Commercial pharmaceutical medicine and medicalization: a case study from El Salvador

This study illustrates the impact of prepackaged pharmaceutical products, usually manufactured by multinational firms, on the health care sector of developing market economies. In many Third World countries Western biomedical practitioners do not exercise the degree of control over the use of one of their major healing resources, prescription medications, that is characteristic in most Western developed countries. Instead, these products have become integrated into healing strategies of alternative medical practitioners, giving rise to a popular sector of medical care, here termed to commercial pharmaceutical sector. In this context a form and process of medicalization has taken place which is only tangentially related to the presence of Western biomedical practitioners. A dependence has been created on a particular form of therapy, Western manufactured drug products, as well as on the agents and institutions that make the products available, that has produced cultural, social and clinical forms of commerciogenesis. These general propositions are examined in a case study of the impact of the pharmaceutical invasion of the health care sector in a Central American town.