Just to avoid any possible confusion, I should probably point out here that the Samizdata Illuminatus is a collective pseudonym used when any of the regular writers of this site wants to publish something anonymously. The author of this post is actually in London, not Massachusetts
Dale posted below about the idiotic rules he encountered when attempting to buy asprin in (I presume) Northern Ireland. I cannot answer the question as to whether the situation with asprin is really as absurd as his pharmacy said it was, but in answer to the question of whether it could be that absurd, I can assure him that the answer is very definitely yes. In this regard I have a little story of my own.
I have a hiatus hernia, which causes acid reflex in my oesophagus, which is intensely painful and uncomfortable, makes it difficult to eat certain kinds of food (anything at all acidic), and if untreated could lead to longer term problems that are even more serious (In the worst case cancer of the oesophagus). There is a class of drugs called proton-pump inhibitors that are used to treat this condition, and they are simply wonderful. You take one pill a day, and all your symptoms go away. They are really this good. The best known of these drugs is omeprazole, sold under the brand name “Losec” in Europe and “Prilosec” in the US. To get this drung, I could get a prescription from a doctor, but I would rather not have to deal with the NHS, as I find doing so to be too soul destroying.
However, the drug is available in the UK without a prescription, so no problem.
Well, not exactly. Omeprazole is a “behind the counter” drug in the UK, meaning that it is only available in pharmacies and you cannot simply pick it up off a shelf and then take it to the cashier and pay for it, but you have to actually walk up to the pharmacy counter and ask for it, supposedly so that you can receive proper advice. However, the nasty sting is that pharmacies tend not to display the price of such drugs in clear view, so you don’t usually find out the price until after you ask for the drug. They are relying on people being too embarassed to say that the drug is too expensive after having asked a pharmacist for it, so “behind the counter” drugs tend to be priced much higher then they would be if they were on the regular shelves.
To make things worse, the law states that the over the counter version of omeprazole must be sold in 10mg pills (the standard for the prescription version is 20mg) and in packets containing no more than 14 pills. There is nothing stopping you from buying a larger number of pills to obtain a larger dose, other than the fact that the way the drug is regulated and sold makes it expensive to do this. I am charged about £8 for such a pack of 14 pills, but as they are half dose pills, this is only a week’s supply. (This is almost entirely profit for the pharmacy, as the patent on the drug has expired).
So, although the drug is very effective for people with certain ailments, not prone to any kind of abuse, pretty much completely harmless, out of patent and very cheap to manufacture without any intellectual property issues, I cannot buy it without vast numbers of rent seekers in the medical and related professions profiteering from doing so (either by charging me directly or charging the government via the NHS) and the price being pushed up to a level I find annoying.
The US lacks this “behind the counter” racket, and omeprazole is also available over the counter in the US in large packets of proper 20mg pills, so there is nothing preventing me from buying it in large quantities at Wal-Mart when I am in the US, for about a quarter of what I pay for it in the UK. However, the Americans have lots of other rackets and the situation with this drug is sadly not typical, as American regulators (under pressure from doctors groups) are extremely reluctant to reclassify other prescription drugs as over the counter.
Sadly, though, I visit the US only once a year, if that, and my supplies seldom last until the next trip. Recently, I have found another solution, however, which is to buy the drug on eBay from people in Delhi. The price in this case is much less than I would pay even in the US, and less than a tenth what I would pay in the UK. It is possible to argue about the ethics of importing patented medicines from abroad, but in a situation in which the patent has expired, parallel imports are definitely something to be encouraged. It is probably not technically legal for me to conduct my own parallel imports from abroad, but I really do not care.
And there is something supremely ironic about using India to get arount the permit-Raj of the developed world medical bureaucracy.