The preceding chapter defined different ideal types of health systems and insurance systems and their respective components. This chapter will detail the situation of financing and dispensing medicines within the framework of the health insurance systems in the countries selected in the study. It uses the information collected in the survey applied in six countries.

Table 10 shows some of the main aspects of the pharmaceutical market in each country.

Table 10:

Source: Country surveys.

As shown above, of the countries included in the study, Guatemala is the one that dedicates the smallest fraction of its total GDP to spending on pharmaceuticals. Nevertheless, it is second highest in overall health spending and spends the least per capita. It is important to note that countries that spend more resources on the acquisition of medicines consistently occupy leading places in indices of general health. According to the index of health in Latin America, Costa Rica holds first place, while neither Argentina nor Guatemala are among the first ten Latin American countries in terms of health (World Health Report, WHO, 2000).

The social security component of the pharmaceutical sector is financed and managed in different ways in each country, in line with the prevailing arrangements as shown in Table 11.

Table 11:

The following section describes the pharmaceutical situation in each health system and country considered. The medicines included are specified to the extent that the information collected permits, as is the manner in which they are prescribed, purchasing schemes, discounts and dispensing modes. The existence of price and quality regulations will be covered. A brief description of the health systems existing in each country is presented first to place each modality in its proper perspective.