Buying medicine while traveling overseas can be intimidating and dangerous, but some medicine retailers are safer than others. If you have to buy drugs in the developing world, here’s two ways to minimize your health risk.
The two key factors to consider when purchasing drugs overseas are price and the retail outlet. Purchasing a Coke in Nairobi, Kenya and New York is a similar experience; the surroundings are different, but the drink and salesman are identical for all practical purposes. But buying medicine is vastly different; in Nairobi, prescriptions are often optional, and you can buy your antibiotics and Coca-Cola in exactly the same way. In New York, on the other hand, the process is very different.
The market in Nairobi is more varied too. Ten pharmacies may carry hundreds of different brands of the same types of medicines, especially antibiotics and antimalarials. Prices can range from under a dollar for a locally made version of an older medicine to over thirty dollars for a newer drug type made by a Western innovator. It is easy for customers to compare prices—and expensive Western innovator medicines are generally of higher quality.
Analyzing medicines purchased from two main types of pharmacies, my recent working paper provides an initial look into how quality varies by pharmacy type. I find large pharmacies (either a substantial stand alone organization or, more likely, chain pharmacies) typically sell better quality drugs than their smaller counterparts. This makes sense—large organizations will be much more concerned with their reputation and likely to have systems to monitor medicine orders. Companies like Nairobi’s 65 CFW Shops, or the Apollo pharmacy chain, which operates over 1,000 shops across India, compensate to some degree for the lack of government oversight out of self-interest—to the benefit of the patient.
The best way to ensure that the drugs you ingest in the developing world are safe is to bring drugs purchased at home with you—no regulatory agency in an emerging market is as thorough as the U.S. Food and Drug Administration. But if you’re in a pickle, you can minimize your risk by choosing brands you know, purchasing innovator products, and finding large pharmacies that are part of a recognized pharmacy chain. This finding has important implications for policymakers as well—perhaps a crucial step to improving drug quality is to encourage the growth of pharmacy franchises.