DOES PERU REALLY NEED...

[Philipc4u59]

SO MANY PHARMANCIES???

For the life of me, I don't comprehend why there are SO MANY PHARMANCIES in Peru?
Most have prime locations on busy streets; how can they all make a decent profit & pay for the "overhead"?
Are there any advantages to choosing one over the other - price, selection, service, etc.???

I have been told it is against the law for food stores to carry pharmancy items; please enlighten me...
Where can you purchase ASPIRIN & VITAMIN C - at democratic prices? In the US, I buy at "dollar stores".
Also MULTI-VITAMINS; nothing "name brand" - just generic/good quality at fair prices?

Thanks & GOOD HEALTH to all,
Philip

[chi chi]

SO MANY PHARMANCIES???

For the life of me, I don't comprehend why there are SO MANY PHARMANCIES in Peru?
Most have prime locations on busy streets; how can they all make a decent profit & pay for the "overhead"?
Are there any advantages to choosing one over the other - price, selection, service, etc.???

Most pharmacies are part of a chain. Not all of them make a profit but that's not a problem to them as they have enough pharmacies that cover the losses of the losing ones.

[falconagain]

The problem is that everything is centralized in Lima and that the free market in Peru
is not as free as it seems. In consequence you will see thousands of businesses selling
the same products or services. (Also, we have almost no industry, the amount of factories
is very limited too, most of the products are imported).

Due to all this you will have:
- Too many pharmacies.
- Too many Roasted Chickent Restaurants (Pollo a la Brasa), Chifas, Franchise places.
- Too many Taxi companies (1 car, 3 shift, one person hired on each shift).
- Too many beauty saloons or parlors.
- Too many bodegas (now in decline).
- Too many supermarkets.
- Too many Moto taxi sellers.
- Too many dealers of Chinese Cars.
- Too many casinos.

[falconagain]

I missed my favorite.

Too many Universities and Institutes.

[chi chi]

The problem is that everything is centralized in Lima and that the free market in Peru
is not as free as it seems. In consequence you will see thousands of businesses selling
the same products or services. (Also, we have almost no industry, the amount of factories
is very limited too, most of the products are imported).

Due to all this you will have:
- Too many pharmacies.
- Too many Roasted Chickent Restaurants (Pollo a la Brasa), Chifas, Franchise places.
- Too many Taxi companies (1 car, 3 shift, one person hired on each shift).
- Too many beauty saloons or parlors.
- Too many bodegas (now in decline).
- Too many supermarkets.
- Too many Moto taxi sellers.
- Too many dealers of Chinese Cars.
- Too many casinos.

The reason is that being self employed is the only way to get a job. Or to make enough money to survive.
If you work for someone, then you have to work 12 hours a day, 7 days a week for a meager wage between 250 and (if you are very lucky and have good diploma) 750 soles a month.

What I noticed in Lima is that many same type businesses are in the same area. You have streets where you only have shoeshops, at the next street you only find hairdressingplaces and at the next block there are only clothingshops.

It's so easy to start up a business with little money. There are people that run a restaurant in their living room, a bodega in their garage,... And in most places you just can run it without a licence or paying tax.

80% of business in Tarapoto are unlicenced and are not registered with sunat.

[Philipc4u59]

Yes, Chi Chi - your comments are quite TRUE!
In Ecuador, they have GUILDS - where an entire section of a town makes ONE ITEM (leather purses, etc.).
I like this idea, as a GOOD SHOPPER (like Kelly); can see virtually everything that is available & pricing.

I really NEED - info on VITAMINS, please!!!
Is there some sort of COLLUSION/CONSPIRACY in Peru related to vitamins & the outrageous prices???
Would there be a problem to order from Puritan's Pride (or others) & have shipped here?

This would seem like a good START-UP BUSINESS venture; to import quality vitamins at FAIR PRICES.

Good health to all,
Philip

[kpw]

Back to the original question: why there is so many pharmacies, I can provide 2 reasons:

1) Due to costs, most peruvians do not have medical insurance nor visit a general practitioner to get diagnosed. The first place they go when sick is the pharmacy and ask the pharmacist for advise/diagnose.

2) Following the Chilean model, in the last years there has been a buying spree of pharmacies into chains. The main ones are owned by Interbank (Inkafarma), Quimica Suiza (BTS, MiFarma, BTL), Grupo Albis (Arcangel) which are 3 pharma distributors, and thus push their own medications to the public.

Then there is a lot of small boticas, that are everywhere just like bodegas that live of small sales. These will probably be eaten by the big chains in the long term.

[Philipc4u59]

Quite enlightening - THANKS!

Philip

[kpw]

Yes, Chi Chi - your comments are quite TRUE!
Is there some sort of COLLUSION/CONSPIRACY in Peru related to vitamins & the outrageous prices???
Would there be a problem to order from Puritan's Pride (or others) & have shipped here?

This would seem like a good START-UP BUSINESS venture; to import quality vitamins at FAIR PRICES.

In order to import vitamins (or any other medication) you would need a registro sanitario from DIGEMID. Costs over 1000 USD to submit form, then you need all the documents officially translated and signed off by quimico farmaceutico that takes part of the liability with you as general manager.

[Kelly]

What's really needed is better training for the pharmacists.

My son recently had a bad cold with lots of congestion and coughing. My husband went to the pharmacist, told them the problem was nasal congestion. (I had Nyquil at home, which doesn't have an nasal decongestant, so I just wanted something I could use with that). Instead of selling a stand alone nasal decongestant (which I've since learned doesn't seem to exist in Peru), they asked:

- does he have a cough? wet or dry?
- does he have a fever?

Then, because he had a fever, they wanted to sell us antibiotics -- as usual. "But he has a fever, that means he has an infection!" Yes, it's a viral infection, antibiotics won't touch it. Fortunately, my husband called first.

But then - comes home with Ibuprofen and Tylenol with codeine - both for fever.

The kid didn't need anything for fever, the fever was already being treated with the nyquil.

And they gave us nothing for congestion.

I was an army medic and stayed working in medicine for quite a few years after I left the service, so I have a pretty good knowledge of drugs. But what about the average person on the street who doesn't know anything about what antibiotics are for?

And wtf giving a 13 year old kid tylenol with codeine for a fever?? It wasn't even a high fever!

This is the THIRD time that my husband has come home with medicines that were not what was needed, because the pharmacists sell what they want to without caring about what is really needed.

[Josh2U]

I think sometimes we forget we are not in our home country where what is true at home is not true in Peru. Each country has its own standards many dictated by the government. What might be a standard treatment in one country is not standard in the other. If you are unfamiliar with Perus standards a face to face visit to a doctor who is familiar, would be advisable so an educated diagnosis and treatment can be made.

[metal moth]

What's really needed is better training for the pharmacists.

My son recently had a bad cold with lots of congestion and coughing. My husband went to the pharmacist, told them the problem was nasal congestion. (I had Nyquil at home, which doesn't have an nasal decongestant, so I just wanted something I could use with that). Instead of selling a stand alone nasal decongestant (which I've since learned doesn't seem to exist in Peru), they asked:

- does he have a cough? wet or dry?
- does he have a fever?

Then, because he had a fever, they wanted to sell us antibiotics -- as usual. "But he has a fever, that means he has an infection!" Yes, it's a viral infection, antibiotics won't touch it. Fortunately, my husband called first.

But then - comes home with Ibuprofen and Tylenol with codeine - both for fever.

The kid didn't need anything for fever, the fever was already being treated with the nyquil.

And they gave us nothing for congestion.

I was an army medic and stayed working in medicine for quite a few years after I left the service, so I have a pretty good knowledge of drugs. But what about the average person on the street who doesn't know anything about what antibiotics are for?

And wtf giving a 13 year old kid tylenol with codeine for a fever?? It wasn't even a high fever!

This is the THIRD time that my husband has come home with medicines that were not what was needed, because the pharmacists sell what they want to without caring about what is really needed.

Maybe you should go next time since you've got a pretty good knowledge of drugs.

[chi chi]

What's really needed is better training for the pharmacists.

My son recently had a bad cold with lots of congestion and coughing. My husband went to the pharmacist, told them the problem was nasal congestion. (I had Nyquil at home, which doesn't have an nasal decongestant, so I just wanted something I could use with that). Instead of selling a stand alone nasal decongestant (which I've since learned doesn't seem to exist in Peru), they asked:

- does he have a cough? wet or dry?
- does he have a fever?

Then, because he had a fever, they wanted to sell us antibiotics -- as usual. "But he has a fever, that means he has an infection!" Yes, it's a viral infection, antibiotics won't touch it. Fortunately, my husband called first.

But then - comes home with Ibuprofen and Tylenol with codeine - both for fever.

The kid didn't need anything for fever, the fever was already being treated with the nyquil.

Kelly, they are very highly trained in ''sales skills''. I even think they get a commision on the sales.

When you go to the pharmacia, they first always try to sell an expensive brand. If you say that's too expensive then they suddenly come up with a cheaper brand. And they try to sell you things you don't need.

[Kelly]

I think sometimes we forget we are not in our home country where what is true at home is not true in Peru. Each country has its own standards many dictated by the government. What might be a standard treatment in one country is not standard in the other. If you are unfamiliar with Perus standards a face to face visit to a doctor who is familiar, would be advisable so an educated diagnosis and treatment can be made.

A trip to the doctor isn't really necessary for a common cold. But you can't just go in the pharmacy and pick up what you need, you have to tell the pharmacist what all your symptoms are so they can choose what to give you. That's great - but train pharmacists not to sell antibiotics for problems that they don't treat. I'm pretty sure that Peru's standards do not dictate selling useless and quite possibly dangerous medications to people who don't need them.

When someone says they have a cavity in a tooth, you don't put a cast on their arm. Why on earth would you sell antibiotics to someone with a cold or flu? It's just as ridiculous and I'd be willing to bet that there is no 'Peru standard' that calls for it.

[Philipc4u59]

I have NO FAITH in the most of the medical profession here in Peru; this including the PHARMACIAS!

I now consult with my daughter in the US - who is a DOCTOR; I tell her what the "sales people" suggest & she informs me there are better options or (as in Kelly's case) - the recommendation is TOTALLY INAPPROPRIATE!

I have been told that one of the few places to get PROFESSIONAL ADVICE, is go to the Clinica Americana - but this is extremely expensive. Any other options???

Philip
PS - I enjoy that Peru is like the US in the 1960's (small stores, etc.); but not for HEALTH ISSUES!

[Josh2U]

Going a bit overboard aren't you? A cast for a bum tooth?
You want the employees trained better without knowing what their training actually is. I would venture they are trained quite adequately, just not trained to deal with gringos.
Funny thing here in Peru and probably other countries terms and words get lost in translation. It has been my experience that when some one has the sniffles, what I would call a cold everyone says oh you have the flu even though it is apparent I have no fever or throwing up. Still not sure what they call the flu.
A visit to the doctor is certainly not necessary in my home country for a cold. But going to a pharmacy and describing some symptoms to someone trained to sell pills and unfamiliar with your understanding of the medical field and terminology that is different from theirs invites a false diagnosis and the wrong treatment.
You really should go to a doctor who has training in diagnostics and remedies relevant to Peruvian standards and practices, before condemning the pharmacy employees. He will make a diagnosis that a Peruvian pharmacy will understand and the correct treatment handed out. After that you will be empowered and will not have to visit a doctor you now have the correct terminology and knowledge.

[fanning]

I just call the insurance, and they send a pediatric to the house ( for a cold or flu ) and my kids get diagnosed by him/her. Any prescribed medicines are delivered to the house, and the cost is S/. 30 for the consult, including any medicine and exams ( if they want a blood sample, or urine sample they take it, and you get the results later ). There is no copayment, just the S/. 30
This is with most insurances from Mapfre, Rimac, La Positiva and Pacifico.

[Kelly]

Going a bit overboard aren't you? A cast for a bum tooth?

No, don't think I went overboard. Wrong treatment is wrong treatment - either is just as bad.

You want the employees trained better without knowing what their training actually is. I would venture they are trained quite adequately, just not trained to deal with gringos.
Funny thing here in Peru and probably other countries terms and words get lost in translation.

And that's why I have always sent my Peruvian husband, even though after nine years, my Spanish is pretty good.

We decided not to do that anymore though, because when I have gone back and explained what the problem is, we get what we need. So obviously, communication is not the issue.

I've seen the same thing when the boys were small and their mother (i'm a stepmom) would get medicine for them (she's also Peruvian) - they get antibiotics that they don't need.

It's pharmacists who take advantage of the ignorance of their customers and prescribe medicines that aren't adequate or not needed. And if that's part of their training, then they're being trained poorly. If it's NOT part of their training and they're doing it on their own, then they're being trained poorly. Either way, better training is needed.

[Josh2U]

Sounds like a communication break down somewhere. You tell your husband what to get but he does not come back home with it but when you go and ask for the same thing you come back home with it.
Curious, since you wanted a stand alone nasal decongestant and Peru does not have it, what did you end up with? Might need that one day.
You still want to blame those pharmacy workers. You have suspicions and make accusations, poorly trained, part of their training to take advantage of people. You really do not know. All you know is how it should be done according to you.
You expect them to dole out the proper meds to someone they probably never talk to or seen. May be the hundredth person they seen that day and a hundred more bringing up the rear and they still have to finish stocking those shelves. Even if they were trained diagnosticians, under those conditions I think once in a while they might be allowed a mistake or 2 or miscommunication.

[Kelly]

since you wanted a stand alone nasal decongestant and Peru does not have it, what did you end up with

Can't remember the name of it exactly - something like lergical plus. It was just a LA version of zyrtec-D.

[vivaperusurf]

My experience,

Mostly in all the cities of northern peru, was there were tons of farmacias, and also boticas. It is quite amazing to see just how many but then again i think this appears to be a good busniess to be in for many peruvians and in some areas there are not enough farmacias.

That was a good side conversation about trainging of the staff, but i would prefer to self educate and self diagnose or go to a real dr rather than let the pharmacy sales person tell me what i needed, as if i did this i would often endup with something incorrect for my situation. Like it was mentioned though many cannot afford healthcare or a dr visit, and i have seen many sick kids with their parents discussing with the pharmacist what the best treatment would be.

it is better to go to the store with the name of the medication you may need or the chemical name before you entertain the idea of letting a pharmacist sell you something.

My biggest concern with pharmacies was the "sketch factor" of the products sold. Such as, how long had the meds sat on the shelf, was the store open and exposed to the extreme hot/cold temps during day and eve. Is it possible they were selling fake or expired meds. For this reason it is important to find a place which you felt confident with their storage procedures.

For example do you really think that pill box was designed to be sitting baking out in the hot sun all day? Prolly not? For that reason i usually avoided the more open pharmacies.

I also looked for ones that seemed to be busier and closer to the center of town, betting their supply would turnover faster.

It also seemed to me that you could negotiate prices and if they were not willing to negotiate thay was usualy a bad sign.

Many times i would buy a medication from one pharmacy so i knew they would always have a fresh supply.

Lima may be saturated with pharmacies but i think there are places outside the capital where there is still room for growth in this area. I also think it would be nice to see the prices drop a bit and that happens with competition, so the more the better rigt?

[TShadow]

You really should go to a doctor who has training in diagnostics and remedies relevant to Peruvian standards and practices, before condemning the pharmacy employees.

You are certain of that? In my time being in Lima I had nothing than negative experience with doctors, including the ones from the American Clinic. I have also submitted a complaint against the clinic with Pacifico because of their bad and wrong handling of an emergency of my girl friend. After 2 months they had to pay all the damages they made.

The doctors taking care of my girl friends father did not conclude anything, I had to tell them what to do and what kind of analysis to do. Only then they found out that his illness is due to a malignant cancer. I found a doctor who is currently living and studied in Germany and who agreed with me that due to the age of the patient it will be better not to operate. I am really afraid of doctors here, and at the pharmacies I also made the experience that they are sellers not interested or they do no have knowledge of what to sell when.

I still am lucky that I have no health problems, but you can be assured that I won't stay here any longer should arise something.

[Josh2U]

Well I guess nothing is really certain, all you can do is give it your best shot and be vigilant. Good that you were there to advise the doctors.
I just feel we should be careful when condemning an entire sector.
Thanks Kelly for the name of that medication. I am sure I will need it one day.
Good advice, vivaperusurf.

[panman]

Health is big business in Peru. Hypocondria combined with medical ignorance are what these pharmacies thrive on. The sales assistants are more than happy to sell you 2 antibiotic tablets even though they should be taken as a course, over a period of time, and the course should be completed.
The belief in the dangers of cold drinks, and Dr T.V reminding you daily of all the illnesses that you'd forgotten you might just have, also fuel the profits.

[falconagain]

Lima is one of the few cities in the world outside of Africa where you can
find people dying Cholera, Meningitis and Tuberculosis on a yearly basis.

People got used to get antibiotics for anything just in case. It is better
to be cautious than to die. Which is why Pharmacists are always trying
to push the antibiotics to everybody.

There is a list of the rare diseases worldwide that are quite common
in Peru, which is updated for tourists on a yearly basis. It would be
nice for someone to post it.

[panman]

Pushing antibiotics is one thing, mispushing them is another.
As far as I'm aware, antibiotics should be take as a complete course for a length of time determined by a doctor.
Selling someone two tablets over the counter, as I have witnessed numerous times, is simply ridiculous and tantamount to theft.

[Kelly]

Pushing antibiotics is one thing, mispushing them is another.
As far as I'm aware, antibiotics should be take as a complete course for a length of time determined by a doctor.
Selling someone two tablets over the counter, as I have witnessed numerous times, is simply ridiculous and tantamount to theft.

This is what I'm saying.