Las_drogas
Pharmaceuticals are fun in Costa Rica for those of us from backwater countries where you still need a prescription for everything that keeps life pretty. Last night, I spent $200 at a local farmacia [far-MA-see-ah, pharmacy]. Here’s what I got:

Retin-A 0.05% 40g
My dermatologist* recommended this. I’ve never used it before, she’s 33 and uses it everyday. One look at her and you’d be buying a lifetime supply. *White girls with freckles living in the tropics practically own their dermatologists.

Price here is 9,163 colones ($18) – I’d love to know what this costs in the states, but I can’t find prices online. [In the comments, Robert says $73 for 20g, .04%… so this would have cost me $146 in the states and not even as strong as I get here. I guess, what, it’s "worth" more there????]

Canada pharmacies sell 20g for $20; they are at least half U.S. prices, so I’m estimating this tube would cost at least $80 in the states. Not including the doctor’s visit. This visit was $45.

Efudix 5%  20g
Dermatologists love turning the ice torch on me. The first time my doc said the words "basal skin cell carcinoma," I was terrified. While waiting for the biopsy, I was writing out my will, saying good bye to friends, planning who would get my valuable stuff. But basal cells are so nothing. They never even turn into cancer. A complete waste of good drama. Of course, you have to have every spot looked at to make sure it’s basal and not something else. In Key West, that’s $95 to walk in the door. Then each burn is $100… it’s ridiculous. Last year at Clinica Biblica, I got a skin screen and about a zillion places burned off while the doctora and I chatted… $50 total.

I’ve said it before, I’ll say it again: I can afford to stay healthy in Costa Rica.

Efudix (Efudex in English) has been around for awhile now. It’s like home chemotherapy for your skin. You apply the cream, your skin burns and bubbles and erupts in ugly lesions while the cream is killing ALL the skin cancer cells wherever you’ve applied it. You look like you stood too close to a pan of frying bacon. Six weeks later, you are beautiful. Girlfriends in Key West pay around $300 for Efudix treatments and do it every couple of years. They look HIDEOUS while going through it, but love the effects.

I have a tiny annoying place on my neck, driver’s side. It’s not basal but some completely benign skin damage. She told me to dab Efudix on it every night for 30 nights to burn it off. I put it on last night, didn’t feel a thing, but I figure that spot is going to look Frankenstein-ish in a few days. The Efudix was 11,478 colones ($22). It’s $80 from an online pharmacy, so probably double that in the states.

Fisiogel Crema Liquida 120ml
This is one of those Cadillac (read expensive) pharmaceutical skin lotions. I’m to apply it over the Retin-A so my skin doesn’t totally dry out. I’m not big on expensive creams, love my Lubriderm. On the other hand, my skin basically looks like it’s seen a hard 51 years and I don’t "moisturize" like I’m sure Greta Garbo did. Only if the lotion is handy do I partake. So, I’ll give it a try… maybe expensive stuff really IS better? We’ll see. It’s not greasy and does feel different than other lotions. Therapeutic, in fact. I feel pretty-er for only 10,220 colones ($20).

Glicolic (Acido glic├│lico) 10% 60g
Basically an acid exfoliating treatment at home. I put it on my sun damaged legs and chest, arms. Doesn’t burn, does make the skin softer, all good. 11,589 colones ($22), could not find similar products for sale and costs in the U.S. or Canada.

Umbrella Plus 120g
Sunscreen, what else? She told me to put it on everyday in the am and again at noon. OK. 8,684 colones ($16). In Colombia, the price is $52.500… not sure how that translates: if it’s in pesos or already in dollars. Must be dollars.

Symbicort 160/4.5
Ryan’s turbohaler (I love that name) for his asthma. No one ever prescribed this for him in the states and this works GREAT. In the states, he was prescribed several different daily inhalers to manage his asthma, but none worked so well he couldn’t live without rescue inhalers also. We went through rescue inhalers like candy.

Daily Symbicort with Singulair kicks butt. We don’t even buy rescue inhalers anymore. Which are cheap and over the counter here, btw. 18,189 colones ($36). I’ve paid $100 to $150 for other inhalers in the states which basically didn’t manage anything. Makes me angry that this stuff is so expensive. Why? The libertarian in me goes right out the window on this topic (pharmaceuticals) and I want to throw those bastards in jail for making so much money at the expense of sick people.

Singulair 10mg 30 tablets (one month supply)
One a day for asthma sufferers, works like a charm. Giving your child daily drugs for anything is terribly worrisome. You wonder will it stunt his growth, have horrible consequences down the road that no one knows about now? On the other hand, he can BREATHE and live basically a normal life with these drugs.

I’ve done all the checking I can find, read all the books on managing asthma "naturally" and there ain’t no such thing. We’ve done the breathing cure, the water cure… some other things. Looked at allergy treatments. One doctor suggested twice weekly shots to curb allergies (before she’d even had him tested). I couldn’t get out of there fast enough. Not that those shots aren’t appropriate for some people, but she had a steady stream of kids going in and out getting shots… looked too much like money in the bank. Jaded. I know what foods and material affect him: I’ve hovered over him while he ate, slept, bathed… With these two drugs, nothing adversely affects his breathing except not taking them.

I have zero faith in pharmaceutical companies to look out for the well-being of its customers (really?) and remain convinced they care only about profit centers. Like my child. 36,549 ($72), $100 in the states. There is a generic here that is significantly cheaper and just as good – it’s the same stuff (montelukast sodium). Can’t remember the brand name, but he’s used it before and I’ll buy it next time. I just forgot…

The packaged pills are acetaminofen (acetaminophen): 40 pills for $3. Have no idea if this is more or less. Sounds expensive – I’ll check it out next trip stateside and cart it back in bulk.

Many of these drugs are prescription only in the states. Why? Would you die if you ate a box of Singulair? Would your skin fall off if you rubbed all the Efudix onto it? Has anyone in any of the many, many countries in the world that sell these products sin [seen, without] prescription ever died? Let’s face it: only a mad person would waste time abusing these drugs (narcotics are sold by prescription only). Sane people are not at risk.

With doctor visits required to renew prescriptions (which is why doctors don’t fight pharmaceutical companies and, in fact, own stock in them) on top of the exorbitant price of the drug, it costs a fortune to stay healthy in the states. Probably less expensive to fly to Costa Rica once every 6 months, $350 rt to FLL on Spirit Air (have I mentioned this?), and stock up! Pura vida = pure life. Yes, indeed, you can get it here.

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