Many Prescription Drugs are Moving to Over-The-Counter

Reaching out to consumers comes naturally to the cheaper and, these says, more cheerful side of the business: over-the-counter (OTC) medicines: For example, Xenical, Roche's anti-obesity drug, was launched with great fanfare in 1998, but sales failed to take off, in part because of the way the drug works: it blocks the absorption of fat in the gut, so greasy foods come out at the other end as oily stools. Earlier this year Roehe teamed up with GSK to turn Xenical into a lower-dose over-the-counter medicine. Instead of getting a bottle of pills, customers will buy a weight-loss kit with information and advice on how to change their diet and behavior. So the drug becomes a tool to help customers identify and avoid hidden fats in food. Provided it meets all the FDA standards for safety, efficacy and customer comprehension, the drug could be on the market next year. Such consumer marketing-where a pill becomes part of a broader health-care solution-is just the sort of thing prescription drugmakers need to do more of.

The OTC market used to consist of drugs to treat acute conditions that were easy to self-diagnose, with little potential for harm from abuse by the patient. The new generation of OTC drugs, switched from prescription status, break that mould. They include Zocor, a cholesterollowering statin, which was switched last year in Britain, and Prilosee, an anti-ulcerant now available over the counter in America. Others that might make the leap in the next few years are drugs for asthma, osteoporosis and migraine. OTC drugs are sold much more cheaply than branded prescription pills, but big drug " firms welcome them as a way of managing their product lifecycle, especially when a drug is about to go off-patent.

Private payers and governments like OTC because it offers the potential of reducing their drugs bills and saves on the cost of doctors' prescriptions. Such switches also fit well with the movement - towards empowering patients: In Britain, taking Zocor OTC is part of a government strategy to help people at moderate risk of a heart attack to control their cholesterollevels.

America's FDA is also keen on selling more drugs over the counter. But America lacks the sort of "behind-the-counter" system found in many European pharmacies, where pharmacists hand out advice together with the medicine. Until something similar is introduced there, many potential OTCS will have to wait.

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