Americans Flock To Mexican Town For Cheap Medicine

LOS ALGODONES, Mexico - Rising from the desert, garish signs scream out the healing promise of this frontier town: medicine, X-rays, dentures and contact lenses. All cheap. Very cheap.

With 20 pharmacies, 49 optometrists and 40 dentists' offices in its two square blocks, Los Algodones is an oasis of affordable health care in the scorching corner where California, Arizona and Mexico meet. Like dozens of Mexican border towns that first boomed selling liquor to Americans escaping Prohibition, it is booming again, hawking medicine and routine medical services for an average of 60 percent less than in the United States.

"We take a bottle of Kahlua back, and some Ibuprofen," said John Grunenwald, 67, of Corpus Christi, Texas, his shopping bags filled with Tylenol, allergy pills and insulin for his diabetic father.

"Listen, it's ridiculous to buy medicine in the States. Here it's cheap, it's good quality, they don't make a big deal out of it."

A regular in town, he has been coming four times a year for seven years. He estimates he saves about $200 every trip - more than 1,000 miles one way.

Urged on by doctors, nurses, newsletters, Internet postings or word of mouth, more Americans are becoming regular customers of pharmacies, physicians and dentists across the border. In Los Algodones alone, city officials say, more than 2,000 U.S. citizens cross into town every day, most seeking medicine or basic health care.

In Tijuana, Nuevo Progresso and other border cities, pharmacies are crowded together near border checkpoints.

A 1992 study found medication costs on average three times more in the United States than in Mexico, where brand-name drugs are generally sold for between 20 percent and 60 percent less than the same drugs in the United States. With the peso sharply devalued since December, the price differences today are even greater.

For instance, a month's supply of a popular birth-control pill made by Wyeth Laboratories costs $24 in San Jose, Calif. In Los Algodones, the identical pills cost seven pesos - $1.31 at the current exchange rate.

Why the big price difference? First, because of the lower standard of living in Mexico, U.S. pharmaceutical companies have long sold their drugs at far lower prices than in the States. Second, the Mexican government heavily subsidizes certain drugs and regulates prices - practices not covered by the North American Free Trade Agreement.

Most drugs sold in Mexico are identical to their U.S. counterparts, often manufactured by the same laboratory, and are available without a prescription.

There are no precise figures on how many Americans regularly go to Mexico for drugs or health care, but health workers say the practice is widespread.

At Loma Linda Hospital in San Bernadino County, Calif., nurses give patients maps of Tijuana with pharmacies marked in red. On the Internet's infertility bulletin board, women are advised to go to Mexico to buy the fertility drugs that would otherwise cost thousands of dollars at home. Newsletters likewise recommend that senior citizens go south for medicine and services.

But the savings aren't risk free, health-care advocates warn.

With no prescription needed to buy drugs in Mexico, they say, shoppers might buy the wrong dosage of the right drug, or buy drugs they think they need but their doctors do not.

The U.S. Food and Drug Administration warns that quality-control standards on generic drugs made in Mexico may be less rigid than for generics made in the United States.

And Americans have no legal avenues to complain about bad medical care in Mexico.

On any given day in Los Algodones, one of a half-dozen health-care oases along the border, waiting rooms are filled with middle-aged and elderly clients sifting through U.S. magazines and chatting about allergies and arthritis. Many pass through on vacation or make special trips from as far away as Seattle.

"You can't afford to buy drugs in the U.S., it's too expensive for retired people," said Loretta Henry, 52, of Bakersfield, Calif., who stops in Los Algodones twice a year on her way to visit friends in Arizona. She estimates she saves more than $400 a year on the estrogen tablets she needs, using some of that money to help pay for her trips.

"You have to save a dollar where you can," Henry said.