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The ridiculous control of over the counter medication

October 15, 2013

Disclaimer: I wrote this entry with no background on the regulations dictating the sale of over the counter drugs.  A rant per se, nothing more.

Have any of you ever gone to the pharmacy during allergy or cold and flu season to grab a larger than normal round of over the counter medication like pain killers and anti-histamines only to be told, “You can only buy one package at a time?”

My way of thinking is like this: It is allergy season for me right now. The moulds flying around in the air because of decaying and dying plant life outdoors always get me every fall. I want to get a couple of packages of anti-histamines to get me through the next little while, so I don’t have to visit the pharmacy every few days. Who has the time, right?

I’ve been stopped in my buying tracks a couple of times over the last few years: No, I cannot buy that extra box of Panadol Hot (for relieving cold and flu symptoms – the Mr. and I were sick at the same time), that extra bottle of Burana 400 mg (30 caplets) during the cold and flu season, that extra box of allergy pills…

And in Finland you cannot buy any medication in any other place than a pharmacy. That’s right, and most pharmacies around the country are closed on Sundays. Getting medicine when you need it requires planning. In Canada you can buy all sorts of over the counter medication in virtually every store – even corner stores (equivalent to R-kioski in Finland).

I don’t understand – Finland has a public health problem due to inexpensive and widely available alcohol, but they want to limit the amount of over the counter medication that normal people buy to make their days a little easier. Gimme a break.

Back in 2010 I visited Canada and stocked up on pain relievers to bring back to Finland – not only because I can buy them inexpensively, but because no one is going to tell me that I can’t. I can buy as many bottles of pain medication as I want, for example acetaminophen (500mg) – 400 caplets per bottle. I know several people who do this when they leave the country to visit elsewhere.

I was curious so I asked the person serving me at the pharmacy, “I am buying a large amount of over the counter pain medication here, are there no limits?”

“No,” she said.

“Aren’t you concerned there is enough pain medication here for a person to overdose on?”

“No, we trust that customers who are buying over the counter pain medication will use it wisely.”

I think the control in Finnish pharmacies is a little over the top. There is a problem with prescription drug abuse, but no mention of over the counter medication. I wonder if the authorities think the regular Finn cannot control their use of over the counter drugs.

Background on drug use in Finland in a report from the European Monitoring Centre for Drugs and Drug Addiction

One of many stories over the years that prescription drug use is rampant in Finland, September 18, 2010

And another, March 19, 2012

15 Comments leave one →
  1. Katie permalink
    October 15, 2013 8:16 am

    I live in the US, in Washington state. Here you can’t buy cold medicine off of a shelf, you have to get it from a pharmacist. Though you don’t need a prescription for most cold and flu meds (thought there are some that used to be OTC which are now regulated), there are some that were so abused that they now require a prescription. The problem here was that they were using them to make methamphetamines. So there are regulations now on how you can buy them and how much you can purchase. Pharmacies have to log how much people purchase, and it’s reported. It’s a frustration, but it has actually cut down on the amount of meth cooking in our area. I will say though, that I LOVE going to Canada and buying muscle relaxers and tylenol with codeine over the counter!! I always stock up on my trips as well 🙂

    • October 15, 2013 9:19 am

      Thanks for chiming in Katie. I do remember reading about the heavy control of cough medicines in the US and Canada. I can understand logging purchases, that is a good idea… Most cough medicines are only available through a prescription here and the ones you can get over the counter don’t work anyways.

  2. anonymous permalink
    October 16, 2013 12:44 am

    Every year people die from over-the-counter painkillers in Finland (and all over the world). I don’t know the circumstances or their physical condition, but I don’t think they’re necessarily overusing them in a normal sense. Over-the-counter medication is safe, but “safe” is a relative concept.

    If you need to buy more drugs, get your doctor to write you a prescription. Not only does the pharmacy not give you any grief, but larger packages are a lot cheaper, e.g. 100 pills of Zyrtec for allergies costs about the same as two or three 10-pill over-the-counter packages, IIRC.

    BTW, “inexpensive alcohol”? What?

    Also, how much Burana are you using anyway and what sort of ailments are you taking it for?

    • October 16, 2013 10:37 am

      I’d merely like to have that extra box / bottle so I don’t have to make repeat trips to the pharmacy. It feels like a waste of time and rather trivial to ask my doctor to write me a prescription for anti-histamines. I am sure she has better things to do.

      Alcohol is cheaper here than it is Ontario… At least when you get it off the Estonia / Sweden-bound boats… Pretty crazy to see people bringing in whole pallets of alcohol for their “personal use.”

  3. Sonia permalink
    October 16, 2013 11:02 pm

    It will be longer again…

    First of all
    “Carmen: I wonder if the authorities think the regular Finn cannot control their use of over the counter drugs”

    –> I have the impression, that there is a lot of other nanny’ing cases (preferable measure: more tax, unavailability, control) than only the over-the-counter medication. Hm, inexpensive and widely available alcohol?! Do we live in the same country? 😉 The problem lies elsewhere than in the price and availability and restrictions/hikes bring the opposite result, as seen.

    I have the impression that far too many pills are consumed here, no matter if freely purchased, advertised on TV and radio or prescribed by doctors. This is quite contradictory to your experience of limitation. Since I rely on nature rather than on pharmacy, the biggest free pack I ever bought are 3xBerocca and nobody removed one pcs. from the package yet, who knows…

    Nonsense, I experienced with the heavy-paperwork-public-health-and-pharmacy in Finland:

    – The doctor usually prescribes a huge amount of the same medicine. Once I wanted to buy them all at once (because I tend to lose the paper), e.g. for Thyroxin (one package is enough for 2/3 of year), she told me, when I buy them at once, the second is not “sponsored” by KELA. I asked what if I come “later”. Then again, it is. I did not bother to ask what’s the definition of “later” to get the 85 cents of subvention – same evening, in a week, month or half a year?

    – My hay fever is quite minor anymore these days. The doctor’s prescription is again huge (100 pcs.). I wanted to save the environment and asked only for a small package (30 pcs). The pharmacist said that then I had to pay the full price by myself. It turns that the big package is cheaper in this case than the small on own cost… The rest expires and needs to be thrown away.

    – One doc gave me an prescription for some eye drop stuff. The pharmacist asked me, if I really want to use the prescription, because bought without, it’s cheaper (apparently some prescription handling fee and very tiny subvention).

    – Do you know that you are not allowed to import medicine in your luggage from abroad (I guess, it affects even the EU) or get it in a package / buy it online/abroad? My friend had an unpleasant customs tete-a-tete only because of vitamines/food supplements (nothing “forbidden”) and another one was invited to customs office so that they “destroy” 10 pcs. of painkillers in front of her (exceeded the limit). A fine payment would do, too.

    – I had an eye infection and ran in the weekend to the pharmacy to get at least a bit of relief (not “medication”). This is quite common in Germany, because pharmacists have high education (so are they here) and are capable to give you initial help. Nevertheless, the pharmacists looked at my piggy eye and told me that she was not allowed to make advices. Eye doctor reception told me that the next appointment was in six weeks (private), public service was wondering how I could imagine to pass immediately to a specialist doctor and finally after several days of pain, work healthcare doc looked at me, speculated what is wrong (without inspecting the eye) and gave me a heavy antibiotics treatment without proving if it’s viral or bacterial at all…

    -“ePrescription” is easy and saves terveyskeskus time. I had an emergency case this summer for the first time and after speaking/being tested for 5-10 min. in the hospital hallway by the emergency doctor (after 4,5 hours of waiting), I have got a giant cortison dose without seeing a proper doctor at least once earlier than a week after the happening.

    – I do agree that online shopping of medication may be quite a risk, but there are several European places which are certified, acknowledged and e.g. in Germany advertised even in local shops, because they increase the competition. Ouch, exactly. Competition. I think, the local protectionism plays a big role in scaring people that everything baaaaad comes genuinely outside of Finland.

    – What is quite laid-back again in comparison to my country – pet medication, such as tick repellants and regular worming suspension. Those are only available at the vet or upon prescription in Germany and are freely available in Finland. Anytime I presented some questions, I couldn’t get a professional answer from the pharmacist, but only ahhhh ehms… even if it’s a heavy stuff for these creatures.

    All these does not boost my confidence, especially not in the public service. Work healthcare was good so far and health problems minor (except of summer).

    • anonymous permalink
      October 16, 2013 11:48 pm

      I wouldn’t really know, but I think if you have prescription (from abroad, possibly of a specific kind), you’re allowed to bring the prescribed medicine.

      A big problem in Finnish healthcare is the two-tiered system. People with money/ healthcare through work get better and faster treatment and I think the government even subsidizes them more (in absolute monetary terms). That leaves very little incentive to try to fix the public side of things and also makes most doctors flee to private side. If everyone relied on the public system, any problems and under-resourcing would have been fixed already.

      • Sonia permalink
        October 17, 2013 11:55 pm

        This is very true! The Finnish public system in very serious cases can be world top class though IF (!) you are lucky to be taken seriously. This is quite an effort when you are not in good shape and cannot argue with the bureaucrats on the way. I was very happy with the follow up at a specialist after I finally got through the jungle of bullet-proof receptions (there were 3 or 4 on the way along the yellow line 😉 ). That was nearly the only time, I visited the public service, because it was an emergency case. Otherwise I am truly enjoying the work healthcare (private). The “taksa”/fee basis for the private doc visit are so low that I doubt if those people get more assets. Perhaps only because they really get to the doctor more often and don’t have to queue like the others…?

        I suppose you cannot yet buy meds with a Finnish prescription abroad and being abroad/in my country, I can’t get a regular prescription, because I am not insured anymore (only in emergency cases). It’s about over the counter stuff. But there are no controls on luggage or private packages (except some “damages” sometimes).

      • anonymous permalink
        October 18, 2013 3:46 pm

        The private side doctors also handle a lot less patients. I remember reading about this on Osmo Soininvaara’s blog; IIRC the public side doctors get over 2000 patients (yearly, I think) whereas the private side handles less than a thousand. They also get more money, of course (subsidies + fees on their own practice vs. subsidies on the full public system). They also use more resources in the non-basic health care sector (handled exclusively by the public sector in Finland).

        “It’s about over the counter stuff.”
        I think it would have to be over-the-counter in Finland, too, to import it, if you don’t have a prescription.

  4. steverp permalink
    October 21, 2013 1:48 pm

    I couldn’t agree more. We have a similar thing in the UK (to Canada), whereby you can go to any supermarket or corner shop & purchase most basic (over-the-counter) medicines. We do have slightly stricter regulations around how much you can buy i.e. you can’t waltz in & buy 100 packs of paracetamol (I think the limit is 4 packs of about 30 for most things), but we can at least go & get some from pretty much anywhere, 24 hours a day.

    I guess here there are restrictions on competition (legal or not) as there is in almost all of the retail industry which keep choice minimal & prices high. Again, in the UK I can go to my local Tesco & buy their own-brand painkillers – approx 30 for less than £1. Here – I can only pick from the ones the government-controlled pharmacies sell – & they tend to be all the same in each one & prices are set to whatever they want as there is no other direct competition.

    There certainly seems to be focus here on controlling the things that really don’t need to be, while at the same time turning a blind eye to inadequate & failing processes & organisations that affect people’s lives.

    • Sonia permalink
      October 25, 2013 10:41 am

      Oh boy, same experience here about the prices (even if bought in a pharmacy in Germany). I guess we don’t have stuff in supermarkets, except for some flu medicines. Need to check.

      I do agree about overcontrolling consumers and restricting competition (if any) here in Finland – on an EU market! Actually in many areas in addition to pharmacy. An artificially taught loyalty to local products and their superiority boost the prices sky-high, even there is seldom data of objective comparisons to foreign products available. if any.

  5. steverp permalink
    October 22, 2013 1:52 pm

    I did in fact just go to the local Apteekki. I bought four things. All of these things would have been available in ANY supermarket in the UK & would have cost no more than €15. Here, €51!!

    • steverp permalink
      October 22, 2013 1:53 pm

      I actually had to ask the woman serving me if that was correct, assuming she may have scanned something through more than once!

      • Sonia permalink
        October 25, 2013 9:44 pm

        This question is on my mind quite often 😀

    • October 23, 2013 7:52 am

      Sheesh! That’s crazy!

  6. getting worse permalink
    October 27, 2013 12:12 pm

    Welcome to hell

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