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Pharmacists are not obliged to sell drugs over-the-counter

Prescrire suggests that pharmacists who do want to make drugs available over the counter draw up a strict list.

In France, as of July 2008, some drugs have become available over the counter in pharmacies.

It is not compulsory for French pharmacists to sell drugs over the counter. Pharmacists who opt to do so should select the drugs they intend to sell very carefully, so as to ensure they are offering medicines that are useful and appropriately packaged.

The official list of drugs approved for OTC sales contains the worst alongside the best: useful drugs, with a clearly favourable risk-benefit balance for a range of indications, such as painkillers paracetamol and ibuprofen; drugs that are no longer reimbursed because their efficacy remains unproven, such as mucolytic agents (acetylcysteine, carbocisteine); and drugs with a negative risk-benefit balance, such as the combination of fixed doses of aspirin + caffeine for toothache.

Allowing OTC sales of drugs in France is one more step towards drugs being treated as a commodity. Advertising is bound to increase as a result.

To promote the best care, patients need sound advice from pharmacists who both listen to them and offer informed guidance on whether or not treatment is necessary, which does not systematically mean a drug treatment. And this service also deserves to be remunerated.

©Prescrire October 2008

Source: "Médicaments en "libre accès" : faire les bons choix et privilégier le conseil". Rev Prescrire 2008; 28 (299): 653.

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