Several factors are driving the move to make medicines that were previously obtainable only on prescription available over the counter from pharmacies.1 One factor is the decline of paternalism and the consumerist belief that the populations of highly developed societies are educated enough to be able to treat themselves without the need to consult a doctor. Another is governments' interest in controlling expenditure on health care. A drug bought over the counter at a pharmacy not only saves the costs of any subventions given to prescribed drugs but also eliminates the cost of a consultation to obtain the prescription. Finally, the pharmaceutical industry also has an interest in increasing the sales of generic products and sees scope for doing so through advertising directed at patients who make their own decisions.2 These forces may be irresistible. The question then becomes where to set the threshold to ensure an acceptable risk in relation to the benefits.

Danish experience may be instructive since the two H2 receptor antagonists cimetidine and ranitidine became over the counter drugs (limited to pharmacies) more than five years ago. The …