The Economic Impact of a Switch From Prescription-Only to Non-prescription Drugs in Italy

Abstract

The paper analyses the potential economic impact of switching drugs from prescription-only to over the counter status, using Italy as a case-study. The study assumes a societal perspective, investigating the effects of switches (and consequent delisting) on drugs spending, avoided visits by GPs (General Practitioners) and avoided time spent by patients for these visits. It overcomes the main pitfalls of previous studies, providing a rational for listing switchable products and applying both a static (no impact of switch on prices and volumes consumed) and a dynamic approach (impact on pricing policies and volumes depending on price-elasticity). Different scenarios were assumed including shorter/longer time spent for visits and inclusion/exclusion of the economic value of time of retiree patients. Results show that switching policy provides with societal savings ranging from 1 to 2.1 1 billion Euro. The economic impact on patients is less straightforward and depends on the scenarios used. If a longer time is spent on visits, the economic value of this time will compensate the cost of the switch to patients due to delisting. Despite the net economic benefit should be carefully interpreted, the results demonstrate how switching can contribute to the sustainability of the health care system in the middle-long run thanks to the more rational use of resources, combined with an increased awareness and responsibility of the involved stakeholders.

Self-Medication in Europe: Economic and Social Impact on Individuals and Society

“…The unexploited self-medication potential is equivalent to the proportion of GP visits that could be substituted by self-medication. This effect has been discussed in various European studies and is often expressed in terms of time spent and appointments allocated to MA cases during GP visits or as the number of avoided GP visits resulting from a switch from prescription-only to OTC medicines [21,39,40]. The identified potential of freed GP resources can especially benefit severe cases of illness and reduce waiting times for patients [41,42].…”

“…In recent years, self-care studies with a specific focus on quantifying self-medication have been conducted at the national level for Greece [19], Spain [20], Italy [21] and Germany [3] as well as one study focusing on seven European countries [22]. These studies consistently demonstrate that various positive effects can be achieved for national healthcare systems if a proportion of prescription-only medicines or unnecessary GP visits are replaced with responsible self-medication.…”

“…The latter is determined using a database on the OTC status of medicines in all European countries [30]. As the availability of OTC products is obviously a necessary condition for self-medication to be practised [21,31,32], this condition is not yet sufficient since the population must also be willing to use these preparations. Against this background, the estimation of the development potential is based firstly on how many over-the-counter medicines are available or how many more Rx-t-OTC switches are still possible and secondly on the extent to which the given potentials for self-treatment are currently already being used by the population.…”

Review of Regulations Governing Switching Drugs From Rx to Over-the-Counter in the Usa, India, and Eu

“…The driving forces behind switches are diverse and multifactorial and depend on potential benefits implied by an individual switch for the various stakeholders affected [6]. Multiple economic analyses of Rx-to-OTC switches demonstrated entire cost savings to the health-care system by shifting parts of these costs "from the public purse to the private" [7,8]. In this way, upgrading self-support and amplifying consumer choice without compromising the consumer's safety and economic well-being are the guiding values for the switch evaluation process [9].…”

Evaluación del cambio de condición de venta de una molécula de prescripción médica a venta libre en el gasto en medicamentos : el caso de la fexofenadina en Colombia

“…Esto muestra un mayor acceso y al mismo tiempo un menor costo para los pacientes al poder adquirir los medicamentos en una droguería sin visitar a un médico, lo cual impone barreras de tiempo, distancia y costo (Isacson, 1999). Pero además puede generar mayores eficiencias dentro del sistema, ya que el tiempo ahorrado por parte de los médicos que antes atendían enfermedades menores puede ser utilizado en enfermedades más severas y complejas (Otto, 2018).…”