Pharmacies and the Pharmaceutical Industry in Latin America

• DOI: http://doi.org/10.1002/wmh3.307
• Published date: 01 June 2019
• Author: Nuria Homedes,Adriane Fugh‐Berman
• Date: 01 June 2019

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doi: 10.1002/wmh3.307

© 2019 Policy Studies Organization

Pharmacies and the Pharmaceutical Industry in Latin

America

Nuria Homedes and Adriane Fugh‐Berman

Latin American community pharmacies treat large segments of the population, especially the poor.

Self‐medication rates are high, and prescription‐only medicines are often available without a

prescription. Patients rely more on pharmacists’advice than clinicians’, but conflicts of interest are

rampant: companies may offer discounts, extra drugs, or a higher profit margin to pharmacy owners;

pharmacy staff recommendations may be compromised by lack of education or financial incentives,

including bonuses and commissions for recommending specific drugs. Pharmacists and staff rely on

pharmaceutical company education on drugs. Pharmacy chains, which tend to provide poorer service,

are replacing family owned pharmacies in most Latin American countries. Pharmacies are a de facto

safety net for the poor and uninsured and should be considered part of the health‐care system, not just

commercial establishments. Medicine dispensation should be professionalized, and pharmaceutical

company‐funded education should be banned to minimize the conflicts of interest that affect

medication recommendations.

KEY WORDS: Latin American health care, pharmacies, conflict of interest

Introduction

Latin American pharmacies are the first line of health care for many, especially

the poor. As such, it is important to analyze how they respond to the needs and

demands of their clientele; if they recommend the appropriate use of medicines,

especially antibiotics; and if rational care is compromised by pharmacy relation-

ships with wholesale providers and pharmaceutical companies. In this article, we

describe the magnitude of the role that community pharmacies play within the

Latin American health systems, the prevalence of self‐prescribing, how the quality

of prescribing and dispensing in private Latin American pharmacies affects the

rational use of medicines, explore the effect of commercial interests, discuss how

the rise of pharmacy chains may impact appropriate use of medicines, and critique

governmental responses to current challenges.

Bypassing Medical Professionals

Early studies documented that community pharmacies were an important

source of treatment for large segments of the population, especially the poor

(Brown, 1963; Ferguson, 1988; Harrison, 1976; Ledogar, 1975; Murray, 1988;