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The Goodman Institute Health Blog

Why Most Drugs Should be Sold Over the Counter

Posted on February 19, 2026February 19, 2026 by John C. Goodman

(Michael Brochstein/Sipa USA/Newscom)


FDA Commissioner Marty Makary recently stated that when it comes to drugs that currently require a prescription, “everything should be over the counter” unless they are unsafe or need monitoring. Here is why that’s good:

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.

Source: Jeffrey Singer, Reason

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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