Pharmacy here in Dominica

One major difference I notice from the practice of pharmacy here as compared to the States is that their is no private/government run insurance companies that you bill for a prescription.  If a patient goes to the health clinic in their village the medication (although VERY limited in drug variety) is free of charge to them.  However, if the health clinic pharmacy does not have the prescribed medication, the patient has to go into Roseau and get the drug.  If they go to Roseau, they must pay for the prescription out of pocket.  You can most closely compare this to formularies in the states.  The government will supply a certain amount of drugs to each village health clinic (such as captopril, amlodipine, metformin, glyburide) and forces the patient to pay for other medications that the health clinic does not have in stock.  From what I have encountered, the government supplies the bare minimum to treat each different disease state with only 1 or 2 drugs for each disease, and the amount they give is very limited.  Today for example the clinic ran out of metformin tablets which if that happened in the States I feel like customers would be very angry and definitely not understand how you don't have enough tablets.  But the people here understand that supplies are limited and sometimes must go a week or two without their metformin!

-Anthony