Factors influencing pharmacists' preference for the legal classification of Rx–to–OTC switched drug products

The United States is one of the few developed countries that has only two legal classifications of drug products, prescription (or legend) and nonprescription. U.S. pharmacy associations, however, are lobbying for legislation that will classify drugs which are switched from prescription to non–prescription (Rx–to–OTC) status as a third class of pharmacist–legend or pharmacy–only drug products. Pharmacists have indicated that their demand for a third class of drugs is to enable safer use of switched drug products by consumers through pharmacist supervision. Critics of the third class concept, however, have attributed the pharmacists' demand to a desire to gain economic control of the products. In order to assess empirically pharmacists' motivations, data collected from 389 randomly selected U.S. pharmacists, forming part of a larger study, were used to assess: (i) pharmacists' preferences for five selected conditions of sale for drug products switched from prescription to non–prescription status and (ii) the role of selected demographic and practice characteristics on pharmacists' preferences. Analyses of the data indicated that ‘permanent pharmacist supervised sale (or a third class status)’ and ‘general unsupervised’ sale were pharmacists' most and least preferred conditions of sale for switched products, respectively. Overall, pharmacists preferred conditions of sale that involved pharmacist supervision over those that did not. Pharmacists' preferences differed significantly when compared on the basis of their employment status. Owner or partner pharmacists indicated a greater preference for the pharmacist–supervised third class status for switched drug products and a lesser preference for unsupervised sale of switched drug products than staff, employee, director, or manager pharmacists. Pharmacists' preferences for the conditions of sale also differed by the nature of the professional association in which they were members. Pharmacists who were members of the American Society of Hospital Pharmacists (ASHP) indicated a greater preference for ‘unsupervised sale after initial diagnosis and prescription from a physician’, than pharmacists who were not members of the association. Pharmacists who were members of the National Association of Retail Druggists (NARD) viewed unsupervised sale of switched products with greater disfavour than the non–members of that association. Overall, it appears that some pharmacists may be governed by safety concerns and some by economic concerns in their demand for a third class or pharmacy–only status for Rx–to–OTC switched drug products.