OTC Medicine in the Americas

One of the wonders of the scientific/industrial revolution is the mass production of cheaply priced, widely available and highly effective medicines.  These are referred to as Over-The-Counter (OTC) medicine because one can walk into a pharmacy and find them stocked on the counter for purchase, without requiring a formal prescription from medical professionals.

We will begin by citing some survey data from the 2003 MARS OTC/DTC Pharmaceutical Study.  This is a mail survey of 21,106 adults in the United States conducted during the first quarter of 2003.  From this survey, we found the following usage levels for American adults:

For comparison, we refer to the the 2002 TGI Latina study.  This is a survey of 57,189 persons 12 years or older in eight Latin American countries conducted during 2002.  From this survey, we found the following usage levels for Latin Americans:

Considering that the Latin American sample includes teenagers who are less likely to be ill, the Latin Americans must be considered to be slightly higher users of these OTC remedies than the North Americans.  In the next chart, we show the incidences by socio-economic level.  Whereas socio-economic level restricts the ability to consume high-priced goods, the OTC remedies are sufficiently cheaply priced and widely available that there are virtually no significant differences by socio-economic level.  At least, in this sense, these medicines are democratizing.

In the next chart, we show the usage levels by education attainment.  There is little or no difference by educational level.  By this time, these OTC medicines are broadly used and sufficiently understood that there is no impenetrable mystique.  

So which factors influence the use of OTC remedies?  The next chart shows one such factor:

Why do Chileans rely so much on OTC remedies?  An explanation is offered by Isabel Allende in My Invented Country: A Nostalgic Journey Through Chile:

In our clan, it was also bad taste to talk about religion and, most of all, money.  On the other hand, illness was a constant topic of conversation, it is Chile's most chewed-over topic.  We specialize in exchanging remedies and medical advice; everyone loves to prescribe a cure.  We distrust doctors because it's obvious that good health does not promote good business, and we go to them only when everything else has failed, after we've tried all the remedies recommended by our friends and acquaintences.  Let's say you faint at the door of a supermarket.  In any other country they call an ambulance, but not Chile, where several volunteers will pick you up, haul you behind the checkout counter, pour cold water on your face and whiskey down your gullet to bring you to; then they will force to swallow pills some lady takes from her purse because "my friend has these attacks and this is a fantastic remedy."  There will be a chorus of experts who will diagnose your condition in clinical terms because every citizen with an ounce of sense knows a lot about medicine.  One of the experts, for example, will say that you have an obturation of a valve in your brain, but another may suspect a complex torsion of the lungs, and a third that you have ruptured your pancreas.  Within a few minutes there will be a hue and cry all around you, and someone will arrive who's run to the pharmacy to buy penicillin to inject you with --- just in case.  Come to think of it, if you're a foreigner, my advice is not faint in a Chilean supermarket; it can be a deadly experience.

(posted by Roland Soong, 10/12/2003)

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