title: Impact of vaginal antifungal products on utilization of health care services: evidence from physician visits.
abstract: BACKGROUND
  Recently many medications formerly available only by prescription have been approved for over-the-counter (OTC) status. In 1990, clotrimazole became the first available OTC drug to treat candidal vaginitis. Subsequently several other prescription antifungal medications have also been available in OTC products. One proposed benefit of these switches from prescription to OTC status is a reduction in the utilization of health care services.
  
  
  METHODS
  Using National Ambulatory Medical Care Survey data, the average numbers of annual visits for vaginal complaints were estimated for 1985, 1990, and 1994. These years were chosen because they represented periods before, close to, and after the approval of the OTC antifungal preparations. The estimated visits for each year were compared using a chi-square analysis with a sample weight correction.
  
  
  RESULTS
  There was a 15% decline in the number of vaginitis visits from 1990 to 1994 that potentially could be attributed to the availability of the OTC antifungal preparations. The decrease in physician visits results in approximately $45 million in direct cost savings and another $18.75 million in indirect savings by reducing time lost from work.
  
  
  CONCLUSIONS
  It appears that the availability of OTC anticandidal fungal preparations reduces the number of physician visits for vaginitis, resulting in cost savings.
authors.affiliation: Department of Family Medicine, Northwestern University Medical School, Chicago 60611, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Lipsky
authors.forename: T
authors.initials: T
authors.lastname: Waters
authors.forename: L K
authors.initials: LK
authors.lastname: Sharp
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy* / Q000191:economics; D019317:Evidence-Based Medicine; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D004366:Nonprescription Drugs; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D012648:Self Care
chemical_list: D000935:Antifungal Agents; D004366:Nonprescription Drugs