SEOUL - What started as a simple task of widening public access to some over-the-counter drugs has now evolved into a turf war between South Korea's pharmacist and doctor associations, and the Ministry of Health And Welfare is now calling for a new round of OTC distribution revisions before the first round has finished.

At the ministry's Central Pharmaceutical Affairs Council meeting June 15, pharmacist, doctor, and four civic group representatives agreed on a plan to allow 44 OTC drugs to be sold in supermarkets.

The products are currently sold only in pharmacies, but the health ministry intends to reclassify the products as "quasi-drugs" to give them broader sales distribution. The list of drugs include 15 digestive products, 11 intestinal disorder treatments, four ointments, two pain-relief patches and 12 energy drinks.

About half of the 44 products are no longer sold in the market due to lack of demand, but the new sales channel may spark revived interest in some of the products. The top sellers on the list include Dong-A Pharmaceutical Co. Ltd.'s energy drink Bacchus, Yuhan Co. Ltd.'s ointment Antipramin, and Dongkook Pharm Co. Ltd.'s madecassol ointment.

Drugs in Korea are classified in three categories: prescription drugs, nonprescription drugs and non-drug/quasi-drugs.

The health ministry reversed its position twice in the past month. In early June, the ministry rescinded its previous support for expanded OTC drug access. But less than a week after strong protest from the Korean Medical Association, which represents 100,000 doctors, Health Minister Chin Soo-hee announced the ministry would once again support revisions to OTC classifications (Also see "Korea's Health Ministry Flip-Flops Again On OTC Drug Position; Now Seeks Expanded Consumer Access" - Scrip, 15 June, 2011.).

Pharmacists Fear Potential Loss In Sales After Wider Public Access To OTC Drugs

On hopes that the OTC products would be available in supermarkets by August, the health ministry's advisory council met June 21 to re-categorize the products. But the three-hour meeting did not proceed far as the committee's four pharmacist representatives demanded that some prescription drugs should be sold in pharmacies without prescription.

Pharmacists requested products such as Hanmi Pharmaceutical's emergency contraceptive pill NorLevo (levonorgestrel), Roche's obesity treatment Xenical (orlistat), GlaxoSmithKline PLC's Zantac and generics lactulose and ranitidine should be allowed to be sold in pharmacies without prescription. These products are available without prescription in many markets in the U.S. and Europe.

Analysts noted that pharmacists and doctors are in the midst of a turf war for OTC sales, and pharmacists are looking for ways to make up for any potential losses in sales when supermarkets can sell OTC brands.

An official at the Korean Pharmaceutical Association told PharmAsia News that pharmacists are calling for the Rx-OTC switch for some products as a matter of convenience for the public. KPA represents South Korea's 30,000 pharmacists, and about 20,000 drug stores.

Local media has portrayed doctors as wanting to keep the OTC debate between pharmacists and supermarkets while doctors keep their prescription territory intact. An official at the Korean Medical Association refused to comment, saying that he was told not to comment because "KMA doesn't want the current situation described as a confrontation between pharmacists and doctors."

KMA had called for the resignation of Health Minister Chin Soo-hee when she temporarily withdrew her support for expanded OTC sales.

Prescriptions Rising

The market share of prescription drugs in Korea has risen in recent years. Prescription drugs accounted for 72% of drug sales in 2005 and rose to 81% in 2009.

Unlike other advanced countries, which reclassify products occasionally, Korea has not done so since it launched a system in 2000 to separate the prescription and dispensing channels. Under that system, doctors can no longer sell drugs in hospitals, while pharmacists can no longer prescribe drugs, even for minor diseases.

Amid rising criticism over its ability to manage the drug market, Health Minister Chin told reporters June 21 that the ministry will push to revise the drug law so that nonprescription fever reducers, pain killers, anti-inflammatory products and cold medicines are reclassified as quasi-drugs so they can be sold in supermarkets and convenience stores along with the 44 OTC products already under review.

"The 44 OTC products can only be sold [in supermarkets] with the health ministry's permission," ministry spokesman Park Chan-soo told PharmAsia News. "But for the sale of fever reducers, pain killers, anti-inflammatory products and cold medicines in supermarkets, a drug law must be revised, which we are trying to do now."

The recent meetings by the Central Pharmaceutical Affairs Council are its first meetings since 2000 when the new prescription and dispensing system was launched. At the council's most recent meeting held July 1, eight of the 12 committee members supported the sales of cold medicine in supermarkets, raising hopes that the drug law could be revised soon by the health ministry.

- Peter Chang (p.chang@elsevier.com)

Korea's Pharmacists, Doctors Clash Over Prescription Drug Sales; Ministry Calls For Expanded Painkiller Distribution

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