A prescription for recklessness?

Many prescription-only drugs are much cheaper abroad – as well as being available over the counter – and the Irish have been stocking up on holidays. Doctors and pharmacists are alarmed, reports CONOR POPE

DRUG TOURISM used to be confined to lost weekends in Amsterdam coffee houses, or opium dens on Bangkok’s Khaosan Road, but not any more. Now everyone from globe-trotting grannies to otherwise sensible Irish folk who are visiting Spain and Manhattan are adding a trip to a local pharmacy to their itinerary in order to take advantage of dramatically lower prices and more relaxed regulatory regimes.

Stocking up on cheaper drugs while on holiday can be both sensible and incredibly dangerous. Earlier this week Go spoke to a leading Irish pharmacist who recognised the trend for more self-medication among holidaymakers. He said that while he could understand why people might buy certain drugs overseas – he cited much cheaper cholesterol-lowering medication, asthma inhalers and low-dose aspirin – he was appalled at the recklessness with which others were buying sleeping tablets and antibiotics.

Everyday drugs routinely cost more than 75 per cent less in Spain and the US than in the Republic. This means that the savings that can be made by incorporating a (legal) drug deal into a holiday can be so great that they can easily offset the cost of the entire break, particularly in an era of low-cost flights and cheap deals.

A reader who was in the US recently found 500 low-dose aspirin – used as a blood thinner and prescribed as a heart medication – selling over the counter for $17 (€12.50).

In this country a month’s supply of the same drug – which is available only on prescription – costs about €10, while the two visits to a GP each year, to get the prescription updated, will cost another €120.

All told, a year’s supply of the drug in the Republic will set a patient back by €240, compared with about €10 in New York.

There are even more remarkable price differences elsewhere. Omeprazole is a chemical used to relieve the symptoms of reflux. One of the most popular brands of it in the Republic is Losec, which costs about €45 for a month’s supply. A patient taking this drug will spend €540 annually. Add two GP visits and the price of this fairly basic treatment rises to €660.

In Spain, where omeprazole sells under the brand name Pensa, a month’s supply costs €3.50; that means a year’s supply costs €42.

While a prescription may be required for the drug in Spain, where the regulatory system is similar to Ireland’s, many pharmacists there – particularly away from the most popular resorts – adopt a relaxed approach when dealing with tourists as opposed to locals and appear to be willing to sell them pretty much anything without a prescription.

This free-for-all approach is not without its problems. Patients who buy cheap Spanish omeprazole may think they’re suffering from relatively benign reflux, and the drug may well alleviate the symptoms, but it could also mask those of a gastric cancer long enough for it to be too late to cure.

Sleeping tablets are also sought-after by Irish tourists overseas, with heavy-duty pills to be found in harmless-looking bottles on pharmacists’ shelves worldwide.

One popular sleeping pill is Zimovane. Although it is significantly cheaper outside the Republic, cost does not appear to be the motivating factor in many people’s purchasing decisions.

Two separate readers contacted us recently with stories of elderly relatives – travelling home from Hong Kong and Spain, respectively – with hundreds of the sleeping pills spilling out of their suitcases. Both stories involved the drug purchaser cheerfully dispensing them to all their friends when they got home because their friends’ GPs had declined to do so. This type of behaviour gives sensible drug tourists a bad name and the medical profession sleepless nights.

“Sleeping tablets are incredibly dangerous and incredibly addictive, and people should never buy them without a proper prescription,” said one doctor we spoke to.

And then there are antibiotics, which bring a problem all of their own. Broad-spectrum antibiotics, such as Augmentin, can be readily bought in many pharmacies on the Med for a fraction of their cost in Ireland. Many adults stock up on their summer holidays, in preparation for the winter malaise that commonly afflicts their families. It may seem sensible, but it’s not at all clever.

“If you take an antibiotic unnecessarily, then you just build up your resistance to the drugs, and then at some future point, if you get a serious infection, the available drugs will be useless,” warned the pharmacist we spoke to.