Canadian Pharmacies: Are the Savings Worth the Risk?

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In a past life – or, at least, career – I was an office administrator for a cardiologist/pharmacologist who saw many senior citizens with chronic conditions and patients with complicated disorders. The staff was often asked about Canadian pharmacies.

Most patients had the money for their prescriptions, but they didn’t want to part with hundreds to thousands a year for pills if they didn’t have to.

We informed those patients that foreign prescriptions are illegal and unsafe, and we taught them how to find the cheapest prices at U.S. pharmacies.

But a few patients asked out of necessity. The cost of their prescriptions – even at the cheapest domestic prices – would literally consume most (if not all) of their fixed income, leaving them two options: Go off their meds or buy them from somewhere like Canada.

We told those patients the whole truth about Canadian pharmacies.

It’s illegal, but…

The truth: With rare exceptions, an individual who imports prescription meds from a foreign country will break federal law. Specifically, the Food, Drug, and Cosmetic Act, overseen by the U.S. Food and Drug Administration.

The but: You’re unlikely to be prosecuted or even scolded. The FDA’s own import policy actually allows inspectors to look the other way in some situations. From the FDA’s Regulatory Procedures Manual:

FDA personnel may use their discretion to allow entry of shipments of violative FDA regulated products when the quantity and purpose are clearly for personal use, and the product does not present an unreasonable risk to the user. Even though all products that appear to be in violation of statutes administered by FDA are subject to refusal, FDA personnel may use their discretion to examine the background, risk, and purpose of the product before making a final decision.

To lessen the chances of your meds getting intercepted by the feds:

  • Only order meds for yourself using prescriptions written in your name – and have them sent to your home address. This should help communicate to inspectors that the shipment is for your personal use.
  • Order a 90-day supply or less. The Regulatory Procedures Manual considers larger quantities a sign that you might be reselling your foreign (and not FDA-approved) prescriptions inside the United States.
  • Avoid controlled substances. That’s actually a technical term for five categories that the U.S. Drug Enforcement Administration calls the most addictive and hazardous drugs. These include oxycodone and Xanax, and they raise more red flags than other drugs. If you’re unsure whether your prescriptions are controlled substances, ask your doctor.

The other but: Just because the feds might look the other way, that doesn’t mean you’re risk-free. As the FDA puts it, “The drugs remain illegal and FDA may decide that such drugs should be refused entry or seized.”

The bottom line: Talk to your doctor about your options before you resort to foreign prescriptions. Then be honest with yourself about your finances: Does the price break outweigh the risk?

It’s dangerous, but…

The truth: Imported meds endanger your health – and your life. Because they’re not approved or otherwise overseen by the FDA, they aren’t held to the same standard as U.S.-made meds. They might not have been held to any standard.

“Patients who buy prescription drugs from Websites operating outside the law are at increased risk of suffering life-threatening adverse events, such as…contaminated drugs, and impure or unknown ingredients,” says the FDA FAQ.

In other words, when you swallow a pill from a foreign country, you have no way of knowing what’s in it. It could be a counterfeit, a diluted version of the real thing, or something with no actual medicine in it at all.

Canadian online pharmacies are often a front for unlicensed, unregulated outfits based in Second and Third World countries. In 2005, an FDA operation found that 85 percent of imported prescriptions billed as Canadian actually came from 27 different countries.

I clearly remember a patient. Let’s call him John.

John ordered his statin from a Canadian pharmacy without telling the cardiologist, and his cholesterol levels continued to climb. The doctor was certain that John was ignoring his strict diet, so the doctor asked me to call John’s wife. After she read the bottle to me over the phone, we learned that John was taking something supposedly similar to, but not quite the same as, the prescribed statin – and it came from India.

The doctor figured there was no medication at all in those capsules.

The but: Some Canadian pharmacies are better than others. The safest ones are based in Canada and have been verified or certified in some way.

In the United States, legitimate online pharmacies partake in something called the “Verified Internet Pharmacy Practice Sites” program. Consumers can tell those pharmacies apart from others by looking for the VIPPS symbol on the pharmacies’ website. If you don’t see that symbol, the National Association of Boards of Pharmacy (NABP) has a verification page where you can check a Web address.

The NABP’s Canadian counterpart is called the National Association of Pharmacy Regulatory Authorities (NAPRA), which is currently working on a Canadian version of VIPPS. Until it’s up and running, there are two other websites that help consumers find the safest Canadian pharmacies:

The bottom line: Again, talk to your doctor and be honest with yourself about your finances. Taking a remote risk of getting caught breaking the law is nothing compared to taking a real risk with your health.

Karla Bowsher runs our Deals page, writes “Today’s Deals” posts every Monday, Wednesday, and Friday; and covers consumer and retail issues. If you have a comment, suggestion, or question, leave a comment or contact her at [email protected].

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