Clerks at traditional pharmacies pharmwcies more years of experience, in part because some of these pharmacies had been family-owned for many years and employees were related by kinship or friendship. On average, the presence of a QFB was limited to less than 2 hours per week, and consequently the clerks worked without supervision and without access to a professional capable of resolving doubts or addressing clients' questions.
Among the respondents, a high-ranking administrator of a pharmacy chain stated he was proud of the weekly trainings provided by drug suppliers and pharmaceutical companies. In addition, the study uncovered that pharmaceutical companies were offering financial incentives to promote their products, and those incentives were often extended to pharmacy clerks.
The final income of some clerks, especially those working for pharmacy chains, was based on the amounts and types of products they were able to sell. Ninety percent of clients who bought bordeer type of medicine without a prescription asked for the product by name, and pharmaciss of the mexican border pharmacies referred the client to a physician or expressed concern about selling the product without a prescription. Of 19 clients who went to the pharmacy seeking advice, all received a recommendation from the clerk and all but one bought the recommended drug.
Only one client was referred to a physician. The clerks provided very little information about adverse events; drug interactions were not discussed during any of the observed clerk-client interactions. This is the first study to examine the risks and benefits of Mexican border pharmacies and the training and substantial role played by the clerks in these pharmacies. Pharmacy clients might be spending their meager resources to treat symptoms; for example, some bought medicines for fatigue or weight loss, most probably pharjacies ruling out underlying health problems, and delaying necessary treatment.
Patients also purchased medicines that could hinder recovery e. The availability of walk-in clinics-where physicians diagnose and prescribe for a minimal fee-is very attractive to patients, including United States residents who are either uninsured, cannot access medical care in mexican border pharmacies timely manner, or cannot afford co-payments. It is also common for pharmacies to contract or employ physicians to prescribe and refer the patient to the pharmacy.
In some instances, the physician's compensation mexican border pharmacies based on the number of prescriptions, a situation that creates a conflict of interest and might lead to the prescription of unneeded medicines The Mexican government's decision August to enforce the legislation requiring mxican prescription to purchase antibiotics may have decreased the number of OTC sales of antibiotics.
The potentially biased information offered by the drug industry and distributors and compensating pharmacy mexican border pharmacies based on sales also may cause overmedication.
The sale of unneeded medicines coupled with the absence of pharmacists, the presence of untrained clerks, the mexican border pharmacies tendency of Mexican physicians pjarmacies mexican border pharmacies few instructions in their prescriptions, and the limited information contained in the package inserts of prescription-only medicines, translate into clients having access to medications, but receiving very little or incorrect information on how to use them.
This study has documented that, contrary to people's perception, medicines are not always cheapest in Mexico, therefore United States-Mexico border crossers might want to compare prices before buying. They also might want to seek advice from pharmacists in the United States, an issue that was not addressed in this study and deserves to be explored.
The study limitations are the use of a convenience sample, the fact that two pharmacy chains refused to participate, and its relatively small sample size.
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While the findings cannot be extrapolated to all Mexican pharmacies, the study parmacies unveiled regulatory mexican border pharmacies and pervasive organizational practices that are not exclusive to the pharmacies studied, ones that impact the type of products purchased and how medication is used. Additionally, the observers of client-clerk interactions could not always capture the name of the product under discussion, which limited analysis of the dispensation process.
As long as there is no universal access to medical care, United States border residents will continue to use Mexican pharmacies as their last resort. We would like to suggest some measures that could reduce the risks and improve the use of pharmaceuticals in the border area. It would be advisable to limit the conflicts of nexican built into financial compensation offered to pharmacy clerks and mexifan working in close collaboration with pharmacy chains.
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These financial incentives lead physicians to over-prescribe and pharmacy clerks to increase the sale of selected products, and do not contribute to promoting the appropriate use of pharmaceuticals.
Pyarmacies could distribute informational leaflets with all pharmaceutical products, but especially in prescription-only phaarmacies that are currently sold with very limited accompanying information. These leaflets should be designed by communication bordet and the information should be provided by experts not under the payroll of the pharmaceutical industry.
United States clinics and others serving the poor and uninsured might remind those in need about the availability of some low-priced, generic medicines in United States pharmacies. Given the dearth pharmscies QFBs trained in community pharmacy 25consideration should be given to the development of a technical degree, such as the pharmacy technician degree mexican border pharmacies in Cuba Given the importance of Mexican pharmacies for United States mexican border pharmacies, the Pharrmacies States border leaders may consider collaborating with Mexican health authorities in the development of joint programs to promote the adequate use of pharmaceuticals, including antibiotics; in training pharmacy technicians; and in the development of educational materials to be distributed in pharmacies.
Finally, policymakers and professional associations may need to take decisive steps denouncing norder that put the health of pharmacy clients at risk. Successful implementation of these solutions will require a concerted effort by stakeholders, i. Gross DJ. The consumer and reimportation. Managed Care. Boshle MJ, Balkrishan R. Drug reimportation practices in the United States. Ther Clin Risk Manag. Am J Mexican border pharmacies Syst Pharm.
Shepherd MD. Drug quality, safety issues and threats to drug importation. Impact of drug importation on community pharmacy and patient care. J Am Pharm Assoc. Msxican States Food and Drug Administration.
Previous research regarding US patients who cross into Mexico for prescription medications focused on the volume and cultural characteristics,  while others have examined the dangers and legal issues associated with doing so . Specifically, patient-based surveys were used pharmcaies describe and identify why US residents cross into Mexico from Arizona, California, New Mexico, and Texas to buy prescription drugs and medications. In addition, Homedes and Ugalde found that those who crossed to Mexico for health care faced a variety of challenges including administrative, legal and cultural barriers .
In spite of these difficulties there continues to be a considerable number of border crossings for medications. Although there are no exact figures on the number of Americans purchasing medications in Mexico, research suggests that it is significant.
Purchasing prescription medication in Mexico without a prescription. The experience at the border
In October and November ofresearchers who conducted over telephone interviews and found that The hybrid nature of pharmacirs populations is a factor . Populations living along the border are at ease interacting with others from different cultures and are not apprehensive of other cultures and culture groups compared to people living away from the frontier [12,21]. The primary reason for crossing the border for medications however is cost savings.
Mapping and provider-based surveys were utilized to examine trends. The file contained street and colonia similar to census tracts data however, street segments did not have any coordinate reference system horder, and in addition it did not contain address ranges, which prevented geocoding operations.
Although address matching mexiczn not possible, the street and colonia files were imported into ArcMap for mapping purposes only. Streets, colonias and distances were accurate and were used boredr identify street names and define distances for manual bofder of facilities. A three-step process for manual placement of the facilities was performed.
Pharmcaies, the street name of each facility was identified and located in the street file. A second query was performed to locate that section of street within a polygon, in this case, a colonia since this information was provided by the Yellow Page advertisement. The third step in the location process placed pharmacies in a particular order on the street and within the colonia as follows. As a result, pharmacies were mexican border pharmacies on the correct street and in the correct colonia, however the exact location of each facility on the street itself could be slightly inaccurate because each was manually placed in ArcMap.
This process proved to be a useful method for locating pharmacies in those cases where address matching was unavailable. Once the pharmacies were located and mapped, a cluster pattern was clearly visible. The same questionnaire was used in and and whenever possible, sites interviewed in were interviewed in The border zone one and one-half miles from the principal border crossingsitself, saw an increase of 90 new pharmacies, accounting for The distance between the two main border crossing points is approximately two miles, gorder with the border zone of one and one-half miles from each crossing point, the border zone has an mexicwn of approximately 7.
The dramatic increase in mexicqn number of pharmacies in the border zone is further illustrated in Figures 1 and mexican border pharmacies and again indicates that US customers were the reason for these new facilities being built within one and one-half miles of the two principal border crossings see Figures 1 and 2.
As shown in Https://canadianpharmacy-us.com/8-reputable-canadian-mail-order-pharmacies-pytyr.php 1in facilities are closely clustered near the US border crossing points in the northern part of the city.
The remainder of the city has a much sparser distribution. Although pharmacies are found in other parts of the city, mxican clustering and concentration is in the north—near the two US border crossing points.
This was the case in and remains so in The mexican border pharmacies in Figure 2 de. Table 1. Number of pharmacies Number of interviews conducted shown in parentheses. Figure 1. Distribution of pharmacies, As the inset maps show, in both years the facilities tended to be located near the mexican border pharmacies crossing points and along the main streets leading from those entry points, and close to their clients.
Figure 2. The demand generated by US residents is significant. In other words, the further these facilities are from the border, and US base El Pasothe fewer customers are from the US. Many products purchased were of limited therapeutic value, and others could be harmful when used inappropriately. Pharmacy clerks were poorly trained and did not offer appropriate information on drug use; contraindications were never discussed. Contrary to popular perception, some generic drugs were cheaper in the United States than in Mexico.
Conflicts of interest were identified that could be leading to over-medication. Blrder authors suggest five steps for reducing the risks and improving pharmaceutical utilization in the border area.
Series Rev Panam Salud Publica;33 3 ,mar.
OBJECTIVE: To determine the benefits and risks of using Mexican pharmacies by better understanding the sociodemographics and medication needs of pharmacy. US customers started deluging Mexican border pharmacies after Texas passed an anti-abortion law last fall. A two-pill combination costs.