The Role of Pharmacies in Medicine AccessBy Miriam Bello | Wed, 02/16/2022 - 19:00
Health access in Mexico has been compromised by medicine shortages, poor infrastructure, long waiting times and high out-of-pocket expenditures. Experts in the private sector try to fight these problems to guarantee the right to health.
Medicine access depends on many actors. The first are manufacturers of generics and innovative medicines. The second is the distributor, which is responsible for bringing the products to all pharmacies while overcoming the logistical challenges in efficiency and cost. The final actors are pharmacies. “Private sector pharmacies ensure supplies meet the highest quality standards in accordance with the law, while respecting the prescription,” said Ignacio Merino, Director General, Farmacia Paris.
The entire health chain intervenes so patients can access medicines and health treatments. “We cannot fail to see how the public and private sectors can be complementary in improvingthe health of Mexicans. Trained health personnel, adequate infrastructure, medical devices and medications should be available at both sectors, so their collaboration is fundamental,” said Américo García, Vice President and General Manager LATAM, Apotex.
Both sectors play equal but complementary roles throughout the entire health chain to supply medications. But regulators also play a key role in ensuring access to medications. In the case of generics, authorities need to work faster so generic drugs can reach the population on time, said García, which will furtherpromote a “framework that will propel quick access to new medications.”
In the case of specialized medication, access becomes more critical. “Bringing highly specialized drugs to the country in the private and public sectors can be facilitated by effective health authorities and regulations that readily authorize medicines for common and rare diseases,” said Rodrigo Fernández, LATAM Head and General Manager, TEVA Pharmaceuticals. Pharmaceuticals must also help the industry “go beyond the prescription, help detect diseases and collaborate with medical professionals to support them in making the diagnosis more efficient.”
Mexico’s limited access to healthcare services has seen a short-term solution in the form of Pharmacy-Adjacent Medical Offices (PAMOs), which are equally used by those who have access to public health services and those who do not. “The primary reasons why PAMOs are the top choice is because they offer low-prices, immediate attention, high schedule availability and the opportunity to obtain an immediate prescription,” said Merino.
Only 12 percent of those who use PAMOs could satisfy their ambulatory health needs through public health services, found a study called “The responsibility of the state in the access of health services.”
In Mexico, social security provided by IMSS, ISSSTE and PEMEX is conditional to formal employment. “However, being affiliated to these services does not guarantee access,” highlights García. He shares that in 2018 there were 32,000 pharmacies but in 2021 this number grew to 37,500. This growth increases attention and relieves pressure from the public health system. Moreover, despite their inability to address the most complex diseases, PAMOs are convenient, fast and inexpensive.
In Mexico, 49.1 percent of medical care was obtained at a private healthcare provider and a large percentage of it financed by the poorest segment of the population. “Prior to the pandemic, homes in rural areas of the country with seniors and young children were the ones with the highest expenditure on health,” explained Sergio Bautista, Researcher, CISS-INSP. Those with chronic diseases also had some of the highest health expenditures.
The private sector mostly relieves the public sector in the treatment of acute illnesses, according to García. “Mexico lives with acute and chronic illnesses and the pharmacy has been instrumental in covering these acute illnesses that represent urgency to the public sector.”
To date, Mexico has 18,000 PAMOs employing a total of 36,000 doctors, said Marcos Pascual, Commercial Director, ANAFARMEX. “Through these offices, we offer almost 400,000 appointments per day. Doctors at PAMOs are treating mild COVID-19 cases and directing complex cases to specialists. Aware of the importance of increasing health access, we are allying with CCE and the government of Mexico City to strengthen our health provision and our role as the primary health contact with the patient.”