The Daraprim Drama: Prices Keep Going Up in the U.S. AND at Foreign Online Pharmacies

Contrary to the belief of the pharmaceutical industry and their minions, is not a champion of foreign online pharmacies, even the safest ones.  They just charge a lot less for medication, which helps American consumers stay healthy and avoid bankruptcy. But they are, like their U.S. pharmacy counterparts, just businesses.

Drug prices up up up

And that brings us back to our blog topic from last week, which was Daraprim, the parasite-fighting drug that, in the blink of an eye, went from $13.50/pill to $750/pill in the U.S. a few weeks back. We wrote what seemed impossible: a 99.8% international pharmacy savings on a medication. When we published that post, the price of Daraprim, manufactured and marketed by GlaxoSmithKline in Europe, was $1.53 a pill at the lowest cost international online pharmacy in the PharmacyChecker Verification Program. Well, those international online pharmacies jacked their prices, too…kind of.

As PharmacyChecker founder Tod Cooperman, MD, was writing an article for the Huffington Post about Daraprim, prescription drug importation and overall drug affordability problems, we discovered that the online price of Daraprim 25mg jumped from $1.53 a pill to $6 bucks! An increase of 292%.

It was reported that the villain of this whole story, the head of Turing Pharmaceuticals, the company that owns Daraprim in the U.S., was planning on lowering the price of Daraprim, which appeared to be an almost necessary public relations move. I called chain pharmacy giant Walgreens today expecting that the price would be less than $750 but found out that the price was actually $796/pill.

So the potential international drug price savings on Daraprim has plummeted from 99.8% to 99.25% A little Rx irony to end our week here at


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Martin Shkreli trying to look cool

Martin Shkreli, founder and chief executive of Turing Pharmaceuticals. Not that cool.

It’s no secret that Americans are unhappy with Big Pharma. Pharmaceutical companies regularly rank as one of the least loved industries, right up there (or down there) with Big Oil and Big Government. And while this has usually been expressed as contempt towards the industry as a whole, recently the negative spotlight is shining brightly on one man: Martin Shkreli, hedge fund investor and drug company entrepreneur.

Soon after his company Turing Pharmaceuticals purchased the marketing rights to the drug Daraprim, Shkreli raised the price of Daraprim from $13.50 per pill to $750.00 per pill in the U.S. market where Turing has exclusive marketing rights. But that only affects America! Thankfully, consumers can purchase Daraprim, marketed by GlaxoSmithKline in the UK, from a verified international online pharmacy for as low as only $1.53 per pill. A mere savings of 99.8%.

Daraprim is used to treat toxoplasmosis, a disease that results from infection with the Toxoplasma gondii parasite. This parasite is very common (in fact it’s been estimated that 22% of U.S. population have been exposed to it and it usually infects people who have eaten undercooked meat, raw vegetables, or have handled cat feces. In healthy people it usually only causes flu-like systems. However this disease can cause severe complications in people with compromised immune systems, such as those with HIV or cancer, including brain lesions and seizures. The disease can also be very harmful to women who are pregnant, leading to a stillborn child or a child born with birth defects.

It’s not rare for medications that treat a rare disease or a small patient population to be expensive. Moreover, it’s understandable that pharmaceutical companies want to recoup the extensive costs of developing a drug and make a profit, although Big Pharma’s lust for profits appears insatiable. But let’s take a deep breath…Daraprim is not some new wonder drug. It was originally developed and marketed by Burroughs Wellcome and patented back in 1953 (the patent expired in the 70s). A relatively inexpensive drug, it was long manufactured by GlaxoSmithKline, until that company sold the U.S. marketing rights to CorePharma in 2010. Impax Laboratories later bought CorePharma, and turned around and sold the rights to the drug to Turing.

At that point Mr. Shkreli and our friends at Turing decided to change how Daraprim was distributed. Hospitals, instead of going to a wholesaler, now had to order from Turing’s “Daraprim Direct” program. Patients, instead of going to their neighborhood pharmacy had to order from Walgreen’s Specialty Pharmacy. And since there is no approved generic in the United States, patients who need Daraprim face monopoly pricing, with no competition to Turing on the horizon.  Many people of all political stripes seem to be enraged over price gouging like this, because it seems like they’re getting the worst of corporate monopoly and government protectionism.

In order to get this medication, American consumers may need to look across the pond. As mentioned above, GlaxoSmithKline may have sold their U.S. marketing rights to Daraprim in 2010 but not in many countries around the world, such as England, where it’s sold for pennies to the pill!

It only seems fair, not to mention in the interest of public health, that an important drug like this, that’s listed on the World Health Organization’s List of Essential Medicines, should not be one subject to the twisted reality and bizarre rationalizing of hedge fund managers.


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Image by Svilen.milev

As reported today in The New York Times, a new study shows that the diabetes drug Jardiance (empagliflozin) can reduce the risk of dying from cardiovascular disease by 38%. The drug not only reduces blood sugar levels, but also blood pressure and arterial stiffness leading to a reduced risk of heart failure.

The cost of Jardiance in the U.S. is about $350 to $400 for just 30 pills. It would be a shame if people could not get this medication due to its high cost. Fortunately, this drug is available from licensed pharmacies in other countries (where the price is controlled or negotiated) at prices which are about 70% lower than in the U.S. As shown on, the 10 mg dose is available from several verified international online pharmacies for about $110 a month or, better, if purchasing a 3 month supply, it’s under $300. The 25 mg dose is only a few dollars more.


How to Save Up to 66% on Eliquis


More than six million Americans suffer from atrial fibulation (AFib), a heart condition that puts them at a much higher risk for blood clots and can cause a stroke. Strokes are most often seen in people over 65, and can lead to paralysis and death.

There are many anticoagulants (blood thinning drugs) used to prevent strokes, Coumadin (warfarin) being one of the oldest and most commonly used. But Coumadin is not right for some people: it can cause heavy internal bleeding and requires regular and frequent blood tests.

One of the newer medications, Eliquis, has been shown to have a lower risk of major bleeding and is better for people suffering from kidney disease. It is also effective as a medication for preventing deep vein thrombosis (DVT). DVT is caused when blood clots form in large veins, usually in the legs, and often in those with restricted mobility, such as people who are recovering from surgery.

But Eliquis can be expensive. If you don’t have insurance or are underinsured and have to pay out-of-pocket, the retail price is around $1,182.00 for a 90 day supply at a local U.S. pharmacy. Americans are at serious risk if they can’t afford this medication, especially seniors who are most likely to suffer a stroke. Despite Medicare Part D coverage, according to the National Center for Health Statistics, more than 13% of poorer Americans over the age of 65 did not take their medication as prescribed.1 And that can put their health and even their lives at risk.

There are ways of reducing the cost of Eliquis (see the table below). If you use a pharmacy discount card, you may be able to get it down to about $1,021 at your local U.S. pharmacy. But that still works out to over $4,080 per year. For many Americans those prices are out of reach. Fortunately, Eliquis 5mg, 90 days’ supply, is only $401.99 using a verified international online pharmacy, a savings of more than $3,100 versus the retail pharmacy price over a year’s time.

If you have AFib, and are prescribed Eliquis by a doctor, it’s vital for you to stay on your medication. Hopefully these price comparisons help you evaluate the best option for your health and savings. If you decide to buy internationally, remember, when using an online pharmacy, makes sure it’s one that’s been verified by

Compare drug prices for Eliquis.

Eliquis 5 mg Savings (90 day supply)
Program Price Savings over Local Pharmacy Percent Savings Annual Savings
Local Pharmacy* $1,181.97
Pharmacy Discount Card* $1,021.88 $160.09 14% $640.36
International Online Pharmacy $401.99 $779.99 66% $3,119.94


*Savings based on lowest price listed on compared to local U.S. pharmacy price (8/21/15).

1 Center for Disease Control, National Center for Health Statistics,


“High Drug Prices Are Killing Americans” While LegitScript’s John Horton Gloats

While is not taking sides in the presidential election, last Saturday, the Huffington Post published an op-ed by presidential candidate Bernie Sanders entitled “High Drug Prices Are Killing Americans” that we agree with. Senator Sanders believes that the U.S. government should make it easier for Americans to import lower cost medications from other countries.  He writes: “Americans should be able to do this online or by mail, provided they have the proper prescription from a physician.”  Polls show that most Americans feel the same way.

In contrast, John Horton, the founder of, was busy this week trying to achieve the opposite – keeping the U.S. a captive drug market by scaring Americans away from safe and affordable international online pharmacies. Mr. Horton appeared to gleefully report that a safe international online pharmacy operated from Canada,, was “ordered to be shut down” by the College of Pharmacy in Manitoba. As usual, however, Mr. Horton misrepresented the facts, skipping details that are important to consumers., as it notes on its website, “is not itself a pharmacy, but a prescription referral service.” It refers orders to licensed pharmacies in Canada and other countries, and helps Americans fill their prescriptions at lower cost. We know this is true because PharmacyChecker verifies the licenses of the pharmacies uses. So what’s the current fuss about?

According to an article in CBC News, the College of Pharmacists in Manitoba recently sent a letter to discontinue its marketing efforts, accusing  the website of  “suggesting” that – in its print advertising in the U.S. – it is a Canadian pharmacy, rather than a prescription referral service, through which orders placed online are filled in Canadian and other pharmacies. If that’s the case, we would agree that any such advertising should be clearer.  As noted above, on its website, appears to accurately describe itself. Another complaint is that the website advertises certain popular brand name medications (Zetia, Benicar, and Lexapro) using their U.S. names, when, in Canada, these medications are sold under different names, which may violate Canadian prescription drug marketing laws – even though does not market those products to Canadians. From the perspective of an American consumer this would not seem to be a concern.

The regulatory and legal issues at hand are technical and involve the definition of a “pharmacy,” marketing laws, and potentially conflicting legal jurisdictions. But the bottom line is that is a safe international online pharmacy and the regulatory actions described above do not remotely show otherwise.

In addition to the spin on the CBC news story, Mr. Horton took the opportunity to continue his incessant campaign of trying to embarrass and disparage, so I will address his “concerns.”

LegitScript published a screenshot of PharmacyChecker’s seal profile for Due to an administrative glitch (about which we are embarrassed, but have corrected) the profile read “last verified’ in 11/21/2011, but rest assured that our last regularly scheduled verification was on 8/12/2015. The pharmacy in Canada which uses, Westview Pharmacy, continues to be licensed by the Manitoba College of Pharmacists — the same regulator that sent the letter to you can check the license yourself.

Mr. Horton also criticizes our policy of not always publishing the names of the bricks-and-mortar pharmacies through which international online pharmacies fill orders. We do this for a very good reason, one that benefits consumers: Pharmaceutical companies have a history of cutting supplies to pharmacies outside the U.S. that sell their products at lower prices to Americans! We don’t want drug companies to stop consumers from getting prescribed medications at lower cost. What’s funny, however, is that LegitScript has made a big deal about “outing” the name of a pharmacy we kept confidential only to discover that it’s a licensed pharmacy in Canada. Thanks!

We agree that online pharmacies (and big multinational pharmaceutical companies) should be truthful and as transparent as possible about what they do and how they portray themselves. That’s why, for over 10 years, has required Canadian online pharmacies to disclose the countries in which they partner with local pharmacies and they must identify the specific pharmacies to us. We then verify the licenses of these pharmacies before an online pharmacy can be a member of our Verification Program.  If you look at our site, you’ll notice we list the countries to which an online pharmacy refers orders. We’re not sure what Mr. Horton is talking about when he writes that we “concede” that “other verified dispensing pharmacies” used by are in “New Zealand, Turkey, Singapore, Canada, United Kingdom and New Zealand” – referring to the information publishes in’s Seal Profile. Thank you, Mr. Horton, for finally saying what you know: we don’t help online pharmacies pretend their “Canadian” but provide information to consumers so that they know what’s up.  For newcomers to this issue: we have a blog post that will be very instructive: “So you Want to Buy Cheap Medicine From an Actual Canadian Pharmacy?”

Mr. Horton loves to highlight that a very small number of mostly U.S. online pharmacies, which were once approved in our program, were found or accused of selling controlled drugs without valid prescriptions. What he fails to mention is that most were not in our program at the time that they were charged and none has been in our program for years (since 2010). Yes, licensed pharmacies and pharmacists (and big pharmaceutical companies) break the rules sometimes, on and offline – and they need to pay the consequences commensurate with the harm they have done. But which pharmacy seems to have the worst track record of fueling the addiction epidemic? I believe that award goes to none other than LegitScript-approved Walgreens! Walgreens had to pay $80 million in 2013 to make charges go away that it illegally sold controlled drugs, including opiate-based medications into the black market. [This is not to disparage the thousands of good people and pharmacists who work for Walgreens but to show LegitScript’s hypocrisy.]

Prescription drug abuse is a serious problem and no laughing matter.  The sad truth is that of the of 41,340 annual deadly drug overdoses, 22,810 were caused by legal, often highly addictive opiate-based, pharmaceuticals. It’s a serious epidemic, and while vigilance and enforcement are critical, according to the U.S. Drug Enforcement Agency, the Internet causes a tiny fraction of the problem. Our program excludes international online pharmacies that sell controlled drugs into the U.S. at all.

Seriously and sadly, if the FDA and/or Canadian regulators decide to, they can probably figure out a way to shut down the safest international online pharmacies. Of course, that may lead Americans seeking affordable medication into a minefield of rogue online pharmacies (over 30,000 according to LegitScript). Is that really what Mr. Horton wants? But, as I have written before, and shared with elected leaders, shutting down safe international online pharmacies is bad for public health.

Our 12 years of publishing online pharmacy verification and pricing information, and my advocacy, has made a prime target of Pharma-front groups and their lobbyists. They have misled journalists to believe all kinds of misinformation. They also point out that is a business not a non-profit group — and about that they are correct: We are proud to have started and to run a small American business that, unlike LegitScript, doesn’t rely on taxpayer’s money ($5.2 million) or mislead Americans. PharmacyChecker helps Americans find information about the most affordable and safe online pharmacy options. As Senator Sanders says, “High Drug Prices Are Killing Americans” and we’re glad to be part of the solution, not the problem.


[This is an unedited message from a consumer. You’ll note that, unfortunately, international online pharmacies raise their prices, too! If you have a story you’d like to tell, email us at]


“I chose to order my Celebrex 200mg from a Canadian pharmacy when the price from Pfizer skyrocketed and the generic did the same. I assume you know that Pfizer selected a certain few US generic manufacturers to make it. They have kept the generic price almost as high as Pfizer’s. That is an unavoidable result of price control by Pfizer.

I have had good results from [Pharmacy Name Redacted]* although they have raised the price for 90 about $10 each time I have refilled. May switch to a different one from your list next time.”

-Ann K.


*PharmacyChecker does not wish to highlight specific international online pharmacies in our blog. You can view the current list of online pharmacies that sell branded and generic versions of Celebrex.


Alliance for Safe Online Pharmacies – Using Deception to Keep You Paying More

Pharma-funded group elixir to fool Americans about personal drug importation and online pharmacies

A paid “news release” this week by the Alliance for Safe Online Pharmacies (ASOP) and LegitScript and widely disseminated by PR Newswire– deceitfully and incorrectly associated with a federal indictment involving the wholesale operations of a Canadian company. A former consultant to was, unfortunately, swept up in this indictment for an action having nothing to do with his work with (see our posting about the indictment). But even though PharmacyChecker, nor any of its executives or employees, are the subject of the recent indictment or even mentioned in it, ASOP and LegitScript, who we see as sharks for Big Pharma and Big Pharmacy, could not resist throwing a public relations party, which we believe is aimed at manipulating the media and reporters, government, and worse – consumers!  It appears that they spent a lot of money on a PR firm, ECI Communications, to put together and disseminate lies about and misleading information about international online pharmacies.

Want proof? After reading ASOP and LegitScript’s deceitfully misleading news release, a writer at the publication Medicine Marketing & Media was apparently duped into writing on Wednesday that PharmacyChecker was being indicted! After we contacted that publication about the inaccuracy, we were swiftly given an apology, the article was corrected, and the following statement posted: “CORRECTION: An earlier version of this story incorrectly listed as a defendant. is not a defendant in the case.

A renowned expert in First Amendment Law considers the news release “libelous” and ASOP, LegitScript, and ECI have been asked to take it down.  PR Newswire has also been asked to remove it, as it appears to violate PR Newswire’s own guidelines regarding libelous content and this certainly doesn’t help their existing reputation for distributing “low quality content.”  However,  perhaps due to the enormous funding behind these groups, they have yet to make any attempt to correct the situation. We’ll see how much they care about the truth by their actions.

It’s important to keep in mind who these groups are.  ASOP’s members and funders include large pharmaceutical companies and the National Association of Chain Drugstores. To protect their bottom lines, these companies and ASOP lobby congress and federal agencies, such as the FDA, to try to curtail your access to much more affordable and safe medication from outside the U.S. In fact, ASOP is actually located in the offices of the government relations and communications consulting firm FraegreBD, where ASOPs executive director, also happens to be a Vice President. And ECI Communications is a PR firm which does extensive business for U.S. pharmaceutical companies.  Of course happens to be a founding member of ASOP. Can we trust or ASOP? Well, you already know who ASOP works for, right? On the other hand, much of’s income is from a contract with the FDA for $5.2 million. That’s not bad in and of itself but, if that money is being used to spread misinformation to U.S. consumers and lobby congress and maybe even the FDA itself, then that stinks.

The truth is that American consumers are buying medication from outside the U.S., five million of them each year, because many of them can’t afford prices in the U.S. Since 2003, has been working hard to publish information that helps Americans find safe and affordable medication from these pharmacies. Yet it seems the only safe online pharmacy to ASOP is one that is approved by, which in turn believes that every pharmacy outside the U.S. that sells into the U.S. including licensed pharmacies in Canada, are not “legitimate” or are “rogue.”

ASOP’s and LegitScript’s vision of “legitimacy” is a nightmare for Americans! Thirty-five million Americans don’t fill a script each year because of cost. A safe online pharmacy is not safe for a consumer who can’t afford the medications it sells. ASOP, LegitScript, the NABP, FDA, etc., can’t wish away the fact that safe international online pharmacies are a lifeline for many American consumers. Scaring these Americans away from safe pharmacy options with misleading and false  information means that more Americans will go without their prescribed medications. There is nothing “safe” or “legit” about that.


Almost three years ago, we blogged about a federal investigation of, which for many years has safely sold prescription medication at prices far lower than typically available in the U.S, and which is a verified online pharmacy in the Verification Program. The investigation focused on’s wholesale drug importation and distribution to doctors and clinics — an area has long since exited. It did not focus on’s retail sales to consumers for personal use, which is the focus of the Verification Program and the information we provide to consumers on our website about online pharmacies.

Recently, an indictment was unsealed in federal district court in Montana that charged, Ltd. (the entity which owns and others with illegal wholesale drug importation, which allegedly occurred between three to six years ago.  The allegations include wholesale distribution of a counterfeit version of the cancer drug Avastin to medical clinics in the U.S.

The indictment of CanadaDrugs, Ltd, comes as no surprise, as the investigation was well publicized. It will also come as no surprise, however, when the U.S. pharmaceutical industry tries to use the charges, which focus exclusively on wholesale drug importation, in an effort to discredit safe personal drug importation. As we have written here and opined in the New York Times, the U.S. pharmaceutical industry and pharmacy chains feel threatened because Americans can and do safely purchase their medications online at substantially lower cost from pharmacies in other countries. Thus, the industry, the “non-profit” groups it funds, and the government agencies which it lobbies and seeks to influence, will see this indictment as yet one more opportunity to scare people from personal drug importation.  This slight of hand is wrong, since the investigation and indictment have nothing to do with personal drug importation. In fact, even the Wall Street Journal, which was instrumental in publicizing the investigation, clarified the difference between wholesale businesses and  “There is no indication that fake medicines were sold through the company’s consumer-focused website,”


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Last week, Bing announced a new effort to use its search engine to warn consumers about threats from “fake” online pharmacies. The big problem is that at least some of the online pharmacies they list are not fake, but represent very real, licensed pharmacies, ones that require valid prescriptions and have been safely helping Americans afford medication for years. We know this because these pharmacies have been carefully evaluated, inspected, and monitored by us at, and meet high standards of pharmacy practice. See our standards:

The online pharmacies targeted by Bing, which are approved in our program, are all located outside the U.S. Curtailing online access to lower cost and safe foreign medication using scare tactics is a strategy employed by the pharmaceutical industry. Indeed, Bing’s action seems to have a lot to do with stopping safe personal drug importation and will recklessly alarm Americans so they don’t buy more affordable medication from other countries.

Here is the warning which appears when a consumer’s Bing search results include links to one of these online pharmacies and they try to click on the link to that online pharmacy:

FDA Online Pharmacy Warning

To choose the pharmacies it targets, Bing is relying on a list of online pharmacies which have received warning letters from the FDA. But, in at least several cases, these warning letters, which you can find on the FDA’s website, do not indicate a pharmacy to be fake, nor do they pertain to sales of counterfeit or adulterated medications, nor to any problems with the pharmacy meeting good standards of practice. Instead they relate to 1) sales of lawfully manufactured generic versions of drugs that are still on patent in the U.S., and 2) medications that are approved in Canada but not in the U.S. We will examine each of these letters fully over the next week, but our initial review indicates that these issues have been addressed by the online pharmacies in our Verification Program that received the letters.

The genesis of Bing’s action, which is most likely coordinated with the FDA, comes from the scare tactics about foreign medications conceived by pharmaceutical companies and their lobbying largesse. Why else would Bing decide to target only online pharmacies when many other pharmacies, pharmaceutical companies, medical device manufactures, and dietary supplement distributors have also received FDA warning letters for various infractions, yet Bing does not target them with its pop-up warning?

Bing’s actions would be great if the websites it is targeting were all fake or rogue online pharmacies, but they are not. When consumers see Bing’s warning, they will likely do one of three things:

  1. Keep searching for another online pharmacy that charges a price they can afford. They may find one of the tens of thousands of rogue pharmacy websites that don’t require a prescription (but are not included on FDA’s new list) and buy from that one. Then they are far more likely to end up with a counterfeit drug.
  2. Go to their local big chain pharmacy and pay hundreds if not thousands of dollars more for their prescribed medication. The Warning has a link to “safe online health purchases” but those take you to U.S. online pharmacies only, which are often the websites of the big chain pharmacies!
  3. Not take their prescription medication at all. Thirty-five million Americans each year already forgo prescribed medication due to cost.

These are horrible outcomes. Yes, warning Americans about rogue online pharmacies is good public policy. But leading Americans away from safe personal drug importation will just lead to fewer people getting medications they need, more Americans choosing between food and medicine, and larger profits for the big drug companies.

For those interested in a full policy analysis of FDA’s current campaign, please see our report called: “Online Pharmacies, Personal Drug Importation and Public Health.”


Appearing on Fox and Friends this past Saturday morning, Tod Cooperman, MD, founder of, discussed our favorite topic – affording prescribed medication. The hosts wanted to know what is behind a recent class action lawsuit against CVS Health Corp in which the chain pharmacy is accused of overcharging consumers on generic drugs and how Americans can prevent getting bilked on price by pharmacies.


CVS, like many chain pharmacies, has a prescription discount program, and the discounted prices can often be less than the co-pay required with some pharmacy benefit plans. However, CVS has apparently not been informing customers of the lower, discounted price. What has been happening is that hundreds of thousands of CVS customers have paid more money using their health insurance because the co-payments are higher than the discount program price.

Dr. Cooperman basically informed the public that this is probably a pretty common practice among U.S. chain pharmacies with similar programs. He said: “It’s really kind of ridiculous because you have people with insurance who…are being charged more than if you simply walked in and asked for the cash price or discounted price.” So what do you do? When you go to your local pharmacy, ask the pharmacist or pharmacy technician for the absolute lowest price you can pay. Call different pharmacies in your neighborhood, because generic drugs can sometimes cost five times more at one pharmacy than they do at another.

When medication is not affordable at your local pharmacy, international online pharmacies are an option for savings. Dr. Cooperman stated: “about five million Americans actually are now going outside the U.S. because they can’t afford their prescriptions.” Pharmacies in other countries sell safe and effective medications at much lower prices but rogue websites abound — so stick to verified international online pharmacies and compare their prices on Dr. Cooperman noted the technical illegality of personally importing meds but that the FDA doesn’t “go after consumers for doing it.”

Anna Kooiman, one of the hosts, mentioned that people lose their lives because they can’t afford medication. She added, “Listen, it might be illegal but some people do what they have to do to save their own lives.”

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