Pushing Pills

The World Health Organization’s World Medicines Situation 2011 was released today. The document presents a disturbing account of how medications are prescribed in many developing countries around the world.  Summarizing the report, The Times of India reports that prescription medications often are dispensed by untrained staff members and 20-50% of medications are provided without labels.  Just 50% of patients are not given advice about how medications are to be taken.  Discussions about how to use medications commonly are brief, with most exchanges lasting less than a minute.  Inappropriate dispensing and use of antibiotics is a particular problem. According to the WHO report, 2/3 of antibiotics are sold without prescription, adherence to treatment regimens is low, and doctors routinely prescribe antibiotics to patients who will not benefit from them.  According to Kathleen Holloway, of the World Health Organization’s Department of Essential Medicines and Pharmaceutical Policies, “Irrational use of medicines is a serious global problem that is wasteful and harmful.  In developing countries, in primary care, less than 40% of patients in public sector and 30% of patients in private sector are treated in accordance with standard treatment guidelines.”  Many users of medications, in short, are paying high out-of-pocket costs for medications unlikely to offer health benefits.

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