Views & Reviews Personal View

End pharmacists’ monopoly on selling certain drugs

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3415 (Published 01 July 2015) Cite this as: BMJ 2015;351:h3415
  1. Paul Rutter, professor of pharmacy practice, School of Pharmacy, University of Wolverhampton, Wolverhampton WV1 1SB
  1. paul.rutter{at}wlv.ac.uk

Evidence is lacking that oversight by pharmacists has benefits, writes Paul Rutter, who thinks that the US dichotomy of prescription-only and non-prescription drugs is simpler

In January 2015 the UK Medicines and Healthcare Products Regulatory Agency announced that oral diclofenac would no longer be available as a non-prescription drug sold exclusively under the direction of a pharmacist (a “pharmacy medicine”). Instead, it would revert to being available only on prescription because of a small but notably increased risk of cardiovascular side effects.1

Despite oral diclofenac having previously been restricted to sale through pharmacies the UK regulator decided that risks could not be ruled out—even in short term use and at lower doses than those prescribed. This implies that, even with this system of restricted availability, doubt exists that pharmacists (and their staff) can supervise sales to consumers appropriately.

Given this decision, should any drugs still be restricted to sale only with a pharmacist’s supervision? Globally, many governments have healthcare policies that advocate for less prescription-only control of drugs. The mechanism for deregulation varies, but consumers worldwide can access drugs more easily than …

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