Cough & cold meds spark debate
Pharmacy leaders are supporting Medsafe’s proposal to reclassify cough and cold medicines to pharmacy only, saying it will significantly increase the safety and effectiveness of treatments.
Pharmacy Guild chief executive Annabel Young says it is of “great concern” these medicines are freely available in supermarkets without the professional advice of a trained health professional.
“This is an issue about patient safety – not the interests of grocery shops.”
Pharmacybrands chief executive Alan Wham feels the Government should impose even greater restrictions on the sale of these medicines, considering the risks involved, “for example, the selling of multiple packs of same or similar products with no recognition of interactions or dangerous overdosing”.
Auckland pharmacist Warren Flaunty cites the documented international cases of the abuse of products containing dextromethorphan, which is used as a cough suppressant and has euphoric and psychedelic properties.
Combining the product with serotonergic drugs can cause dangerous levels of toxicity in the bloodstream. This product was removed from sale in tablet form in the US years ago and replaced with syrup in an attempt to cut down abuse.
“The other common examples are: the documented evidence of hypertension in young children and adults taking phenylephrine products; problems associated with the recommended dose of paracetamol (two tablets four times daily) on the INR blood levels of people taking warfarin; and adverse effects such as renal failure in the elderly if ibuprofen is taken with NSAIDs such as diclofenac,” Mr Flaunty says.
The guild’s comments have, however, invited a strong reaction from the Food and Grocery Council.
Calling the Medsafe move “Nanny state power play”, chief executive Katherine Rich says banning common remedies such as Lemsip and lozenges from supermarkets is absurd and does not draw on international evidence or common sense.
“The impact of the proposal is extreme. Banning the sale of 70 cough/cold remedies from supermarkets and dairies will mean New Zealanders pay up to 30–45% more for the same products in pharmacies. New Zealanders’ access to these products when they suffer coughs and colds will be dramatically reduced,” Ms Rich says.
She says putting aside the issue of conflict of interest, the FGC is more concerned by the fundamental errors and misrepresentations that riddle the Medsafe submission to the Medicines Classification Committee.
“Its submission has two main arguments: the UK has made all these products pharmacy only and this recommendation is supported by Medsafe’s Cough and Cold Review Group. Both statements, which are used to add weight to the proposal, are wrong and misleading.
“The UK has not banned the sale of adult formulations and products such as cough lozenges. Lemsip hot drinks and other cough/cold remedies for those over the age of 12 years remain freely available in supermarkets on general sale. The Brits certainly have not made all adult formulations pharmacy only.”
Ms Rich says the CCRG did not actually recommend a change; rather it referred the classification of certain actives to the MCC for consideration for children up to 12 years of age.
“When the potential effect is to demolish a $30 million supermarket category, and make Kiwis pay significantly more, we expect that Medsafe’s analysis will be accurate, robust and based on factual evidence.”
Mr Flaunty says, at the end of the day, pharmacy customers may pay a small premium “but with that price comes the advice which is given free”.
The matter will be discussed at the MCC meeting on 13 April. RK
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