Abstract
The health status of the people of Chile has improved in the last decades as a consequence of a long-term social policy, through a national health service established in the early 1950s. Recently, a new system of health insurance was developed for people with higher incomes. There are nearly 5,500 available drugs; these are commercialized under the free market rules. The approval to introduce a new drug into the market is based upon a report compiled by an expert, but the majority of basic and clinical data provided by the pharmaceutical companies are from studies performed abroad. If the drug is approved, it remains on the market indefinitely. There is no periodic review and update system that could reevaluate the efficacy and safety of the drug.
There are no legal regulations for the development of clinical trials and there is a lack of experts in this subject. Initial efforts have been made in certain areas, for example, clinical cardiology, where a national network has been created with the aim of designing and carrying out clinical protocols. In the field of clinical investigation, transparent cooperation between the pharmaceutical companies and academic or public institutions is now recognized as very important. A special issue in Chile is self-medication. A great number of nonover-the-counter (OTC) medicines (antiinflammatories, analgesics, hypnotics, sedatives, and antimicrobials) are sold without prescription.
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