Topical Hydrocortisone From Prescription to Over-the-Counter Sale

Ravis, Scott M.; Eaglstein, William H.

doi:10.1001/archderm.143.3.413

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Some studies estimate the potential impact of the switch on specific therapeutic classes, such as antihistamines, cough and cold preparations, and drugs for acid-related disorders (Temin, 1983 , 1992 ; Sullivan et al, 2005 ; Ravis and Eaglstein, 2007 ). Other authors estimate a more general economic impact of switching drugs from Rx to non-prescription for some therapeutic classes in countries, such as Greece 1 , Spain 2 and France (European Commission., 2015 ).…”

Section: Introductionmentioning

confidence: 99%

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

Otto

Pillarella²,

Jommi

2018

Front. Pharmacol.

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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.

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Section: Introductionmentioning

confidence: 99%

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

Otto

Pillarella²,

Jommi

2018

Front. Pharmacol.

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“…That is, the risks are higher when consumers of nonprescription drugs deviate from label directions in ways that are associated with increased risk. Importantly, the risks associated with the use of a drug must be evaluated in the context of existing alternatives for the same condition 24 . Furthermore, any incremental benefit–risk analysis is complicated by lack of definitive information about how patients actually use drugs that are accessed with a prescription from a physician.…”

Section: Risk Domains For Nonprescription Drugsmentioning

confidence: 99%

“…Importantly, the risks associated with the use of a drug must be evaluated in the context of existing alternatives for the same condition. 24 Furthermore, any incremental benefit-risk analysis is complicated by lack of definitive information about how patients actually use drugs that are accessed with a prescription from a physician. There is much evidence to suggest that compliance and adherence to prescription directions on the part of consumers are far from perfect, making the comparator for risks in the nonprescription setting less obvious.…”

Section: Risk Domains For Nonprescription Drugs Risks Inherent To a Drugmentioning

confidence: 99%

Improving the Decision-Making Process for Nonprescription Drugs: A Framework for Benefit–Risk Assessment

Brass

Löfstedt

Renn

2011

Clin Pharmacol Ther

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Nonprescription drugs pose unique challenges to regulators. The fact that the barriers to access are lower for nonprescription drugs as compared with prescription drugs may permit additional consumers to obtain effective drugs. However, the use of these drugs by consumers in the absence of supervision by a health-care professional may result in unacceptable rates of misuse and suboptimal clinical outcomes. A value-tree method is proposed that defines important benefit and risk domains relevant to nonprescription drugs. This value tree can be used to comprehensively identify product-specific attributes in each domain and can also support formal benefit-risk assessment using a variety of tools. This is illustrated here, using a modification of the International Risk Governance Council (IRGC) framework, a flexible tool previously applied in a number of fields, which systematizes an approach to issue review, early alignment of stakeholders, evaluation, and risk mitigation/management. The proposed approach has the potential to provide structured, transparent tools for regulatory decision making for nonprescription drugs.

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“…Compound F (hydrocortisone; cortisol) quickly became the first topically applied corticosteroid effective in a variety of inflammatory skin disorders (Sulzberger & Witten 1952, Ravis & Eaglstein 2007. Meanwhile, cortisone was being hailed as a panacea for treating various diseases of unknown cause but with an inflammatory basis.…”

Section: S: Steroid Chemistrymentioning

confidence: 99%

Diamonds are forever: the cortisone legacy

Hillier

2007

Journal of Endocrinology

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The year 1946 was not only the year that the Society for Endocrinology was founded, but also the year that Edward Kendall's compound E (cortisone) was first synthesised by Louis Sarett. By 1948, sufficient quantities of compound E were available for the rheumatologist Philip Hench to test it successfully for the first time in a patient with rheumatoid arthritis. It was immediately hailed as a 'wonder drug' and was shown to be effective in a number of inflammation-associated conditions, most notably rheumatoid arthritis. The subsequent development of endocrinology as a discipline is inextricably linked to the chemistry, biology and medicine of anti-inflammatory glucocorticoids. Sixty years after the first chemical synthesis of cortisone, corticosteroids remain among the top ten most commonly used prescription and over the counter drugs. Basic and clinical studies of glucocorticoid biosynthesis, metabolism and action have trail-blazed developments in endocrinology ever since. This article surveys the extraordinary cortisone timeline, from first synthesis until now. The concluding scientific message is that intracrine metabolism of cortisone to cortisol via 11bhydroxysteroid dehydrogenase type 1 likely sustains local amplification of glucocorticoid action at sites of inflammation throughout the body. The broader message is that the discovery of compound E by Kendall (basic scientist), its large-scale synthesis by Sarett (industrial chemist) and its therapeutic application by Hench (rheumatologist) serves as a paradigm for modern translational medicine. It is concluded that endocrinology will remain a force in health and disease if it continues to evolve sans frontières at the basic/applied/clinical science interface. A challenge for the Society for Endocrinology is to ensure this happens.

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Topical Hydrocortisone From Prescription to Over-the-Counter Sale

Cited by 9 publications

References 9 publications

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

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

Improving the Decision-Making Process for Nonprescription Drugs: A Framework for Benefit–Risk Assessment

Diamonds are forever: the cortisone legacy

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