Nasacort AQ, a popular intranasal corticosteroid spray used for the treatment of allergic rhinitis symptoms, has been approved by the U.S. Food and Drug Administration for over-the-counter (OTC) use. This means that allergy sufferers will be able to buy Nasacort AQ (beginning in the Spring of 2014) without a prescription, similar to oral antihistamines such as Claritin, Zyrtec and Allergy that have been available OTC for years.
In my opinion, there are positives and negatives having an intranasal corticosteroid available OTC. The positives are obvious -- allergy sufferers now longer have to obtain a prescription to get Nasacort AQ. Doctor visits can be expensive and many people don't want to have to wait to see their doctor just to get a prescription for an allergy medication for symptoms that need to be treated now. OTC Nasacort AQ will also likely be less expensive than having to pay cash (for people without medical insurance).
Once you stop and think about it, there are numerous negatives to having Nasacort AQ going OTC. Prescription medicine insurance plans are not likely willing to cover the cost of prescription intranasal corticosteroid sprays when one version is over the counter. For millions of people around the country, that might mean that insurance companies no longer cover other medications such as generic fluticasone, Nasonex, Rhinocort, Omnaris, Zetonna, QNASL, etc. Allergy sufferers will have to pay for Nasacort AQ out of their own pockets. There are also safety concerns. People using intranasal corticosteroid nasal sprays need regular nasal exams to assess for septal ulceration/perforation, and people using this type of medication long-term require routine eye exams to assess for glaucoma and cataracts. People are less likely to obtain this type of care with Nasacort AQ being OTC.
For primary care doctors, this could mean a further drop in business. Many doctors rely on their allergy patients coming in for either an initial treatment with medications such as Nasacort AQ, for refills of such. It probably won't affect allergists too much, since most patients coming to my office have already tried various allergy medications, whether they are prescription or OTC.