HEALTH & SCIENCE

Prilosec latest blockbuster drug to go over the counter

Some physicians feel the move will increase access to the drug, but others worry about missed opportunities to diagnose more serious conditions.

By Victoria Stagg Elliott, AMNews staff. July 14, 2003.

In June, Prilosec became the first proton pump inhibitor to receive over-the-counter status from the Food and Drug Administration. It follows in the footsteps of the hit allergy drug Claritin, which made the OTC switch last year.

"As has been the case for many other over-the-counter switches, the availability of Prilosec OTC will help reduce costs and expand the availability of treatment options for millions of Americans," said FDA Commissioner Mark B. McClellan, MD, PhD.

Physicians had mixed reactions to the news. Most transient heartburn is treated with OTC products, but some doctors worry they will now miss opportunities to treat the chronic form of the disease, to find conditions with more serious implications and to discuss broader lifestyle changes.

"It's a terrible thing," said Raymond Basri, MD, a Middletown, N.Y., internist. "People with severe problems will not be diagnosed appropriately, and anytime you get a patient in the office, you have an opportunity to do lifestyle modification and talk about all sorts of issues. You lose the opportunity to help people if you take away a reason for people to come in."

Some doctors also expressed concern about the impact on insured patients if plans opt to restrict access to prescription PPI's. Some payers, for instance, imposed prior-approval requirements and higher co-pays on non-sedating antihistamines after Claritin (loratadine) went OTC. "Every time one of these products goes over the counter, you're shifting the cost to the patient," said Dr. Basri.

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