Are you overweight, worried about your cholesterol levels, or fighting a losing battle with insomnia? In the past you would have visited your doctor: now, chances are you will hot-foot it to the high street.
The latest Mintel consumer spending statistics showed that the market in over-the-counter pharmaceuticals has grown enormously, with sales expected to swell by a further 18% in the next five years. Last year we spent a whopping £3bn - an average of £59 per person - on everything from cough and cold remedies through vitamins and alternative treatments to painkillers and self-diagnostic kits.
It's a huge trend, underlined by the recent arrival on the pharmacists' counter of the slimming drug Alli - but is it a good one? Yes, unsurprisingly, say the chemists, because it means that we are becoming more aware of what might go wrong before it does and taking preventative measures, such as cholesterol reduction. "People also like the fact that they can just pitch up, no need for an appointment," says Neal Patel of the National Pharmacy Association. "85% of chemists now have private consultation areas, so it's a lot easier to see your pharmacist about something you wouldn't like everyone else in the shop to hear about."
The list of drugs licensed for sale in pharmacies grows all the time, which some doctors are wary of. "There are some downsides," says Steve Fields, chairman of the Royal College of GPs. "One is that a pharmacist makes their profit selling over-the-counter drugs whereas your GP has no pecuniary benefit in giving you medicine.
"And the next problem is that many of the things available over the counter don't work - most vitamins and cold remedies, for example, are a complete waste of time - but they are still things that make lots of profit for the pharmacist. So it would be far better for your health if you invested your money in fruit, but if you go to the pharmacist he or she is unlikely to suggest that, and you're likely to come away with a jar of pills that won't do any good."
When it comes to buying drugs over the counter you can almost hear the cheers from Whitehall. Like face-to-face time with GPs, prescriptions, even when they're paid for, cost the state money.
There is a well-trodden path by which drugs are made available over the counter. "Medications tend to come in first as prescription-only drugs, because trials have been done but the medical profession has still to see the effects in the general population - what side-effects might emerge, how they might react with other drugs, and so on," explains Fields. "So as we learn more about them, through mass use, we're more likely to make them widely available." Statins, the cholesterol-reducing drugs that are now available in some doses over the counter, are an example of this. So too is Alli, a half-strength version of the prescription-only diet pill Xenical.
One obvious concern about people being able to buy medicines, particularly online is that it's a lot harder to control their use. Alli, for example, should only be given to customers who have a body mass index of more than 28, and it shouldn't be sold to children; but what's to stop anorexic teenagers lying about their age and their BMI on the computer? What's more, if concerns about using a drug in a particular way emerge once it is widely available, it can be difficult to pass those on to consumers. "I'm thinking of things like the changes in prescribing antibiotics for children's ear infections - now we advise parents that it's not a good course of action because it doesn't help," says Johnny Marshall, who chairs the National Association of Primary Care.
"But if those patients were buying antibiotics over the counter, a change like that would be much harder to achieve."
Furthermore, while pharmacists have expert knowledge about medicines, they don't have access to a patient's medical history. "Overall, the care may be too fragmented," says Marshall. "If you've got a recurrent problem a doctor or practice nurse will see a pattern and urge you to have it investigated, whereas in the self-medicating model you can continue to treat the symptoms and ignore the underlying cause. At the very least, I'd like to see an evaluation of what we're spending our money on, asking what the knock-on effect is."
