Education And Debate

Over the Counter Drugs: Patients, society, and the increase in self medication

BMJ 1996; 312 doi: (Published 09 March 1996) Cite this as: BMJ 1996;312:629
  1. Alison Blenkinsopp, director of education and researcha,
  2. Colin Bradley, senior lecturerb
  1. a Department of Pharmacy Policy and Practice, Keele University, Keele, Staffordshire ST5 5BG
  2. b Department of General Practice, University of Birmingham Medical School, Birmingham B15 2TT
  1. Correspondence to: Dr Blenkinsopp.

    Self medication with over the counter medicines has long been a feature of the lay health system. With the reclassification of certain drugs, the public can buy preparations that were previously available only on prescription. Sales of over the counter medicines are now equivalent to a third of the NHS drugs bill; governments throughout the world see self medication as a way of shifting some of the cost of health care onto consumers. The trend towards increased self care and with it the increasing empowerment of patients has many potential benefits; collaboration between doctors and pharmacists will be critical.

    Over any two week period, nine out of 10 adults will report having experienced at least one ailment.1 2 Non-prescription medicines, commonly known as over the counter or OTC medicines, are used to treat one in four of these episodes.2 Sales of over the counter medicines in pharmacy and grocery outlets reached pounds sterling1268.5 million in 1994 (box 1)—about a third of the NHS drugs bill of pounds sterling3.6 billion.

    Box 1 Market breakdown for major categories of non-prescription medicines3

    View this table:

    In the late 1980s the government fuelled the over the counter market by making it easier to reclassify certain medicines from prescription only status to allow over the counter sale in pharmacies. Progress was slow at first, with 11 medicines being reclassified between 1983 and 1992 (table 1), but since 1992 a further 40 medicines have been reclassified. This widened range of non-prescription medicines has highlighted the role of pharmacists, to whom the public is increasingly looking for advice.

    View this table:
    Table 1

    Medicines deregulated from prescription only to pharmacy status, 1980-95

    What is driving the POM to P changes?

    Factors promoting and inhibiting the reclassification of drugs are shown in box 2. The deregulation is occurring against a background of pressure on the primary care drugs bill. Self care and self medication with non-prescription medicines are seen by governments throughout …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription