Bioethics Blogs

A Suggestion To Make Prescription Medicine Behind-the-Counter

by Craig Klugman, Ph.D.

I recently returned from a vacation to Central America. Besides having some adventures, I also noticed that the local towns had a large number of pharmacies—far more than would be expected of towns with small populations. When I walked into these pharmacies I saw the walls covered with boxes and bottles of medications—drugs that in the U.S. would only have been available with a doctor’s prescription. Some of them were drugs that at home were available over-the-counter in small doses but here one could purchase the prescription dose. Others were antibiotics, erectile dysfunction drugs, anti-depressants, cardiac meds, blood pressure medications, anabolic steroids, and medications for end-stage kidney disease, contraceptive pills and even some pain relievers with small doses of codeine. Most narcotics (opioids) still required a prescription but since many pharmacies were in physician offices, that process was quick and inexpensive as well. The prices were also lower than one pays in the U.S.

The United States has led the world with high prescription drug prices for a long time. We have a stringent drug classification system that requires many drugs such as antibiotics, narcotics, anti-depressants and more to only be available with a physician prescription. Then you take that order to the pharmacy where a pharmacist sells you the drugs. In a system that is highly expensive and facing shortages of health care workers, it would make sense to make most prescription drugs available without a prescription.

In the U.S., there are three levels of pharmaceuticals. (1) Over-the-counter drugs (OTC) are considered safe enough for a person to purchase and use on their own Often these are medications that have been on the market for 3 to 6 years with a good safety profile.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.