Financiarización de la industria farmacéutica y su repercusión en las periferias urbanas en la zona Metropolitana del Valle de México

Abstract

The process of financialization is present in the health sector, particularly in the case of large pharmaceutical companies. In the case of Mexico, there has been an expansion of pharmacies with medical offices as a result of capital flows, but also due to the absence of a quality public health system. This paper analyzes how the contemporary processes of pharmaceutical company financialization have allowed the expansion of the medical office-based pharmacy scheme and, to a certain extent, the "substitution" of health services managed by public authorities in the urban peripheries of the Metropolitan Zone of the Valley of Mexico. Based on information from Farmacias Benavides and Farmacias Guadalajara, issued by the Mexican Stock Exchange, on several indicators on health and pharmacies in Mexico, as well as semi-structured interviews with residents of the metropolitan periphery, it is argued that the exponential growth of pharmacies in the last two decades is linked to the policy of expansion and construction of social housing. These housing projects, largely due to weak regulatory controls, do not develop an adequate health infrastructure both in qualitative and quantitative terms, thus favoring the opening of financial instruments that have allowed large pharmaceutical companies to expand in recent decades.

The role of private healthcare sector actors in health service delivery and financing policy processes in low-and middle-income countries: a scoping review

“… 43 The business sizes of the private sector groups identified in the articles ranged from small, medium to large and also spanned subnational, national and global scales. For example, multinational companies such as those in the case of retail pharmacies 44 or the insurance industry 45 were present in some papers; most, however, dealt with national or subnational industries ( figure 3 ). Finally, some papers described not-for-profit groups as key policy actors, for example, as an independent interest group in the landscape of South African insurance firms, or as partners with corporate hospitals in India.…”

“… 44 Boosted by the new possibility to get listed on the Mexican Stock Exchange and thus expand their access to capital, these companies rolled out new business models that integrated—and blurred boundaries between—clinical services and drug distribution. 44 Creating conditions more favourable to private actors in order to develop the national economy can be in tension with goals pursued by the Ministry of Health. In Thailand, a focus on medical tourism was driven by the Board of Investment, Tourism Authority of Thailand and Ministry of Commerce, in opposition to the Ministry of Public Health and its goals around narrowing disparities in quality and access between private and public health sectors.…”

“…Formal negotiations (Salinas Arreortua and Rojas 2021 44 , Chakravarthi et al 17 , Gilson et al 51 , Maïga, Maïga, and Maïga 2010 55 )…”

“…Similar scenarios across different dimensions of healthcare sectors were observed in India, 17 47 Nigeria 48 and several Central and South American countries. [43][44][45] Several papers described underlying drivers of the trend towards privatisation as having stemmed from government policy shifts in the 1980s and 1990s away from public investment in healthcare, 17 45 46 48 49 in some cases driven by structural adjustment loan packages from international development and lending agencies due to severely challenging economic conditions in many LMICs in this time period. 45 46 Another structural pattern concerned the expansion of certain healthcare sectors in countries for the purposes of economic growth.…”

“…Papers described how governments sometimes intervene in the healthcare sector to favour the development of the domestic industry or how its reluctance to expand public health infrastructures created market space for private actors. [43][44][45] For example, in Mexico, the general shift towards privatisation and deregulation combined with low coverage of public health facilities in newly urbanised areas created new market opportunities for private chains of pharmacies. 44 Boosted by the new possibility to get listed on the Mexican Stock Exchange and thus expand their access to capital, these companies rolled out new business models that integrated-and blurred boundaries between-clinical services and drug distribution.…”