title: U.S. pharmacy policy: a public health perspective on safety and cost.
abstract: A public health perspective based on social justice and a population health point of view emphasizes pharmacy policy innovations regarding safety and costs. Such policies that effectively reduce costs include controlling profits, establishing profit targets, extending prescription providers, revising prescription classification schemes, emphasizing generic medications, and establishing formularies. Public education and universal programs may reduce costs, but co-pays and "cost-sharing" do not. Switching medications to over-the-counter (OTC) status, pill splitting, and importing medication from abroad are poor substitutes for authentic public health pharmacy policy. Where policy changes yield savings, public health insists that these savings should be used to increase access and improve population health. In the future, pharmacy policies may emphasize public health accountability more than individual liberty because of potential cost savings to society. Fear of litigation, as an informal mechanism of focusing manufacturer's attention on safety, is inefficient; public health pharmacy policy regarding safety looks toward a more active regulatory role on the part of government. A case study of direct-to-consumer advertising illustrates the complexity of public health pharmacy policy.
authors.affiliation: Division of Management, Policy, and Community Health, School of Public Health, University of Texas, Houston, Texas 77030, USA. pauline.rosenau@uth.tmc.edu
authors.forename: Pauline Vaillancourt
authors.initials: PV
authors.lastname: Rosenau
authors.forename: Lincy S
authors.initials: LS
authors.lastname: Lal
authors.forename: Jay H
authors.initials: JH
authors.lastname: Glasser
mesh_terms: D000329:Advertising; D003256:Community Participation; D016527:Drug Costs; D064420:Drug-Related Side Effects and Adverse Reactions; D007880:Legislation, Drug; D004366:Nonprescription Drugs; D011050:Policy Making; D011634:Public Health; D014481:United States
chemical_list: D004366:Nonprescription Drugs