Madhaven S
Behavioral and Administrative Pharmacy Department, School of Pharmacy, West Virginia University, Morgantown 26506.
J Clin Pharm Ther. 1993 Aug;18(4):281-90. doi: 10.1111/j.1365-2710.1993.tb00589.x.
The United States is one of the few developed countries that has only two legal classifications of drug products, prescription (or legend) and non-prescription. 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.
美国是少数几个药品仅有两种法定分类的发达国家之一，即处方药（或有标识药品）和非处方药。然而，美国药学协会正在游说立法，将从处方药转为非处方药（从Rx转为OTC）状态的药品归类为第三类药剂师有标识或仅药房销售的药品。药剂师表示，他们对第三类药品的需求是为了通过药剂师监督，使消费者更安全地使用转换后的药品。然而，第三类概念的批评者将药剂师的需求归因于他们想要获得对这些产品的经济控制权。为了实证评估药剂师的动机，从389名随机挑选的美国药剂师那里收集的数据（这些数据是一项更大规模研究的一部分）被用于评估：（i）药剂师对从处方药转为非处方药状态的药品的五种选定销售条件的偏好，以及（ii）选定的人口统计学和执业特征对药剂师偏好的影响。数据分析表明，“药剂师永久监督销售（或第三类状态）”和“一般无监督”销售分别是药剂师对转换后产品最偏好和最不偏好的销售条件。总体而言，药剂师更喜欢涉及药剂师监督的销售条件，而不是不涉及的。根据就业状况进行比较时，药剂师的偏好存在显著差异。与员工、雇员、主任或经理药剂师相比，药店所有者或合伙人药剂师对转换后药品的药剂师监督第三类状态表现出更大的偏好，对转换后药品的无监督销售表现出较小的偏好。药剂师对销售条件的偏好也因他们所属专业协会的性质而异。美国医院药师协会（ASHP）的成员药剂师比非该协会成员的药剂师更倾向于“在医生初步诊断和开出处方后无监督销售”。美国零售药剂师协会（NARD）的成员药剂师比非该协会成员更不看好转换后产品的无监督销售。总体而言，在对从Rx转为OTC的转换后药品要求第三类或仅药房销售状态方面，一些药剂师的需求似乎可能受安全问题支配，而另一些则受经济问题支配。
