Value of Consumer Health Products

Value of Consumer

Health Products.

The Impact of Switching Prescription Medications to Over-the-Counter

REPORT MARCH 2017

Value of Consumer Health Products: The Impact of Switching Prescription Medications to Over-the-Counter Isabelle Gagnon-Arpin

Preface The use of over-the-counter (OTC), non-prescription medication--known as self-medication--is a common practice in Canada and around the world. Prescription to over-the-counter (Rx-to-OTC) switching has an impact on a variety of stakeholders, making it important to evaluate the potential economic impact of such potential changes. This report, the first in a two-part research series, models the economic impacts--including time and productivity savings, and changes to the cost burden--associated with switching three drug categories from Rx to OTC. Overall, the annual economic value of switching is estimated at a total of $1 billion in savings.

To cite this report: Gagnon-Arpin, Isabelle. Value of Consumer Health Products: The Impact of Switching Prescription Medications to Over-the-Counter. Ottawa: The Conference Board of Canada, 2017.

?2017 The Conference Board of Canada* Published in Canada | All rights reserved | Agreement No. 40063028 | *Incorporated as AERIC Inc.

An accessible version of this document for the visually impaired is available upon request. Accessibility Officer, The Conference Board of Canada Tel.: 613-526-3280 or 1-866-711-2262 E-mail: accessibility@conferenceboard.ca

?The Conference Board of Canada and the torch logo are registered trademarks of The Conference Board, Inc. Forecasts and research often involve numerous assumptions and data sources, and are subject to inherent risks and uncertainties. This information is not intended as specific investment, accounting, legal, or tax advice. The findings and conclusions of this report do not necessarily reflect the views of the external reviewers, advisors, or investors. Any errors or omissions in fact or interpretation remain the sole responsibility of The Conference Board of Canada.

CONTENTS

i EXECUTIVE SUMMARY

Chapter 1 1 Introduction 4 Research Goals 5 Modelling the Economic Impact of Switching 6 Proton Pump Inhibitors 10 Oral Contraceptives 14 Drugs for Erectile Dysfunction

Chapter 2 17 Methodology 18 Economic Model 19 Data Sources 23 Study Population

Chapter 3 24 Economic Impact of Switching PPIs to Treat GERD 25 First Impact: Health Care System Utilization 32 Second Impact: Medication Purchase and Cost Burden 38 Third Impact: Treatment and Labour Productivity 40 Net Impact of Rx-to-OTC Switching of PPIs to Treat GERD

Chapter 4 42 Economic Impact of Switching Oral Contraceptives 43 First Impact: Health Care System Use 49 Second Impact: Medication Purchase and Cost Burden 55 Net Impact of Rx-to-OTC Switching for Oral Contraceptives

Chapter 5 56 Economic Impact of Switching Erectile Dysfunction Drugs 57 First Impact: Health Care System Utilization 63 Second Impact: Medication Purchase and Cost Burden 68 Net Impact of Rx-to-OTC Switching of ED Drugs

Chapter 6 69 Conclusion 71 Implications and Next Steps

Appendix A 74 Bibliography

Acknowledgements

This report was researched and written by Isabelle Gagnon-Arpin, Senior Research Associate, Health Economics; under the direction of Thy Dinh, Director, Health Economics, The Conference Board of Canada.

The authors would like to thank Dr. Jeff Taylor, Professor of Pharmacy, College of Pharmacy and Nutrition, University of Saskatchewan, and Dr. Nardine Nakhla, Adjunct Clinical Assistant Professor, School of Pharmacy, University of Waterloo, for being external reviewers; and Greg Sutherland, Principal Economist, Health Economics, The Conference Board of Canada, for his internal review.

This report was made possible through the financial support of Consumer Health Products Canada.

The design and method of research, as well as the content of the report, remain the sole responsibility of The Conference Board of Canada. The findings and conclusions of this report do not necessarily reflect the views of the investors, expert advisors, or reviewers. Any omissions in fact or interpretation remain the sole responsibility of The Conference Board of Canada.

EXECUTIVE SUMMARY

Value of Consumer Health Products: The Impact of Switching Prescription Medications to Over-the-Counter

At a Glance

? Switching prescription medications to over the counter (Rx to OTC) has an impact on a wide range of stakeholders.

? The Conference Board of Canada adapted a model to investigate the range of economic impacts associated with switching three drug categories from Rx to OTC.

? The analysis estimated the annual economic value of switching at $709.9 million for proton pump inhibitors, $222.2 million for oral contraceptives, and $106.2 million for erectile dysfunction drugs, totalling $1.0 billion in savings.

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