The WSJ Health Blog wrote that Merck is considering selling their asthma medication Singulair over the counter.
It’s Merck’s best-selling drug, with revenues in excess of $1.3 billion. But internist Matthew Mintz has some reservations about the proposal.
His issue is that Singulair merely treats the symptoms, rather than the problem that can exacerbate asthma:
Singulair works in the same way that antihistamines work: by treating the symptoms. Inhaled corticosteroids (ICSs) work by blocking inflammation which is what causes the release of leukotrienes in the first place. Singulair is not anti-inflammatory, ICS’s are. Singulair treats the symptoms, whereas ICS’s treat the problem. This is why study after study proves that ICS’s are superior to Singulair, and why guidelines place ICS’s as first line treatment and Singulair as alternative.
His concern is that, if the drug is increasingly used when placed over the counter, chronic asthmatics may have their symptoms controlled, but in fact, their lung function may be gradually worsening over time.
Related posts:
- Daniel Carlat goes counter-detailing
- My take: Counter-detailing, Match Day, communication
- When your hospital debt is sold
- Combo drugs
- Selling drug samples
- Mammograms before age 50
- Meet the anti drug reps
{ 9 comments }
personally, I don’t think it should be sold OTC mainly because of the possible psyhiatric side effects associated with Singulair
I don’t think it is a very good idea given that about a month-and-a-half ago FDA issued a very serious warning on potential neuropsychiatric side effects of montelukast. It is more likely to get a black box warning then an approval to go OTC.
Sorry, also meant to post this link in my previous comment.
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm165489.htm
I’ve seen how people use OTC allergy meds (i.e. in vast excess of directed dose), so I would want to know Singulair is also safe when used like crazy before seeing it appear OTC.
I have never seen Singulair do much good for asthma–for allergies it’s worth a try, but asthma, unlike most cases of allergic rhinitis, is a serious medical condition that merits effective treatment. OTC Singulair will lead to more money for the drug company and, possibly, less effective treatment for asthma. Everyone who reads a paper or two knows that inhaled corticosteroids are the way to go for persistent asthma. The real question is why do so many docs prescribe Singulair in the first place.
I like the way JSmith is thinking. Asthma is a serious condition, people die from it (although not as often as they used to). Still the potential consequences of poorly managed or improperly treated disease are serious enough that OTC treatments for it are worrisome simply from the point of view that the patient, instead of partnering with a clinician on their treatment plan, is making their own decisions probably without knowledge of the risks or consequences. Some people could indeed do this, but many could not. I don’t see the logic to placing them at risk.
Why would Merck, having taken a bath from Vioxx suits, want to get a potentially black-boxed drug OTC? But hey, maybe all drugs marketed DTC should be sold OTC. What the hey? Caveat emptor. Cry Lawsuit and Unleash The Sharks of War.
I think every medication should be sold over the counter. Why we allow cigarettes and booze and fast food but not life saving medications that many patients need, but can’t afford because of regulations is beyond me.
My personal opinion, everything should be over the counter, including narcotics. Patients should have a right to pay for care they think they need. If they want the advice of a physician, they know where to turn to. I think the cost of regulating the industry is causing more harm than good and creating greater road blocks having an open pharmacy society.
I don’t see why it’s necessary to charge a patients insurance $100 to refill their thyroid medication or their asthma inhaler.
I thought we got rid of paternalistic medicine. Why do we need a doctor telling patients what medicine they need? They should be free to look it up themselves and get what they think they need. And seek medical attention if they think they need that too.
Yeah, this stuff should stay on the shelf. I have never heard of it before but does anyone know if it causes any sever side effects?
Comments on this entry are closed.