The National Drugs and Poisons Scheduling Committee has withdrawn permission for Xenical to be advertised directly to consumers. However, it did not change Xenical's status to a S3 'pharmacist only' drug. CHOICE argues that Xenical needs to be dispensed by doctors to ensure that consumers are not paying for a product that won't work for them.
In their decision the NDPSC "noted the advice from professionals and consumers that direct-to-consumer advertising increased pressure on pharmacists to provide orlistat to consumers. This in turn had the potential to result in inappropriate patterns of use, in patients for whom orlistat was neither indicated nor appropriate."
Xenical (also known as orlistat) is a drug that's promoted as a treatment for overweight and obesity. It can help you lose weight, but it's only suitable for people who are obese with a body mass index (BMI) of 30 or more, or with a BMI of 27 or more with obesity-related risk factors such as high blood pressure or cholesterol. It can also have unpleasant side effects if not used correctly (see Xenical: Q&A).
What's the problem?
Originally when it went on sale in Australia Xenical was a schedule 4 (S4, 'prescription only') drug. But in October 2003 it was granted schedule 3 (S3, 'pharmacist only') status, which doesn't require a prescription. And subsequently in June 2006 the pharmaceutical company, Roche, was given permission to advertise the drug to consumers using its brand name (Xenical).
When its recent advertising stint during TV shows including Australian Idol put Xenical into the mainstream, we were concerned that the audience -- with a high proportion of young female viewers -- could be left with the impression that the drug was a quick-fix solution suitable for anyone who wants to lose weight. We also heard of anecdotal evidence that there had been a noticeable increase in the number of people in the healthy weight range requesting Xenical coinciding with the onset of branded advertising for the drug.
Xenical has an important place in helping people who are obese or who are overweight with obesity-related health problems. But Choice is concerned that its S3 status means that Xenical is too easily accessed by people who shouldn't be taking it, and that there's potential detriment to consumers if it's marketed inappropriately.
The Pharmaceutical Society of Australia (PSA) has issued guidelines for pharmacists to follow when supplying Xenical. In summary, pharmacists should:
- Assess whether or not Xenical is appropriate for the patient.
- If supplied, provide counselling on points including dosage, side effects and lifestyle modifications required.
In theory, if the guidelines are followed only eligible people should receive the drug and they'd receive appropriate advice and counselling. We sent a researcher to pharmacies across the Sydney metropolitan area to see what happens in practice.