PHARMACIES, SELF-MEDICATION AND PHARMACEUTICAL MARKETING IN BOMBAY, INDIA

Studies of pharmaceutical practice have called attention to the role p layed by pharmacists and pharmacy attendants in fostering self-medicat ion and medicine experimentation among the public. Left undocumented i s the extent to which clients passively follow the advice of pharmacy personnel or question their motive or expertise. While research has fo cused on pharmacists and pharmacy attendants as agents encouraging sel f-medication and medicine experimentation, adequate attention has not been paid to pharmacist-client interactions that are sensitive to the social, cultural, and economic context in which medicine sales and adv ice occur. This paper highlights the context in which pharmacy attenda nts engage in ''prescribing medicines'' to the public in Bombay, India . An ethnographic description of pharmacies and pharmaceutical-related behavior in Bombay is provided to demonstrate how reciprocal relation ships between pharmacy owners, medicine wholesalers and pharmaceutical sales representatives (medreps) influence the actions of pharmacy sta ff. Attention is focused on the role of the medicine marketing and dis tribution system in fostering prescription practice, pharmacy ''counte r-pushing'' and self-medication. In documenting the profit motives of different players located on the drug sales continuum, it is argued th at the economic rationale and the symbiotic relations that exist betwe en doctors, medreps, medicine wholesalers and retailers, need to be mo re closely scrutinized by those advocating ''rational drug use''. (C) 1998 Elsevier Science Ltd. All rights reserved.