Mexican Pharmacy Offer High-quality Medicines at Low Prices
Due to the constant growth of drug prices in the USA, a significant part of citizens cannot afford to buy medicines at local drugstores and has to search for alternative solutions. And most of them choose either to make trips to neighbouring countries to purchase medicines there or to turn to online pharmacies. Many American patients prefer to buy medicines from Canada, since this country is located nearby and offers high-quality products at the prices, which are dramatically lower than in the USA. In fact, certain American politicians have even made an effort to legalize the importation of medications from this country. But that plan has not been approved yet, due to a series of political and economic obstacles. As of now, US citizens can legally purchase medicines at a limited number of Canadian pharmacies only. Sure, Canada is not the only country, where Americans can buy cheaper medicines. Millions of patients from the USA also use of the services of Mexican pharmacies. And, according to some sources, it is much easier to obtain medicines from this country, since the control of the legislation enforcement agencies is weaker there. The reason for such a situation is that there is a risk the enforcement of strict regulations may cause negative consequences for the health of people.
The Conformity of Medicines from Mexican Drugstores to the US Quality Standards
You have probably heard of the cases, when medications from Mexican drugstores have turned out to be unsafe or ineffective. That is associated with the lack of the control over the operation of manufacturers and pharmacies.
Here is a couple of examples to think over:
- In 2014 it was found out that a range of Mexican pharmacies located near the border sold two medications ― simvastatin and carisoprolol ― with the concentration of the active ingredients that was significantly lower than that indicated in the corresponding specifications.
- In 2015 the FDA checked other popular medications ― Viagra, Lipitor and Evista, and it turned out that the dosage of active substances in these medications was also lower than it was claimed.
Still, one should note that the situation is not so threatening. The cases mentioned are rare exceptions. No doubt, the FDA and other controlling agencies have checked a huge amount of other products from Mexican pharmacies, and the majority of them have met the current US quality standards.
The Socio-Demographic Situation near the Border between the USA and Mexico
24 counties of the USA border Mexico. And about 6.8 million Americans live there. About 30% of these citizens are under 18. Over 50% of people living near the border are Hispanics. As for the financial status of these citizens, in this region the poverty rate is higher than the average rate across the country. Also, the situation with uninsured people is identical. Besides, the majority of the residents of these areas have received elementary education only. More to the point, there is a shortage of health professionals of all the specializations.
To obtain these data, experts have analyzed the situation in two biggest cities in the bordering area ― El Paso (Texas, USA) and Ciudad Juarez (Mexico). These two cities are closely connected and form a single metropolitan, and at the same time they are separated by the border, which involves strict regulations.
Speaking about the situation with the use of pharmacies in the cities specified, one should note that the majority of Americans that turn to Mexican pharmacies are people with low income. As for migrants living in El Paso, researchers studied 100 families with low income and found out that 40% of people, who were sick during the previous year, practiced self-treatment and 10% turned to Mexican pharmacies. Also, 85% used medications, received directly from Mexico.
The Role of Mexican Healthcare Services
As for the situation in Ciudad Juarez, which is situated in Mexico, there are both small pharmacies and chain ones. The first category is popular among locals mainly. Such businesses are usually family-owned and have one outlet only. In recent years such local drugstores face decreases in revenue. The point is that it is difficult for small pharmacies to compete with large chains and to set the same low level of prices. As a result, the majority of their customers start using the services of chain facilities with cheaper prices. Also, some of local businesses include additional items (apart from medications) in their assortment in order to encourage loyal customers to stay and to attract new ones.
According to the results of a series of studies that have been conducted in recent years, a significant part of the US citizens living in the bordering counties prefer to turn to Mexican health service providers. Also, it has been estimated that about 30% of the population of the bordering counties have turned to health care services one time and more during the previous year. About 50% of Americans living in these areas go to Mexican pharmacies instead of those located in the USA.
For Americans buying medications in Mexico provides a wide range of advantages. First of all, in this country the majority of medicines can be bought without a prescription. The exceptions include: antibiotics, analgesic opioids, benzodiazepines, codeine, barbiturates. As for antibiotics, they are sold on prescription since 2010.
The Situation with the Pharma Business in Mexico
The outlets of Mexican pharmacy chains are usually located at large malls situated near bridges connecting the country with the USA. No doubt, such malls are highly popular among people crossing the border.
In Mexico there is no law specifying the categories of citizens that can own a pharmacy. Still, there is the regulation that physicians cannot work inside such facilities. Therefore, many pharmacies collaborate with medical centers located nearby. In some cases they can be located even next to drugstores. But they should have separate entrances to comply with the law. At such centers patients can have a consultation with a doctor for an affordable fee in order to find out which medicines to buy at a pharmacy.
It is noteworthy that, apart from prescriptions on antibiotics and controlled substances, other prescriptions have no expiration date. Consequently, patients can apply them for years without any medical control.
As for prescriptions themselves, they contain the basic information only. The local health authorities have implemented this regulation in order to prevent patients from self-medicating. Consequently, if a prescription does not include any instructions, a patient has to turn to a sales employee at a pharmacy in order to receive them.
But one should note that such sales employees bear no responsibility if any of their recommendations lead to adverse health consequences. In fact, they do not even have any medical education, to have secondary education is considered to be enough.
More to the point, at Mexican pharmacies there are neither managers nor supervisors to control the work of sales employees. There are licensed chemists or pharmacobiologists that are responsible for controlling the distribution of antibiotics and controlled substances, but such personnel are required to work at pharmacies for several hours per week only. So, they cannot provide sufficient assistance to sales employees. As a rule, pharmacobiologists work in the medical laboratories or in the chemical industry. But there are no hospital or community pharmacobiologists with specialized education that could deal with local community challenges.
Speaking about online Mexican pharmacies, it is still difficult to control them. In the first place, most Internet platforms offer generics, i.e. the copies of popular brand medications that contain the same active ingredients and produce the same effects. As of now, the Internet pharma market in Mexico cannot be called well-developed. The majority of customers using the services of online Mexican pharmacies search for medications for treating erectile dysfunction (like Viagra or Cialis), products for losing weight, medicines for dealing with the problem of hair loss and similar items. But, due to low prices, Internet Mexican drugstores become more and more popular year after year. Still, most Americans buying medications in Mexico prefer traditional offline pharmacies, since purchasing medicines online involves higher risks of buying counterfeit products or putting personal and banking data at risk.
The Short Overview of Mexican Drugstores and Their Customers
According to the results of the researches mentioned above, about 25% of customers that turned to the pharmacies located in Ciudad Juarez during the previous year were Mexican citizens legally employed in the USA. And those Mexicans helped US citizens to make purchases at Mexican pharmacies. Also, about 10% of customers were US residents working in Mexico and buying medications for residents of this country.
Speaking about the distribution of prescription medications, about 40% of customers, who were surveyed, claimed that they bought medicines with a prescription. Meanwhile, 90% of those prescriptions were provided by Mexican doctors, and 70% of them were given to US citizens.
It is noteworthy that, when it comes to buying prescription-mandatory medicines at a Mexican pharmacy, a customer can actually buy a prescription for a fee of about $2. Visiting local drugstores, one can see advertisements informing that they have specialists who can make a medical examination and write a prescription afterwards.
Here are the main reasons why US residents opt for Mexican pharmacies:
- lower prices (about 80%);
- sufficient drug quality (around 38%);
- no prescription requirements (about 39%).
The Peculiarities of the Products that Enjoy the Biggest Demand at the Pharmacies in the Border Cities
Let us discuss the medications bought by both Americans and Mexicans offline and online.
According to the results of the research, 120 medications out of 200 purchased without a prescription belong to those medicines that should be sold on prescription only. For example, no one of those customers, who bought analgesic opioids or birthcontrol pills, has a prescription. Also, a large part of the customers, who were surveyed, managed to purchase antibiotics, blood pressure medicines, thyroid products, corticosteroids and remedies for erectile dysfunction without a prescription. Sure, in the USA regulations are much more stringent.
Let us have a look at the exact percentage of medicines bought with a prescription:
- 0% of medications containing thyroids or testosterone;
- 10% of products for normalizing blood pressure;
- 20% of corticosteroids;
- 25% of antibiotics;
- 50% of antidepressants, anxiolytics and medicines for treating epilepsy.
30% of the medications under study were bought by US residents. And in 70% of those cases customers purchased them without having a consultation with a doctor. In fact, only in 10% of cases medicines were recommended by doctors. Sure, when there is no prescription, that is the sign that there is no medical control. As for 20% of cases left, those customers made purchases on the recommendation of sales employees or healers.
Speaking about the medicines bought by Mexico residents, 45% of such customers bought prescription medicines at their sole discretion, 25% ― turned to a medical specialist for advice, and 20% ― entrusted their health to a sales employee from a pharmacy. As you can see, the rates are higher than those of US residents.
In many cases sales employees recommended using antibiotics and analgesic opiates to customers, and both of these drug categories should be available on prescription only.
The Characteristics of Sales Employees Working at Mexican Pharmacies
According to the results of the research, sales specialists working at border pharmacies don’t have sufficient medical education. About 90% of them were taught by the colleagues, who also did not take any formal training courses.
Meanwhile, employees working for small local pharmacies turned out to have formal education. So, customers can safely turn to them for medical advice. And those qualified pharmacists are at the service of buyers during the bigger part of a day.
It is crucial to highlight that it is common for Mexican pharmacies to openly advertise products. In fact, the income of sales employees depends on the sales volume.
The research showed that sales assistants at pharmacies made an effort to find out more details about the customers’ health problems in about 30% of cases only.
At the same time, when customers brough prescriptions, in about 25% of cases sales employees offered alternatives that would provide higher salaries to them. And in 80% of cases customers with low incomes agreed.
In only about 5% of cases sales assistants recommended visiting a physician in order to receive recommendations. In all the other cases they strived to sell any medicines that might have suited the situation.
In 15% of cases customers were given verbal recommendations on the use of medicines. And personnel at pharmacies failed to provide exhaustive information about potential side effects and drug interactions.
As you can see, as of today, there is a range of serious risks associated with buying medications from Mexican pharmacies. However, most of them can be easily avoided by having a consultation with a qualified doctor beforehand and strictly sticking to his recommendations.
Risks and benefits of Mexican online pharmacies
- The border studies have shown that use of Mexican pharmacies across the border with the United States would definitely entails the set of risks and might result in complications with a user’s health.
- The consumers might simply waste their money on the medications they would not need at all. For example, a consumer might purchase the medications to battle the fatigue or for weight management, while not taking care of the underlying condition, of which the fatigue or weight loss were only symptoms.
- Patients might also obtain medications that could potentially result in hindering the recovery. For example, cough medications might be counteractive with productive cough.
- Consumers might obtain medications that could be detrimental to the health. For example, thyroid regulators and various fixed-dosage medications.
- The attractiveness of a medical consultant present at the walk-in pharmacy and who is able to prescribe the medication on the spot for a small fee.
- The uninsured American citizens, as well as those who are falling their co-payment plans.
- The Government of Mexico has issued the legislation which enforces a prescription for any antibiotics purchases. The sales of the latter have decreased as a result, which in its turn have caused massive opening of the professional consultation businesses situated next door to the pharmacies. There was a little effort to encourage the appropriate use of antibiotics.
- The medication industry is biased in any country, and, when it is out of the strict control by the governmental agencies, such as FDA in the United States, can influence the pharmacies with lucrative incentives to promote one medication over another: the practice widespread in Mexico, especially when a customer is asking for an advice from the sales consultant who belongs to the pharmacy.
- While there is not a significant difference in price between popular medications in Mexico and in the popular stores in the United States (such as Walmart), online Mexican pharmacies may offer lucrative, cheaper solutions, with the delivery included inside the Mexico, which makes these offers extremely attractive for American residents.
Our Suggestions and Recommendations
- It is highly recommended to eliminate conflicts of interest that result in financial incentives offered to pharmacy sales persons and medical specialists working closely with pharmacy stores. These conflicts currently lead physicians to over-prescribe medications that don’t need to be prescribed, while, on the other hand, the sales persons are incensed to sell these medications more and more, regardless if a consumer needs them.
- Increase the amount of information easily accessible and written in a simple language to orient a consumer in the effects, side-effects, and precautions of the medications, especially those that require prescription.
- Make pharmacy-oriented college degrees mandatory for sales assistants at regular stores and implement the system of promoting the benefits of education in the pharmaceutical field across the border provinces in Mexico.
- The United States border government and its departments responsible for health may consider working closely together with Mexican health authorities in the research and implementation of joint health programs to promote the proper use of pharmaceuticals.
- The border authorities may start to denounce practices that put the health of pharmacy customers at risk and that result in the decline of health of customers.
Este diplomado tiene como objetivo identificar nuevas formas de ejercicio del poder donde se contemple la interlocución y corresponsabilidad entre el gobierno y los actores sociales para diseñar, implementar, monitorear, y evaluar las políticas de atención a los mexicanos en el extranjero y a los migrantes en nuestro país, a fin de potenciar su eficiencia.