Saturday, June 23, 2007

Mexican Pharmacies

One of the more interesting things here in Mexico is the number of drugs available without a prescription - basically everything that is not on the our controlled substances list can be bought by anyone at any pharmacy.

This means that antibiotics, heart medicines, diabetes pills, and other common chronic drug regimens can be purchased during a trip to the market. No benzos or opiods but plenty of other medications to allow people here to deal with many problems on their own.

Of course, this also means that medications are a lot cheaper here (except for some of the big gun antibiotics). For example, I can purchase my month long supply of allegra for less than $20. Many U.S. health insurance companies won't even cover Allegra these days due to the availability of the similar (but for me and many others, less effective) Claritin over the counter. Anyway, the old Blood pressure meds and DM regimens are certainly cheaper, as are the old generation and generic antibiotics.

The good thing about this system is that people with very little money can treat common conditions much more easily. It's not too hard for a women to figure to use a sulfa to tx her urinary tract infections if she gets them a couple of times, or if her sister/mom etc has had them as well. Same goes for mom's treating ear infections with some amoxicillin. The problem of course is that many things are mistreated and of course there is less preventive medicine in this model.

For example, in the emergency room this week I saw a women who tried to treat a bladder infection with an antibiotic that only covers gram + organisms (most bladder infections are a different type of bacteria). So, the infection spread to her kidneys. Since she was pregnant, this became a relatively serious infection likely requiring hospitalization and IV antibiotics (at least in the U.S).

Of course this would throw the economics of medicine in the states out of control as well if these drugs were over the counter - think of all the office visits for med refills and relatively common prescriptions/common problems. Anyway, the argument, of course, that those of us trained in medicine in the U.S. would make is that while it is more costly to have these frequent office visits, it is also the only way to rule out more serious problems and keep up with immunizations and other necessary prevention/health maintenance issues.

Anyway, arguments aside, I will enjoy my $15 Allegra while I'm here, my ability to grab some antibiotics to keep away the Monteczuma's Revenge, and other simple stuff that even with my level of training, I can select the appropriate medicine for treatment. Different world.

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