An FDA advisory panel has rejected Merck's third request to put Mevacor over the counter, though a Merck statin has been available without a prescription in Britain for years. Meanwhile, Britain is considering making prescription-only birth control available behind the counter.
The lesson here isn't that Britain is less paternalistic regarding prescription drugs, but that skittish U.S. regulators need a third option. In the past, members of the FDA panels that opposed OTC Mevacor have said they'd be willing to consider a behind-the-counter status, which would address their concerns about patients unable to self-diagnose or unwilling to read warnings on the label. But they were never given that option; while a very few drugs are sold behind the counter in the U.S., the FDA only recognizes two regulatory categories, OTC and prescription-only. Doctors the least bit worried about the perils of self-care are always going to choose the latter.