Every year, the Food and Drug Administration (FDA) approves a number of new drugs and new dosage forms. Each year, employers are faced with rising drug costs and struggle to come up with solutions to reduce costs. A number of approaches have been implemented, including shifting costs to members on the plan, restricting the formulary, optimizing utilization management programs, and implementing a number of other approaches.
However, one perspective may be commonly overlooked is the optimization of over-the-counter (OTC) therapies…
OTC drugs are often a less costly, yet overlooked, option for treatment.
According to the FDA, over 700 OTC or non-prescription drugs were once prescription-only. Another way to look at this is that at one time, these 700 OTC products were only available after a physician visit and are now are available for public access. In the past, many of these drugs were the choice of therapy for several conditions and some are just as effective as prescription-only options. Some pharmacy benefit plans automatically exclude OTC options; however, in some cases, an OTC drug would be a lower cost option for the plan than the prescription product. According to the Consumer Health Association, for every $1 spent on OTC products, the health care system saves $7. Approximately 75% of primary care physicians prefer to recommend OTC products over prescription products and approximately two-thirds of patients prefer OTC products over prescription alternatives.
Some pharmacy benefit plans have provided members with a pre-paid OTC card to allow for coverage of OTC products upon recommendation of their physician, pharmacist, or prescriber. Some plans cover select OTC products as part of the plan as a cost mitigation strategy. For many conditions, a local pharmacist can provide a patient consultation on the correct OTC options for members and bring cost savings to health plans. Of course, avoiding drug-drug, drug-disease, and drug-food interactions is important…by utilizing the accessibility, expertise, and trust of the local pharmacist (possibly even contracted), member satisfaction and cost containment creates a win-win outcome.