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Although it is seeing week-on-week increase in OTC sales of Imigran
Recovery, GlaxoSmithKline thinks that it will take until the end of this
year at the earliest before it can say whether the POM to P switch has
been a success. But the company’s marketing director for OTCs for
consumer health Tim Brooks said: “We didn’t really start
the full launch to the consumer until the last few months of last year
and if you ask me now how’s it going I would say it’s too
early to say. However we are having a commercial impact and we are seeing
a growth in sales.”
Sumatriptan switched from POM to P in May 2006, reflecting the government’s
commitment to increase patient choice in self-medication. It was significant
for community pharmacists because a key role of the profession is to
give advice about acute self-limiting illness. Neal Patel, communications
director at the National Pharmacy Association says: “It’s
typical for a consultation in the pharmacy to start along the lines of
the customer saying ‘I’ve tried everything for migraine — do
you have something else which might help?’.”
Protocols and training
However, before OTC sumatriptan can be sold, pharmacists must follow
a strict protocol, which was a condition of the product’s P licence.
They have to complete a patient questionnaire with the customer about
their migraine and general medical history. Patients can download
the questionnaire and complete it before
going to the pharmacy but the pharmacist is still expected to go through
the questions with the customer. Alternatively, a pharmacy assistant
could go through the questionnaire with the customer but the final
decision for a sale must still be taken by the pharmacist, who has
to give written approval at the bottom of the questionnaire.
Although there is no audit trail to discover whether questionnaires
are completed before sales, GSK is in the process of carrying out a
randomised
study to check whether pharmacists are following the proper procedures.
Mr Brooks says: “We were required by the Medicines and Healthcare
products Regulatory Agency to carry out a post-use clinical study which
we are doing.” He is confident , however, that community pharmacists
will follow the correct procedures because it is part of their professionalism.
GSK has produced a training manual for pharmacists about offering OTC
sumatriptan and this has been backed up with 10 regional workshops and
seminars. There was also the option of distance learning training. Training
was made available two months before sumatriptan achieved its P status
because GSK wanted to be sure that community pharmacy could handle the
switch with confidence. Last October, GSK extended its training programme
to pharmacy assistants, producing an
NPA-accredited training pack called “Managing migraine in the pharmacy:
a guide for pharmacy assistants”.
According to GSK, pharmacy has been enthusiastic about the POM to P switch
of sumatriptan, and the company sees this as a barometer of the profession’s
willingness to embrace professional change and become proactive health
care managers.
The switch is also having a noticeable impact on how patients manage
their migraine. The City of London Migraine Clinic, a medical charity
that helps patients manage their migraines says the change from POM to
P has made a difference to patients. The clinic’s medical director
Anne MacGregor says sumatriptan already had the confidence of patients
because it was a prescription-only medicine but patients worried about
cuts in prescribing budgets were concerned that they might not be prescribed
the amount of sumatriptan they required, particularly because it should
be taken as soon as a migraine attack begins. She says: “What patients
are doing now is buying an extra packet of sumatriptan over the counter,
on top of what they are prescribed by the
GP so they know they will always have
some available when they need it. [The switch] has taken away a lot of
fear.”
GSK has no regrets about the move of sumatriptan from POM to P and believes
it can be of benefit to the 60 per cent of six million migraine sufferers
who never seek treatment for the condition from their GP. This gap, with
the commercial and professional benefits it brings, is now starting to
be filled by community
pharmacy. |
The
Pharmaceutical Journal