The insurer estimates that about 40 percent of allergy patients are receiving the newer drugs. People will be more alert. Industry experts and others watching the outcome of the case said that it was likely that the drug companies would take the agency to court if it tried to force them to make the drugs available over the counter. David F. Weeda, a lawyer in Washington who has worked in the office of the chief counsel of the F.D.A., said it was not clear whether the agency could legally force a switch. In my gut, I think that it is going to be a close case.
Many doctors oppose the switch.
They say that if more allergy drugs are available without a prescription, fewer people will go to the doctor and more severe health problems like asthma will be left undiagnosed. Dr. Irwin Redlener, president of the Children's Hospital at Montefiore Medical Center in the Bronx, said that he saw many parents who had tried to treat their child with allergy drugs without visiting a doctor only to find out later that their child had asthma. Dr. Redlener said he feared that more parents would be tempted to forgo a trip to the doctor if the newer drugs were available over the counter. He said he also feared that fewer poor people on Medicaid would be able to take Claritin and the other newer drugs if they were sold over the counter because they would have to pay for them themselves. Many people on Medicaid now pay very little or nothing for a prescription, he said.