Food and Drug Administration (FDA) Commissioner Marty Makary recently stated that when it comes to drugs that currently require a prescription, "everything should be over the counter" (OTC) unless they are unsafe or need monitoring. There are several obvious candidates to start the process—but don't expect pharmaceutical companies to ask Makary to reclassify them anytime soon. There's a reason for that.
Evidence suggests prescription requirements don't just restrict access—they also feed directly into the third-party payment system that drives drug prices upward. When a drug requires a prescription, it typically becomes eligible for insurance coverage. That shifts the transaction from a price-sensitive cash purchase to a subsidized one. Patients pay a copay, not the full price, and insurers often absorb the rest rather than provoke backlash. The predictable result is third-party inflation: When someone else pays most of the bill, prices rise.
