WSMI GA expert panel: this is how you respond to key concerns about switch
An international panel of experts on prescription-to-OTC switch have offered some suggestions on how industry can respond to key concerns about down-scheduling.
The panel discussion took place on the final day of the World Self Medication Industry General Assembly in Sydney, following the session Optimising Self Care through Switch.
"Some of the downsides of switch aren't as bad as people might think they are," said Scott Koslow, Professor of Marketing at Macquarie University and acclaimed researcher and commentator on how consumers approach health decisions.
"One of the things that people are afraid of is that people would rush into pharmacy and try to get these [down-scheduled] medicines and use them inappropriately. I don't see evidence of that.
"There are always problem consumers who won't listen, won't follow directions, or they want to misuse a product. Are these folks going to rush into pharmacy to use S3 medicines? I don't think so - they're actually very happy with the doctor-shopping they're doing right now.
"The people who are well-educated consumers and turned on to self care, these are the folks who want to avoid doctor visits. But even when we talk about them avoiding physician visits, it's not the same aseliminatingphysician visits. More typically, these people are typically visiting a doctor seven times a year - that's a lot - and a switch may reduce their physician visits to six times per year. So we need to make the point that it's not like health issues are going to fall through the cracks because a consumer won't be serviced by a medical professional when more medicines are switched."
Earlier, in her presentation Australian pharmacy perspectives on demand and readiness for increased non-prescription availability of medicines, Griffith University researcher Denise Hope raised the point that the biggest barrier to down-scheduling came from other (than pharmacists) HCPs. This raised questions about how the switch of sildenafil in New Zealand had affected the doctor-pharmacist relationship.
"You have to win locally," said Alison van Wyk, Head of Professional services for Green Cross Health. "People talk about 'fragmentation' of health care, but you know health care is working when patients only have to tell their story once. For this, you need to establish good communication lines between doctors and pharmacists that focuses on health outcomes - even if the different groups might be competing for funding and so on."
The panel was also asked how to meet the challenges of "modern" switches - the switch of medicines for chronic or more complex conditions that may require consumers to follow quite complex regimes. How do we get these switches to be more successful, both from a regulatory and commercial perspective?
"One thing we learned several year ago is that when consumers understand the reasons why they're being given a directive on the label, then they're more likely to respond properly to it," said Dr Edwin Hemwall, an independent consultant in non-prescription drug development who served as co-chair of the WSMI Switch Working Group.
"In the USA, drug labels are basically a directive - do this, do not do that. If you tell consumers the reason why they should or should not do something, then there's a lot more willingness to understand and heed the directive.
"We've seen this for a lot of different types of interactions, which ultimately are best written beyond the label itself, like directing them to a website and taking them through a series of steps. If you explain to the consumer the reason behind the instruction and how it affects them directly, then you have a much higher rate of compliance."
Dr Hemwall used the example of statins in the USA, where switch attempts were not successful.
"All labels for statins in the USA have the warning, 'Do not take while pregnant'. Adding, 'because it could harm your unborn child' would increase compliance dramatically."