Although I do not disagree with Anthony Cox’s views on selling only evidence-based over-the-counter (OTC) medicines (The Pharmaceutical Journal 2014;293:176), his views are those of an academic working in a university and not from a pharmacist standing at a medical counter facing a sales executive requesting a cure for a dry cough before a vital presentation in half an hour, or a bride asking for a miracle cure for a cold before her wedding the next day.
Ingredients of most OTC products do not have evidence based on double blind, crossover clinical trials and pharmaceutical companies do not have any commercial incentive to carry out such costly trials for these non-patentable ingredients.
Faced with such customers requesting a cure, I would explain the nature of the self-limiting minor ailment if they have the time to listen and supply a suitable product despite lack of evidence. There are also customers who will demand a product they have seen advertised on the television the night before.
Millions of pounds are spent by the public on vitamins and minerals by self-selection, which experts say are a waste of money.
I do not underestimate the placebo effect of these products. We all know customers willing to pay an extortionate price for a branded ibuprofen because “it works better than the cheap generic”.
We supply licensed products for minor ailments. If we did not, the next port of call would be the GP — if they can get an appointment — or the overstretched A&E departments.
If Cox has questions about the efficacy of these products, he should address them to the Medicines and Healthcare products Regulatory Agency.
He should realise we deal with millions of members of the public who are not educated in academic institutions but by “Dr Google” in the internet age. What is required is public health education rather than blaming pharmacists for selling products promoted by global pharmaceutical companies.
U. A. Patel