Sachit Shah wrote:
>
> I have just seen an advertisement (intended for the general public) here in British Columbia that Famotidine (Pepcid) is going to available as an OTC medication.
>
> I wonder, is this not going to delay diagnosis of Gastric Cancer and Peptic Ulcers in patients who self medicate themselves?
>
> Are there any other jurisdictions where this medication is available in a similar manner and what has been the experience?
>
> Sachit
Yeah, New Zealand.
We(*) released small packs of famotidine 20mg for sale OTC (under
pharmacist supervision) around 1 year ago. This was along with
cimetidine and ranitidine. The company MSD got pretty excited initially
and started advertising like crazy, but you can't change people's habits
overnight. If it's just hyperacidity (or too much red wine..) they feel
safer with an ordinary antacid - reliable and predictable and not a
"drug". MSD has stopped advertising coz there's no money in it. But it
is all part of a de-regulatory plot here to get Government's out of
funding as much prescription drug stuff as they can. Pity the sick
people who can't afford to pay for the drugs but need them once the drug
funder has decided the Government doesn't need to "prop" them up.
[(*) I was a member of our national Medicines Classification Cttee, so
you can blame me partly.]
The big problem as I see it is we don't really understand what happens
with upper GI diseases, despite the Helicobacter revelations. It is
likely that many upper GI problems are indeed from viral triggers (most
oesophageal ulcers in elderly are zoster induced). I am more concerned
about masking these kinds of problems - including bleeding gastric
ulcers - than gastric Ca which is not all that common.
The problem is that the public/Govt demands only extremely safe new
drugs. The requirement is almost such that once they have been around a
couple of years they are almost safe enough to go OTC. That is, if the
patient wants to be their own doctor.
Jon Wilcox
Auckland
PPS: I am about to talk to the New Zealand Proprietary Medicines
Conference in about four weeks. Anybody got any "interesting" OTC
stories they would like to convey?????
I'd _love_ to hear about them..
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