Counselling with a focus on product and price transparency for over‐the‐counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany

Background In Germany, over‐the‐counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure ‘adequate’ counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency. Methods The cross‐sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom‐based sub‐scenario 1 with a request for an OTC medicine for a headache and a sub‐scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items. Results All 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed‐rank test; p