Friday, August 10, 2018

On drugs

No -- this is not a confessional piece!   It’s about drugs, or more precisely their prices.

It’s advisable when traveling, even in countries far more developed than Madagascar, to be supplied with a powerful antibiotic against “traveler’s tummy”.  The “in” drug at the moment is azithromycin, which appears to have displaced the previous “in” drug, ciproflaxin.

Glenview Travel Clinic had helpfully provided prescriptions for three days’ doses of azithromycin, which we duly took to a convenient branch of CVS (one of the major US pharmacy chains).  CVS warned us that the drug could be pricey – up to $180 for each of us, depending on the policies of our health insurer.  We were therefore delighted that, under our health insurance plan, we were able to fill each prescription for a “mere” $20.

With over a week remaining of our time in Madagascar, Sue and I had had occasion to use half our joint supplies of azithromycin.  With the rest of our stay and long international homeward flights ahead, we wondered if it might it possible to obtain fresh supplies.  It seemed unlikely in small-town southern Madagascar, but Rev Patsy offered to call in at a pharmacy in Amboasary to give it a try.  Not only did the pharmacy stock it, but three days’ doses cost us 7,500 Ariary – a tad under $2.50.  All neatly blister-packed and labeled, with the notes from the manufacturer in Chennai, India, to confirm that each tablet contained the 500mg daily dose specified in our US prescriptions.

What is one to make of the huge price difference?  I don’t know.  The US healthcare industry would have us believe that drugs in the US should cost more on account of tighter manufacturing standards, and to reward research and development.  But $2.50 vs. $20 or even $180 ?

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