REVIEW OF REGULATIONS GOVERNING SWITCHING DRUGS FROM RX TO OVER-THE-COUNTER IN THE USA, INDIA, AND EU

Authors

  • MEGHANA G Department of Pharmaceutical Regulatory Affairs,Shri Vishnu College of Pharmacy (Autonomous), Vishnupur, Bhimavaram, Affiliated to Andhra University, Visakhapatnam, Andhra Pradesh, India.
  • SREE GREESHMA SWETHA K Department of Pharmaceutical Regulatory Affairs,Shri Vishnu College of Pharmacy (Autonomous), Vishnupur, Bhimavaram, Affiliated to Andhra University, Visakhapatnam, Andhra Pradesh, India.
  • RAVI KUMAR REDDY J Department of Pharmaceutical Regulatory Affairs,Shri Vishnu College of Pharmacy (Autonomous), Vishnupur, Bhimavaram, Affiliated to Andhra University, Visakhapatnam, Andhra Pradesh, India.
  • VENKATESWARA RAJU K Department of Pharmaceutical Regulatory Affairs,Shri Vishnu College of Pharmacy (Autonomous), Vishnupur, Bhimavaram, Affiliated to Andhra University, Visakhapatnam, Andhra Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2021.v14i9.42393

Keywords:

Rx to Over-the-counter switch, Self-medication, Drug facts labeling, Advertisements, Indications

Abstract

Rx to over-the-counter (OTC) switch is a data-driven, scientifically rigorous, and highly regulated process that allows consumers to have OTC access to a growing range of medicines. Patients often approach a pharmacist instead of a Healthcare Professional for minor illnesses such as fever, aches, nausea, allergies, cough, and cold. Switches are a logical extension for life-cycle management of a product to defense originator company from Generic competitors. The driving factors required for switching are self-diagnosis, self-medication, and self-administration. On increasing of Rx to OTC switching relatively rules and regulations governing are also improving. Label instructions have to be simple and easily understandable by ordinary people by preventing medication errors and drug abuse. Labeling must include indications, warnings, and directions for use especially since they are administered without medical guidance. Adding a graphic description on the label may be useful to patients, mostly illiterate individuals (e.g., Drug Facts Labeling). The advertisement may also influence patients’ decisions on the selection of OTC products. Medicine advertisements should be closely monitored to ensure that they are truthful and are not misleading or unfair. In this respect, it is recommended that advertisements reflect the information that is contained in the product information leaflet, which, in turn, should be unbiased, evidence-based, and presented in a clear, understandable, and easily readable way. This article elaborates on regulatory requirements, challenges, and marketing aspects of Rx to OTC Switching medicinal products.

Downloads

Download data is not yet available.

References

Barbara A. Levey Over-the-counter Medications. United States: MedlinePlus; 2021. p. 1221-4. Available from: https://www. sciencedirect.com/science/article/pii/B9781416032915500913;2009. [Last accessed on 2021 Jul 02].

Chang J, Lizer A, Patel I, Bhatia D,Tan X, Balkrishnan R, et al. Prescription to over-the-counter switches in the United States.J Res Pharm Pract 2016;5:149-54.

Over-the-counterdrug; 2020. Available from: https://www.en.wikipedia. org/wiki/Over-thecounterdrugs.

Marathe PA, Kamat SK, Tripathi RK, Raut SB, Khatri NP. Over-the-counter medicines: Global perspective and Indian scenario.J Postgrad Med 2020;66:28-34.

Kartha S, Kulyadi G, Bhat K, Sathyanarayana M. Switching drugs from Rx to OTC Status-a regulatory perspective.J Young Pharm 2020;9:3-7.

Sengupta G, Rein AM. Rx-to-OTC Switches: Growth, Drivers and the Role of Patients-Lubrizol; 2021. Available from: https://www.lubrizol. com/Health/Blog/2020/11/Rx-to-OTC-Switches.

Otto MH, Pillarella C. The economic impact of a switch from prescription-only to non-prescription drugs in Italy. Front Pharmacol 2018;9:1069.

Cohen J, Millier A, Karray S, Toumi M. Assessing the economic impact of Rx-to-OTC switches: Systematic review and guidelines for future development.J Med Econ 2013;16:835-44.

Available from: https://www.ozpharmagroup.com/_data/docs/ whitepaper_otc%20switch%20as%20patent%20extension_final%202. pdf. [Last accessed on 2021 Jul 03].

Rx-To-OTC Switch Consumer Healthcare Products Association. Available from:https://www.chpa.org/our-issues/otc-medicines/rx-otc-switch.

Rx to OTC Switch-a Case Study of Benadryl. NCK Pharma. Available from: https://www.nckpharma.com/rx-to-otc-switch-case-study-of-benadryl/,2015.

More Than 100 OTC Ingredients Strengths or Indications Are on the Market Today. Course Hero. Available from: https://www.coursehero. com/file/62210847/module-2docx. [Last accessed on 2021 Jul 1].

Available from: https://www.researchonline.ljmu.ac.uk/id/ eprint/11064/3/Pawar%20et%20al%20Supplementary%20 Information%20-%20Details%20of%20Databases.xlsx.

Available from: https://www.ozpharmagroup.com/_data/docs. [Last Accessed on 2021 Jun 29].

Home. Consumer Healthcare Products Association. Available from: https://www.chpa.org/about-chpa. [Last accessed on 2021 May 28].

Edington DW, Schultz AB, Pitts JS. The future of health promotion in the 21st century. Am J Lifestyle Med 2016;10:242-52.

Kakkar AK. Patent cliff mitigation strategies: Giving new life to blockbusters. Expert Opin Ther Pat 2015;25:1353-9.

Over-the-counter Otc Medication: Topics; 2021. Available from: https://www.worldwidescience.org/topicpages/o/over-the-counter+otc+medication.html. [Last accessed on 2021 Jul 02].

U.S. Food and Drug Administration. Prescription to Over-the-counter (OTC) Switch List, FDA; 2020. Available from: https://www.fda.gov/ about-fda/center-drug-evaluation-and-research-cder/prescription-over-counter-otc-switch-list. [Last accessed on 2021 May 25].

Modernizing FDA’s Regulation of Over-the-counter Drugs; 2017. p. 115-55. Available from: https://www.govinfo.gov/content/pkg/ CHRG-115hhrg27228/html/CHRG115hhrg27228.htm.

FDA OTC Glossary; 2021. Available from: https://www.accessdata. fda.gov/scripts/cder/training/otc/topic3/images/Glossary.pdf. [Last accessed on 2021 Jun 28].

Deshpande G, Srivastava R. A Comparative Study to Identify the OTC Brand Preference in The Antacid Segment and The Influencing Factors for Consumer Purchase; 2018. Available from: https://www. Semanticscholar.org,ijipsr. [Last accessed on 2021 Jun 25].

Over-the-counter (OTC) Drug Monograph Process. U.S. Food and Drug Administration; 2021. Available from: https://www.fda.gov/ drugs/over-counter-otc-drug-monograph-process. [Last accessed on 2021 Jun 23].

Over-the-counter (OTC) Drug Review. OTC Monograph Reform in the CARES Act US FDA. Available from: https://www.fda.gov/drugs/ over-counter-otc-nonprescription-drugs/over-counter-otc-drug-review-otc-monograph-reform-cares-act. [Last accessed on 2021 Jul 03].

Now Available Without a Prescription, U.S. Food and Drug Administration. Available from: https://www.fda.gov/drugs/ information-consumers-and-patients-drugs/now-available-without-prescription. [Last accessed on 2021 Jul 04].

Kartha SS, Kulyadi GP, Bhat K. Switching drugs from Rx to OTC status-a regulatory perspective and drugs from Rx to OTC status a regulatory perspective.J Young Pharm 2017;9:3-7.

Available from: https://www.digitalcommons.uri.edu/cgi/viewcontent. cgi?referer=&httpsredir=1&article=1434&context=oa_diss. [Last accessed on 2021 Jun 22].

Rx-to-OTC Switch: Expanding to the US Over-the-Counter Market. Camargo; 2017. Available from: https://www.camargopharma.com/ resources/blog/rx-to-otc-switch-expanding-to-the-us-over-the-counter-market. [Last accessed on 2017 Jun 29].

Self-selection Studies for Nonprescription Drug Products. U.S. Food and Drug Administration; 2020. Available from: https://www.fda.gov/ regulatory-information/search-fda-guidance-documents/self-selection-studies-nonprescription-drug-products. [Last accessed on 2021 Jun 26].

Catlin JR, Brass EP. The effectiveness of nonprescription drug labels in the united states: Insights from recent research and opportunities for the future. Pharmacy (Basel) 2018;6:119.

Regulatory Mechanisms for Marketing OTC Drug Products. U.S. Food and Drug Administration. Available from: https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/regulatory-mechanisms-marketing-otc-drug-products2020. [Last accessed on 2021 Jun 25].

Guidance for Industry Label Comprehension Studies for Non-prescription Drug Products U.S. Department of Health and Human Services Food and Drug Administration, Center for Drug Evaluation and Research (CDER). Available from: https://www.fda.gov/ regulatory-information/search-fda-guidance-documents/label-comprehension-studies-nonprescription-drug-products,2018. [last accessed on 2021 Jun 24].

Voltaren Gel Now. Available from: https://www.goodrx.com/blog/ voltaren-gel-available-otc2020. [Last Accessed on 2021 Jun 23].

Healthcare G. Voltaren Arthritis Pain Gel Empowers Early Morning Risers Living with Osteoarthritis; 2021. Available from: https://Www.Prnewswire.Com/News-Releases/Voltaren- Arthritis-Pain-Gel-Empowers-Early-Morning-Risers-Living-With- Osteoarthritis-301282039.Html. [Last accessed on 2021 May 29].

OTC Sales in the USA From 2000-2019. Available from: https://www. statista.com/statistics/307237/otc-sales-intheus/#:~:text=For%20 2019%2C%20it%20is%20estimated,around%2032.2%20billion%20 U.S.%20dollars. [Last accessed on 2021 Jul 01].

Graph of no. of Switches From 2011-2020. Available from: https:// www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/prescription-over-counter-otc-switch-list. [Last accessed on 2021 Jun 01].

NCK Pharma. Case Study: Rx-to-OTC Switch of Voltaren Arthritis Pain.Karnataka: NCK Pharma; 2020.

Voltaren:A Case Study in the US. Knee Efficacy; 2020. Available from: https://www.Gskhealthpartner.com.

India Corporate Law. Over the Counter Drugs-regulatory Clarity on the Horizon. India: India Corporate Law; 2020.

Wire B. Global Pet Wearable Market (2020 To 2025)-industry Trends, Share, Size, Growth, Opportunity and Forecast; 2020. Available from: https://www.Researchandmarkets.Com. [Last accessed 2021 Jun 24].

India’s Doctor-patient Ratio Still Behind WHO-prescribed 1:1,000: Government. Business; 2021. Available from: https://www.business-standard.com/article/pti-stories/doctor-patient-ratio-in-india-less-than-who-prescribed-norm-of-1-1000-govt-119111901421_1.html. [Last accessed on 2021 Jun 23].

Pharma Formulators Diverge on Strategy for Non-prescription Businesses: IndRa Report Pharma Formulators Diverge on Strategy for Non-prescription Businesses: India Report-Express Pharma. Express Pharma. Available from: https://www.expresspharma.in/management-pharma/pharma-formulators-diverge-on-strategy-for-non-prescription-businesses-india-ratings-and-research-report. [Last accessed on 2021 Jul 04].

Government to Announce Regulatory Guidelines for OTC Drugs: Dy Drug Controller, MoH&FW Express Pharma; 2021. Available from: https://www.expresspharma.in/govt-to-announce-regulatory-guidelines-for-otc-drugs-dy-drug-controller-mohfw. [Last accessed on 2021 Jun 26].

OPPI Seeks Deregulation of Pricing and Promotion of OTC Drugs. Available from: http://www.pharmabiz.com/2018. [Last accessed 2018 Jun 30].

News B, News I, Soon G. Government to Come Up with List of Over-the-counter Drugs Soon-Times of India. The Times of India; 2021. Available from: https://www.timesofindia.indiatimes.com/ business/india-business/govt-to-come-up-with-list-of-otc-drugs-soon/ articleshow/71268127.cms. [Last accessed on 2021 Jun 24].

Shankara R, Joshi M, Pathakc K. Labeling of OTC Drugs in India: Dilemma whether pharmacy centred or patient-centered. Indian J Pharm Pract 2016;9:199-203. Available from: https://www.researchgate. net/publication/309730845_Labeling_of_OTC_Drugs_in_India_ Dilemma_Whether_Pharmacy_Centred_or_Patient_Centred. [Last accessed on 2021 Jun 30].

Axelrod D, Bielory L. Fexofenadine hydrochloride in the treatment of allergic disease:A review.J Asthma Allergy 2008;1:19-29. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121339/. [Last accessed on 2021 Jul 01].

Juniper EF. Comparison of the efficacy, safety and quality of life provided by fexofenadine hydrochloride 120 mg, loratadine 10 mg and placebo administered once daily for the treatment of seasonal allergic rhinitis.Clin Exp Allergy 2000;30:891-9.

Available from: https://www.malacards.org/card/allergic_ rhinitis?showAll=True. [Last accessed on 2021 Jun 21].

EudraLex. Pharmaceutical Legislation for Medicinal Products for Human Use. Vol. 1. European: EudraLex; 2015. Available from: https:// www.ema.europa.eu/en/documents/regulatory-procedural-guideline/ directive-2001/83/ec-european-parliament-council-6-november-2001- community-code-relating-medicinal-products-human-use_en.pdf. [Last accessed on 2021 Jun 21].

European Medicines Agency pre-authorisation Procedural Advice for Users of the Centralised Procedure. Available from: https:// www.ema.europa.eu/en/documents/regulatory-procedural-guideline/ european-medicines-agency-pre-authorisation-procedural-advice-users-centralised-procedure_en-0.pdf,821278/2015. [Last accessed on 2021 Jun 30].

COVID-19 Response: Summer; 2021. Available from: https:// www.assets.publishing.service.gov.uk/government/uploads/system/ uploads/attachment_data/file/949105/reclassification_guideline_ for_20210101_-_final.pdf. [last accessed on 2021 Jul 04].

European Market Infrastructure Regulation. Available from: https:// www.En.wikipedia.org.2020. [Last accessed on 2021 Jul 02].

EMIR 2020-21 Update: REFIT, Benchmarks, Brexit, and Beyond. JD Supra; 2021. Available from: https://www.jdsupra.com/legalnews/ emir-2020-21-update-refit-benchmarks-2828900. [Last accessed on 2021 Jun 20].

Available from: https://www.hpra.ie/docs/default-source/publications-forms/guidance-documents/aut-g0070-guide_to_reclassification_ (switching)_of_legal_supply_status_for_human_medicinal_ products-v4.pdf?sfvrsn=34. [Last accessed on 2021 Jun 29].

Raja BM, Rao KR. Regulatory and Clinical Requirements for Prescription to Otc Switches in us and India. Available from: https:// www.regulatory-and-clinical-requirements-for-prescription-to-otc-switches-in-usa-and-india-13600-prdad. [Last accessed on 2021 Jun 28].

Scientific Guidelines; 2020. Available from: https://www.ema. europa.eu/en/documents/scientific-guideline/guideline-development-medicinal-products-treatment-smoking_en.pdf. [Last accessed on 2021 Jul 02].

Morck H. Rx-to-OTC Switch and the Provision of Data Exclusivity in Europe-specification and Elaboration of Eligibility Criteria Based on a Status Quo Analysis; 2021. Available from: https://www.d-nb. info/1044395648/34.

How are Disparities in Smoking Highlighting the Global Issue of Health Inequality?Tobacco; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco. [Last accessed on 2021 Jul 04].

Wadgave U, Nagesh L. Nicotine Replacement Therapy: An overview. Int J Health Sci (Qassim) 2016;10:425-35.

E A Guideline on Changing the Classification for The Supply of a Medicinal Product for Human Use; 2006. Available from:https:// www.ec.europa.eu/health/sites/health/files/files/eudralex/vol2/c/ switchguide_160106_en.pdf.

Available from: https://www.users.ugent.be/~rvdstich/thesis/written_ drug_information_screen.pdf. [Last accessed on 2021 Jun 28].

Consulting C. 4 Tips for Making the Rx to OTC Switch. Clarkston Consulting; 2021. Available from: https://www.clarkstonconsulting. com/insights/rx-to-otc-switch-4-tips. [Last accessed on 2021 Jul 02].

Rx-to-OTC Switches: Growth, Drivers and the Role of Patients-lubrizol; 2021. Available from: https://www.lubrizol.com/Health/ Blog/2020/11/Rx-to-OTC-Switches. [Last accessed on 2021 Jun 30].

Global Over-the-counter Drugs Market: Consumer Behavior Analysis by Countries, Buying Pattern Analysis, Demographics, Trends Analysis, Survey Findings and Results, Leading Companies and their Mark; 2021. Available from: https://www.markets.businessinsider.com/news/ stocks/global-over-the-counter-drugs-market-consumer-behavior-analysis-by-countries-buying-pattern-analysis-demographics-trends-analysis-survey-findings-and-results-leading-companies-and-their-mark-1029377414. [Last accessed on 2021 Jun 28].

Rx-to-OTC Switches Market Analysis, Opportunities, Demand and Forecast Trends 2018-2028. Future. Available from: https://www. futuremarketinsights.com/reports/rx-to-otc-switches-market.

Health at a Glance: Europe 2020 State of Health in The Eu Cycle; 2021. Available from: https://www.ec.europa.eu/health/sites/default/ files/state/docs/2020_healthatglance_rep_en.pdf. [Last accessed on 2021 Jul 09].

Global Over the Counter Drugs Market Size, Share, Trends and Growth Analysis Report-Segmented by Product Type and Region-industry Forecast (2021 to 2026). Maharashtra: Global Market Insights, Inc.; 2020. p. 461-75.

Insights on the Over-the-Counter Drugs Global Market to 2025-Growing Number of Patent Expirations Presents Opportunities Available from: https://www.globenewswire.com/news-relea se/2020/09/03/2088473/28124/en/Insights-on-the-Over-the-Counter- Drugs-Global-Market-to-2025-Growing-Number-of-Patent-Expirations- Presents-Opportunities.html [Last accessed on 2020 Sep 03].

Global Over-the-counter Drugs Market (2019 to 2025)-North America Generates the Highest Revenue-research and Markets. Business; 2021. Available from: https://www.businesswire.com/news/ home/20200902005541/en/Global-Over-the-Counter-Drugs-Market- 2019-to-2025---North-America-Generates-the-Highest-Revenue--- ResearchAndMarkets.com. [Last accessed on 2020 Sep 02].

Global CHC Market up 3.7% in MAT Q3 2019 Period. Nicholas Hall Company Blog. Available from: https://www.nicholashallcompany. wordpress.com/2019/12/16/global-chc-market-up-3-7-in-mat-q3- 2019-period.

Published

07-09-2021

How to Cite

G, M., S. G. SWETHA K, R. K. REDDY J, and V. RAJU K. “REVIEW OF REGULATIONS GOVERNING SWITCHING DRUGS FROM RX TO OVER-THE-COUNTER IN THE USA, INDIA, AND EU”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 9, Sept. 2021, pp. 12-19, doi:10.22159/ajpcr.2021.v14i9.42393.

Issue

Section

Review Article(s)