Despite concerns about clinical efficacy, phenylephrine was the most common oral decongestant sold in the United States from 2012 to 2021, according to a research letter published online Feb. 8 in the Journal of the American Medical Association.
Timothy S. Anderson, M.D., from the University of Pittsburgh, and colleagues examined patterns of the purchasing of oral decongestants as a drug class based on U.S. data from the IQVIA Multinational Integrated Data Analysis quarterly pharmaceutical sales volume (units; 2012 to 2021).
The researchers found there were 732 unique phenylephrine products (21 standalone and 711 combination products) and 495 pseudoephedrine products (54 standalone and 441 combination products). During the study period, there were 19.8 billion units of phenylephrine products purchased, amounting to $3.4 billion in pharmacy expenditures, and 13.2 billion units of pseudoephedrine products purchased, amounting to $3.8 billion in pharmacy expenditures. Over all the years, units of phenylephrine purchased outpaced pseudoephedrine, which had significantly declining sales from 1.68 billion units in 2012 to 0.98 billion units in 2021. The vast majority of sales of phenylephrine-containing formulations contained three or more active ingredients (85.5 percent), most commonly analgesics and antitussives.
“The delays between concerns about efficacy of oral phenylephrine being raised and Food and Drug Administration action highlight the need for continued reform of the nonprescription drug review process,” the authors write.
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