OTC switch a prescription for rising healthcare costs
SINGAPORE — As online buying of healthcare products increases, and the demand for self-medication gathers momentum amid surging healthcare costs, multinational pharmaceutical companies in Singapore, analysts said, are likely to up the ante to get approvals for their prescription-only products reclassified as over-the-counter medications, alongside common household drugs such as paracetamol and antacids. Doing so would not only help pharmaceutical companies boost revenue, it would also make it easier and cheaper for those on regular prescriptive medication to pop into a store to top up their supply, rather than visit a doctor for a prescription.
For instance, birth control pills are only available in Singapore with a doctor’s prescription at a clinic or from a pharmacist at Guardian, Watsons or Unity. A monthly pack from a clinic typically costs between S$20 and S$30, depending on consultation fees and the brand of the contraceptive.
In several other countries though, such drugs are available over the counter at much cheaper rates, industry experts said.
“It is safe to pull some drugs from prescription lists and introduce them in retail pharmacies, as long as the authorities in Singapore track the usage versus abuse of over-the-counter drugs. The positive implications are access to medicine, visibility and, to an extent, medicines will get cheaper as companies will compete to drive sales,” said Mr Siddharth Dutta, industry manager for life sciences at consultancy Frost & Sullivan Asia Pacific.
Online buying of health products such as health supplements and medicinal drugs is on the rise, fuelled by an increasing demand for self-medication amid greater awareness of health conditions among consumers. The fear, however, is that it could lead to harmful complications because many drugs purchased online have been known to be adulterated or counterfeit.
In fact, about half of the drugs sold over the Internet are counterfeits, according to the World Health Organization. “The proliferation of Internet sites selling health products can be influenced by consumers’ demand. It is therefore important for the public to be aware of the dangers associated with these products,” a Health Sciences Authority (HSA) spokesperson said.
“To address this situation, it is imperative for the HSA to consider the demand for switching certain prescription products to OTC status. Ultimately, this will facilitate easier access to approved medicines and reduce health care costs,” said Mr Abhijit Ghosh, pharmaceutical leader to business consultancy PwC in Singapore.
“The combined efforts of pharma companies and HSA must meet the expectations of local consumers by providing products which are safe, effective, good value for money, and accompanied by complete and relevant information,” he added, emphasising the high standards of information and promotional practices in educating consumers on responsible self-medication. Further, he said, appropriate measures are required to enable consumers to report adverse drug reactions to self-medicated products, and to avoid OTC medicines being misused by drug addicts.
Healthcare spending in Singapore is expected to rise to about US$2,400 (S$3,400) per head in 2030, compared with about US$650 in 2010, according to an Economist Intelligence Unit study using WHO Epsicom data. In countries such as China, India or Malaysia, the healthcare spending per head by 2030 will not be as much as it was in Singapore in 2010, with other Asian countries lagging further behind, the study showed.
“Singapore will have the fastest growth of healthcare costs in Asia, so cost containment will be an issue,” said Mr Dirk Huisman, chairman of Rotterdam-based consultancy firm SKIM. According to the HSA, seven products have been reclassified from Pharmacy Only to General Sales List medicines since 2012, including antihistamines for allergies, anti-inflammatory cream or gel for joint pain or sprains, and anti-fungal creams. At the same time, 13 medicines have been reclassified from Prescription Only to Pharmacy Only, including those by HSA-initiated reviews, with certain restrictions imposed. Examples of these include antihistamines and steroid nasal sprays for allergies, azelaic acid cream for acne and pantoprazole for heartburn.
“Apart from evaluating submissions by pharmaceutical companies to reclassify their products from Prescription Only Medicine (POM) to Pharmacy Only (P), or P to General Sales List (GSL) medicines, the Health Sciences Authority also initiates regular reviews of existing POM medicines, which may be supplied by pharmacists without a doctor’s prescription,” a HSA spokesperson said.
For global pharmaceutical companies, consumer health or the OTC segment is a key focus area besides breakthrough drug development and volume growth of prescription medicines.
“Several global companies follow this route. Johnson & Johnson is the leader while GlaxoSmithKline and Bayer have made several strategic decisions globally on Rx (prescription) to OTC switches to emerge as leaders in the consumer health segment. TEVA has also taken a similar route under its joint venture with consumer goods powerhouse P&G,” Mr Huisman said.
Multinational pharmaceutical companies, according to Mr Huisman, usually introduce their prescription to OTC switch plans at a global level and rely on their local arms to arrange the switch at the ground level and seek approval from the respective countries’ authorities.
“At the global level, Rx to OTC switch continues to be a key imperative for Pfizer and an important growth driver for the consumer healthcare business. We remain committed to advancing our switch pipeline so we can bring consumers greater access to more and better options to manage their health,” a Pfizer spokesperson in Singapore said.
