When prescription drugs switch to over-the-counter status…

Sometimes consumers take a hit to the pocketbook.

The commercials are bound to start soon, if they haven’t already.

Earlier this year, the U.S. Food and Drug Administration (FDA) granted permission for over-the-counter sale of Oxytrol, a popular bladder control patch for women. The drug is just now hitting store shelves in Louisville — at prices that could be much lower than previous insurance co-pays.

Recently, a Kroger pharmacist excitedly told a customer that her 30-day Oxytrol supply was available, without a prescription, in the feminine hygiene aisle for less than half its usual $80 co-pay. The box looks a little different, but the drug is exactly the same.

Switching certain drugs to over-the-counter (OTC) status is part of the FDA’s mission to meet consumer wishes to be more involved. The agency said it is “part of an important trend toward consumer participation in their own health care.”

Consider, for instance, someone who wants to quit using tobacco. Nicotine patches used to be available only by prescription. So aside from the cost of the patch, quitters faced doctor bills and downtime at work.

Nicotine-based “stop smoking aids” started going OTC in 1996, when the FDA approved Nicorette gum and two transdermal nicotine patch products, Nicotrol and NicoDerm CQ, for sale without prescriptions. Other prescription nicotine patches soon followed, including Prostep and Habitrol. Then nicotine lozenges became available over the counter.

All those nicotine products are among more than 700 OTC drugs that would have required a prescription only 20 years ago, according to the Consumer Healthcare Products Association (CHPA), which represents manufacturers and distributors of OTC medicines and nutritional supplements.

Making certain drugs available without a prescription or doctor’s visit has a huge impact, according to CHPA’s 1997 study, which found that the increase in OTC medicines saves approximately $20 billion each year in prescription costs, doctor visits, lost time from work, insurance costs and travel.

However, sometimes consumers take a hit to the pocketbook, if an OTC ends up costing more than a prescription co-pay might have been. Insurance carriers generally stop paying for drugs that convert to over-the-counter status, and OTC drugs don’t count toward insurance or tax deductibles. Allergy sufferers who remember when Claritin, Zyrtec and Allegra switched to OTC may know this all too well.

Also, some insurers drop coverage of certain prescription drugs if there are readily available OTC brands. Prescription Nexium, already off some insurance formularies, will fall off others in January because scores of over-the-counter competitors are available to treat heartburn, gastroesophageal reflux disease (GERD) and conditions that cause too much stomach acid.

Do you have questions about how to save money on prescriptions or potentially dangerous interactions between medications? Contact the experts at Norton Healthcare’s new pharmacy, located on the second floor of Norton Hospital, 200 E. Chestnut St., in downtown Louisville. The pharmacy can be reached at (502) 629-3800.


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