Points: Contraception and the mentally handicapped

Mr M R H KHAN (Edinburgh EHIO 4PA) writes: Dr Derek A McHardy blames practising doctors in the Third World for making profits by prescribing costlier drugs and thus causing reduced compliance and resistance (10 November, p 1310). This is not entirely true. Most of the prescribing doctors in developing countries do not own drug stores or derive any profit from drug selling. A few, who practise in their own pharmacies, do make a profit, which is a small fraction of the price fixed by the manufacturer. The price of the newer and often effective drugs is decided by the large multinational companies. Dr McHardy said that these drugs are often locally manufactured, but local manufacturing in most cases means local bottling, packaging, and marketing on behalf of the parent companies in the West. Therefore the lion's share of the profits is transferred to the developed countries. One should ask why it costs £250 for a year's course of effective antituberculosis drugs when the cost of marketing is so cheap in Third World countries....