Should You Use an Overseas Pharmacy?

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According to a recent CVS Caremark study, 62 percent of pharmacists said cost is the biggest reason some patients don’t take their medication as directed.

Drug manufacturers set their own prices – and those prices can be high. If you have insurance, problem solved. But if you don’t, the inability to afford the prescriptions you need isn’t just an inconvenience – it could be life-threatening.

One thing that might help are generics, typically much cheaper. There are also programs designed to put free or low-cost prescription drugs in the hands of people who can’t afford them. If that’s you, check out sites like rxhope.com, needymeds.org, patientassistance.com, patientadvocate.org, and others to see if you qualify.

If you can’t use a generic, however, and make too much or are otherwise unqualified for assistance, there’s only one thing left to do: shop. And not just among stores – among countries.

In the video below, Money Talks News founder Stacy Johnson interviewed Dr. Tod Cooperman, M.D. and owner of PharmacyChecker.com, a site that compares drug costs at pharmacies worldwide, as well providing assurances the pharmacies they recommend are safe. Check it out, then read on…

What you need to know before filling prescriptions outside the U.S.

1. Savings

As Dr. Cooperman said in the video, buying medications overseas or in Canada can mean healthy discounts. Two examples, supplied by PharmacyChecker.com:

  • Three-month supply of Nexium 40 mg – Overseas: as low as $69, or $0.82 per pill. Stateside: up to $737.99. Savings: $668.99, more than 90 percent.
  • Three-month supply of Crestor 10 mg – Overseas: as low as $60, or $0.73 per pill. Stateside: up to $667.79. Savings: $607.79, more than 90 percent.

So buying either of these medications could save more than $2,400 annually. And shipping and handling from international pharmacies doesn’t add much to the cost. On PharmacyChecker.com, the pharmacies listed charged from zero to about $11 per order.

Obviously, not all medications are as discounted as these two, but it’s easy to check prices. Grab a couple of your pill bottles, go online, and see what you find.

2. Legalities

So they’re cheaper, but are they legal? Technically, no. The U.S. Food and Drug Administration explains: “In most circumstances, it is illegal for individuals to import drugs into the United States for personal use.”

The FDA regulates prescription drugs sold in the U.S., but not those from other countries sold to U.S. consumers; that’s why it’s not legal. But while the FDA doesn’t officially condone overseas pharmaceuticals, they have a policy of not objecting to importing drugs in certain circumstances:

  • The drug treats a serious condition and there isn’t a good treatment available in the U.S.
  • The drug doesn’t have an unreasonable risk.
  • The imported drug won’t be sold or promoted in the U.S.
  • The person buying the drug can certify in writing that it is for personal use and a doctor can back up the prescription.
  • Generally, no more than a three-month supply is imported.

So if you don’t buy in bulk and don’t plan on selling what you buy to other people, there isn’t much of a risk that you’ll actually get in trouble for buying drugs overseas.

Video reporter Stacy Johnson went back and forth via email with the FDA regarding the legality of importing prescription drugs for personal use. Here’s a cut-and-paste from one of his emails…

The simple fact is that commonly prescribed drugs are available from Canada and other places at discounts of up to 90 percent. While I’m aware that the letter of the law prohibits drug importation, I need to know if the FDA has a policy of prosecuting patients who take advantage of this price disparity. That’s the question I need an answer to.

Here’s the verbatim response from the FDA…

FDA is not aware of any actions taken against an individual resulting from their purchase of small quantities of unapproved drugs for personal use.

Does that give you the go-ahead? You be the judge.

3. Quality Concerns

It’s important to thoroughly research the online pharmacy you plan to purchase from. According to the World Health Organization, “in over 50 percent of cases, medicines purchased over the Internet from illegal sites that conceal their physical address have been found to be counterfeit.” However, a footnote to that statement acknowledges, “some Internet pharmacies are legal operations established to offer clients convenience and savings” that “sell only on the basis of a prescription.”

The key is to use pharmacies that are legitimate, but international, rather than the fly-by-night kind that floods your inbox with spam. How can you be sure you’re buying medicine from a legit pharmacy? Check for these:

  • Location and base of operations: Check to see which country the medication is coming from and if the business has a listed address. According to this WHO fact sheet, industrialized countries such as New Zealand, Canada, Australia, and Japan have an “extremely low – less than 1 percent” rate of counterfeit drugs on the market. Conversely, “in many African countries, and in parts of Asia, Latin America, and countries in transition” more medications on the market are likely to be counterfeit.
  • Reputation check and accreditation: PharmacyChecker.com has a list of rogue websites to avoid and a list of pharmacies they’ve approved. The Canadian International Pharmacy Association has a list of trusted member websites and a list of websites of ill repute. The Verified Internet Pharmacy Practice Sites seal indicates that the shop is “a bona fide pharmacy,” according to the National Association of Boards of Pharmacy.

4. Potential risks

Getting a counterfeit drug could be dangerous to your health. These drugs are either made from inactive ingredients and will do nothing for you, are expired and not as effective as they should be, or made from harmful ingredients that could cause serious injury or even death.

For example, the FDA reported a group of people thought they were purchasing Ambien, Xanax, Lexapro, or Ativan over the Internet. Instead, they got a potent anti-psychotic drug. Those who took the drug ended up needing emergency treatment for symptoms like muscle spasms and trouble breathing.

In another FDA case, some U.S.-based medical offices purchased counterfeit Altuzan,a cancer drug not approved by the FDA. In some cases, the injectable medication had no active ingredient and cancer patients were not getting the treatment they needed.

In 2007, The New York Times reported on another counterfeit drug issue. Over several years, companies were adding diethylene glycol, the main ingredient in some antifreeze, into cough syrup, fever medications, and some injectable drugs. Researchers said thousands of deaths could have occurred due to the counterfeit medications.

The bottom line

Buying prescriptions from an overseas pharmacy can save you a ton of money, but done carelessly could be risky. Cut down on the risk by starting with well-known, U.S.-based sites that screen and approve international pharmacies. And avoid any pharmacy doing suspicious things such as not disclosing contact information or supplying drugs without prescriptions.

The prescription for safe savings is common sense.

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