People love nonprescription drugs. Being able to get allergy medicine, pain relievers or an athlete’s foot remedy without spending time and money at the doctor’s office and the prescription counter is a convenience. The modest price of over-the-counter medicines seems like a bonus, too.
But pay attention: that lower price may not save you money in the long run. Insurance companies do not pay for nonprescription products. As a result, you may end up footing the entire bill instead of just making a co-payment as you do for your prescriptions.
Who decides if a medicine requires a prescription or not? In theory, the Food and Drug Administration makes this determination based on criteria of safety and efficacy. In practice, though, the manufacturer has a lot to say about it.
Drug companies have been switching successful prescription drugs over the counter for years. When patents expire, products facing generic competition may maintain profitability if they are widely available. Zantac 75, Tagamet HB, Pepcid AC, Motrin IB and Aleve are just a few examples of popular drugs that were once available only by prescription.
Now, insurance companies are getting into the act. They could save a lot of money if they could talk the FDA into switching a drug, even if the manufacturer isn’t interested. Back in 2001 Wellpoint Health Networks petitioned the FDA to move the allergy medicines Claritin, Allegra and Zyrtec from prescription to OTC status. The company anticipated savings of nearly $100 million if consumers paid for their own allergy medicine.
The maker of Claritin eventually decided to get with the program. It has been marketing Claritin OTC for more than a year at around $30 for a month’s supply.
Even though Allegra and Zyrtec are still available only by prescription, many insurance companies encourage consumers to buy Claritin instead. They have done this by raising the co-pay for prescription allergy drugs to $30 or more, so that people will think twice before resorting to one.
The out-of-pocket costs shouldn’t be the only consideration when it comes to an over-the-counter remedy. Just because the FDA decides a medicine is safe and effective enough to go OTC doesn’t mean these products are totally innocuous. One day it takes a doctor’s prescription to get Claritin or Prilosec; the next day, you can send your teenager off to the convenience store to buy the very same drugs, no prescription needed. But the potential side effects don’t disappear by magic.
Unfortunately, too many people assume that “safe and effective” means always and for everyone. Lots of folks don’t even bother to read the fine print on the package about how to use familiar products like aspirin or other pain relievers.
Even when they do, the information is frequently incomplete. For example, headache or arthritis remedies like ibuprofen or naproxen may raise blood pressure, cause ulcers or interact dangerously with other medications.
Sometimes it may actually make sense to ask your doctor about a prescription rather than diagnose and treat yourself. You might save money in the long run and also be protected from potentially serious interactions or side effects.