powerful prescription ulcer medications as Zantac (Ranitidine), Pepcid and Tagamet (Cimetidine) were moved from prescription-only to over the counter. 64 These were joined by Prilosec, one of a newer class of ulcer medications, in September 2003. 65
- In addition, strong pain relievers such as Advil (Ibuprofen) and Aleve (Naproxen) were approved for OTC sale.
- Claritin (Loratadine), a second-generation antihistamine, has now joined the OTC market along with first-generation cold and allergy medications such as the antihistamines Benadryl and Chlor-Trimeton, and their generic equivalents Diphenhydramine and Chlorpheniramine. Sudafed (Pseudoephedrine) was one of the first popular branded decongestants to become an OTC medication.
“Smart Shopping: Consider over-the-counter versions of prescription drugs.”
Utilizing OTC medications can save patients money. For instance, before moving to the OTC market, prescription Claritin cost $2.92 per day. 66 Currently, OTC Claritin costs 52 cents per day at Costco and its generic equivalent costs less than nine cents per day. 67 Before moving to the OTC market, Prilosec cost $122.99 for 30 capsules at Walgreens.com, a daily cost of about $4.10. 68 Currently, Walgreens.com sells a box of OTC Prilosec with 28 capsules for $19.99, or a daily cost of 71 cents. 69
In years past, drugs were usually only switched from prescription-only to OTC status at the request of the drug maker, and only when patent protection was about to expire. 70 In 2002, however, an FDA panel voted to recommend OTC status for Claritin on a request from the health plan manager WellPoint Health Networks. That was the first time the FDA took such an action without an initial request from the manufacturer. In response, Claritin’s manufacturer asked for OTC status — which the FDA granted — so that it would be able to market the drug as a nonprescription medication while it was still under patent. 71
Many analysts predict that over the next few years a flood of relatively new blockbuster drugs will enter the OTC market. 72 For example, the OTC version of the popular anti-ulcer drug Prilosec — which had $3.7 billion sales and was the second biggest-selling drug in 2001 —became available in the fall of 2003. 73 The price fell from $4 per capsule to 60 cents. 74 Analysts expect the FDA to approve several more nonsedating antihistamines, and possibly cholesterol-fighting medications such as Mevacor (Lovastatin) and Pravachol (Pravastatin) for OTC sale. 75
When products move to the OTC market, their prices drop sharply. 76 For example, Claritin, one of the best-selling allergy medications, was moved to the OTC market in December 2002. 77 The number of Claritin doses sold increased dramatically, while the dollar value of prescription antihistamines sold fell 28 percent in 2003. 78
