OTC drugs in the US & Japan

Very recently, I saw an article in the New York Times warning the use of OTC drugs in the US.

The New York Times: Over-the-Counter Medicines’ Benefits and Dangers

OTC, or Over The Counter drugs are available without permission by the physician. There are huge varieties of OTC drugs in the US. You can buy painkiller, laxative, and even some tranquilizers.

In spite that you can easily get ones, OTCs are not so benign to your body. Maladjusted usage could be fatal, as the article mentioned. I completely agree with the opinion.

On the other hand, very few drugs are available as OTCs in Japan, as I wrote in the past. The situation has not been amended. Until recently, merchandise of drugs via the internet had been illegal in Japan. And still now there are very few types of drugs are available without the prescription by the physician.

My past entry: Drug stores without drugs

The situation is very different in the both countries. There are some reasons for it.

Firstly, the US government is strongly eager to reduce the medical cost. If a drug is categorized to the OTC drug, it means that consultation and prescription fees regarding the drug will be no more required.

Secondly, many patients are also fond of buying the OTC based on their own assessment. It is due to the American culture in which self-decision is respected.

In contrast, Japanese patients tend to visit hospital frequently. They usually trust the physician's judgement more than their own sense. In addition, Japanese public health insurance enables us to consult a physician with relatively low cost. It is funny that some OTC drugs are more expensive than prescription drugs with equal effectiveness because of the health insurance system. It is quite rational few patients want to a drug on the drugstore in Japan.

The Japanese government is as well expanding the range of OTC drugs. However, medical associations are strongly opposing to this policy. They claim that OTC drugs sales cannot guarantee the safety of the patients. But the other reason against OTCs is the fear of decreased amount of patients visiting the hospital. Many Japanese hospitals belong a private sector. Thus, lessened patients mean shrunk income level directly for them.

In my opinion, neither the US nor Japan is the best. For example, SSRIs should not be the OTC drugs for their risk. Even psychiatrists can underestimate the toxicity of these drugs. On the other hand, Japan has excessively strict policy against painkillers, I think. Some years ago, the government planned to relax the regulation regarding the selling of poultices, but it was cancelled accepting the opposing voices by physicians' associations.

Medical drugs are highly specialized remedies to defeat diseases. But they are for the patients, not physicians.