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A different drug war

23 September 2019

Met by the Secretary of the Treasury, the Undersecretary of Health, and a Deputy Secretary of the Navy, a French cargo plane’s arrival is being hailed as the first victory in AMLO’s own “war on drugs”.

The French plane was arriving with a load of methotrexate, used in the treatment of some cancers, emblematic of the administration’s changing economic policies. 

During the Salinas Administration (December 1988 to November 1994) the prevailing theory, as in most of the world, was that privatize state functions where it was felt that the marketplace would create an incentive for better decision making and distribution.  Like with pharmaceuticals.

With three different and competitive pharmaceutical distributors controlling about 70% of all drug purchases in Mexico, and a very competitive private pharmacy industry, coupled with price controls for medication, drugs are generally much lower priced in Mexico than in other countries.  In addition, Mexico has a large pharmaceutical industry (subsidiaries of foreign manufacturers) of its own.

However, there are shortages, and the public health system, IMSS, has long been the focus of complaints about service and about the availability of necessary medication.  The market for methotrexate is extremely tiny, but being used to treat children with cancer, its availability (or lack of availability) is a hot button issue.  Justifying denying cancer treatment to children is not a winning political issue, no matter how much financial sense it might make.  And, turning around IMSS which has been losing money for years, while expanding the public health system is a winning political issue.

By-passing the usual channels, the President, on his own authority, ordered methotrexate through a French source, and has launched an attack on the private distributors, claiming they are holding back certain medications, and over-charging for some products.  Insulin, sildinifil (VIagra), xanax and other common prescriptions and over the counter drugs might be so widely available that pharmacies advertise sales on them, but try getting some special medication or a specific antibiotic in a rural community, or at a reasonable price.

Admittedly, the printed maximum price on any pharmaceutical is usually much more than one actually pays (just looking at a pain reliever I was prescribed, the maximum price is 57 pesos but I think I paid something like 30), it appears that the public health system is paying the full price,   I can’t see what incentive the distributors would have to holding back medications, other than wanting to discredit expanding the public health system to the detriment of the private system… which would require collusion.  Whether going directly to a foreign source to alleviate a temporary shortage or whether it is a sign that the government intends to change its policies, and de-de-nationalize some economic sectors, the administration has found a “winning” issue.



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