Few places show the stark contrast between the two countries so sharply. Look one way and you see the remnants of the Rio Grande through tall fences topped with barbed wire. Border Patrol cars are parked at eyeball intervals, forming an unbroken visual surveillance. People pace the culverted and mostly dry riverbed below. Beyond the fences, you see the odd chaos of Juarez--- miles of undulating hills covered with small concrete and cinder block buildings. Most are grey, but there is an occasional daub of bright yellow, plum, orange, azure, or aqua.
Less than a mile away, Interstate 10 has become the spine of El Paso as the city expands, mall after mall, to the east. "Pretty" is not one of the words that comes to mind. "Thriving," however, does. Some would complain of the pollution but only if they have arrived recently. As one thirty-year resident told me, "It's a lot better now that they have utilities in Juarez. Before, everything was covered in smoke from the cooking fires."
My wife and I have come here to walk the busy Santa Fe Street Bridge into Juarez and check the pharmacies on the other side. This is the lifeline bridge that connects downtown El Paso with downtown Juarez. It has some vehicle traffic but its main use is the movement of thousands of people from one city to the other.
We know, from earlier trips, that pharmacies are in abundance at the Mercado further in the city but we're curious about how easy or difficult it will be, post 9/11, to walk across the border, find a pharmacy, buy prescription drugs, and return.
Quick answer: it's easy.
It's not as much fun or colorful as doing the same thing in a village like Algodones near Yuma, Ariz., which I visited last year. But it's certainly easy.
There are pharmacies on both sides of the street within a block of the bridge. We stop at one about three blocks from the bridge, not far from the oddly named "Kentucky Club" bar. The pharmacist asks if she can help. Her English is excellent.
"Do you have Lipitor and Zetia?"
Lipitor is the well-known cholesterol-reducing drug produced by Pfizer. Zetia, which works on a different principal, is less well known. Produced by Merck, research has shown that Zetia, when combined with a statin drug (such as Lipitor), can reduce total cholesterol by more than 40 percent. When Dr. John Harper, a heart specialist at the North Texas Heart Center, prescribed the combination for me it reduced my total cholesterol from 250 to 150 while increasing my HDL--- all on minimal 10-milligram doses. Purchased through my employers' health insurance plan, the combination costs less than $30 a month.
"Yes, we have Lipitor," the pharmacist answers. "But I haven't heard of the other. It may be sold under another name here." She steps to a large directory nearby and starts going through the pages.
"Oh, yes. Merck makes it. It's called Ezetrol."
A package of twenty 10-milligram pills is $31.85 for Lipitor. It's $30.17 for Ezetrol. This means a one-month supply of both would cost $93.03. At Walgreen's, a one month supply of Lipitor is $90.99 and a one month supply of Zetia is $89.99, a total of $180.98. So the cost in Mexico is nearly half the cost in the United States.
Such savings are common knowledge, of course. But it still gets my attention because this isn't a one-shot deal.
It's a lifetime commitment. I can pay $30 a month, forever, if I have health insurance; $93 a month, forever, if I live near Mexico; or $181 a month, forever, if I have to pay full freight.
A 64-year old man in Texas can buy a life annuity of $30 a month with a single payment of $4,682 according to www.immediateannuities.com. Raise the ante to $93 a month and it costs $14,513. Buy an annuity to pay the full $181 a month bill and it will cost $28,246. Viewed that way, a modest set of prescriptions becomes one of the largest financial commitments most people make.
In fact, the life annuity calculation understates the size of the commitment because it assumes that drug prices don't rise. Pfizer raised the price of Lipitor by 5 percent earlier this month.
We take our two little packages and walk back to the bridge. We pay 30 Pesos to return. On the other side, an immigration officer eyes my packages. He asks if I am a U.S. citizen. He waves me on, leaving me to wonder: How much could I have brought back?
On the web:
Thursday, April 15, 2004: A Visit to Algodones
Sunday, March 12, 2000: A Great Raw Deal in Juarez
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