PharmacyChecker Blog

Big Pharma Drug Price Gouging of American Consumers Continues

On May 17, 2013, in Advocacy, Drug Prices, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

A new report from Reuters suggests that pricing pressures resulting from Obamacare may close U.S. and international prescription drug price disparities – with U.S. prices more than double those of other high-income countries - within three to five years. As good as that could be, it’s a long way away for Americans who currently struggle with drug prices. With tens of millions going without meds due to cost, the problem is more urgent than ever.

U.S. brand-name drug prices continue their vigorous rise, in stark contrast to international price declines. Brand-name U.S. drug prices rose 11% in 2011, almost triple the 3% inflation rate. Meanwhile, prices in Canada stayed the same, and actually dropped in France and Switzerland by 3 and 4 percent, respectively.

Reuters politely explains this gap:

“Companies like Pfizer Inc. and AstraZeneca have grown dependent on higher U.S. prices to generate profits as generic rivals to their best-selling medicines enter the world market, Europe’s government-run health plans clamp down on spending and sales growth in emerging markets stutters.”

Perhaps these price increases explain the 50 million Americans between the ages 19-64 and the 20% of Medicare enrollees who do not fill a prescription due to cost each year.

Look at the price of Januvia, a drug mentioned in the Reuters article. Its wholesale price is 75% higher in the U.S. than in Austria. Our own research shows the price gap at the retail level. The price at a local pharmacy for 90 pills is $978. It costs only $375 online from a verified Canadian pharmacy. That’s 62% cheaper.

Hopefully, the Affordable Care Act will lead to reduced drug prices domestically, but that will take some time. Until then international online pharmacies will remain a lifeline for Americans.

50 Million Americans, Ages 19-64, Forgo Meds in 2012 Due to Cost; 37% of Seniors Concerned About Drug Prices

On May 10, 2013, in Advocacy, Medication non-adherence, Skipping medications, by Gabriel Levitt, Vice President, PharmacyChecker.com

The number of Americans not taking medication due to high drug prices – a public health crisis – has increased dramatically over the past decade. Last year, drug prices deterred 50 million Americans ages 19-64 from filling a prescription, a 28% increase since 2003 and 4% increase since 2010, according to the Commonwealth Fund’s 2012 Biennial Health Insurance Survey. The survey measures gaps in medical care due to cost, such as forgone doctors’ visits, medical tests, specialist care, and prescription medications. The prescription-use data for 2012 was derived from answers to the following question: In the last 12 months, was there any time when you did not fill a prescription for medicine because of the cost? This fifty million – a staggering figure – does not even include seniors or children who also did not fill a prescription due to cost.

Not surprisingly, the problems for the uninsured are much greater, especially for those with chronic conditions. Sixty percent of uninsured Americans with a chronic condition skipped taking medication in 2012 due to cost, compared to 14% of insured Americans. Overall, the figure was 28%; that’s 18 million out of sixty-six million adults with hypertension or high blood pressure, diabetes, asthma, emphysema, lung disease, or heart disease who reported skipping medication.

As far as seniors skipping meds goes, a recent Walgreens survey may have some answers. It found that 37% of Medicare enrollees are concerned about their drug costs and 20% delay filling prescriptions or skip doses to manage costs. That’s almost an additional eight million (using U.S. Census data for 2011) Americans not adhering to prescriptions due to high drug prices. Walgreens attributes such dismal numbers to the fact that people are unaware of cost-saving alternatives, such as the fact that co-pays vary among pharmacies and limited knowledge of how Part D prescription plans work.

Other reasons seniors skip medication are because their Part D plans do not cover brand name medications prescribed by their doctors and the “donut hole,” a coverage gap in Medicare drug plans that has fortunately begun to close due to Obamacare .

We’re happy to note that the Commonwealth Fund’s report shows that more insured Americans under Obamacare in the years to come could alleviate medical cost problems for millions of Americans. We’ll explore in a future blog post new data on how Americans are addressing the problem of high drug prices.

FDA’s Be Safe Rx New Pharmacy License Database Doesn’t Help Americans Afford Needed Medication

On May 3, 2013, in Advocacy, FDA, Online Pharmacy Verification Services, by Gabriel Levitt, Vice President, PharmacyChecker.com

Last year, PharmacyChecker.com criticized BeSafeRx, the U.S. Food and Drug Administration’s online pharmacy public education campaign, for implying that all online pharmacies located outside the U.S. are fake pharmacies. BeSafeRx discourages Americans who cannot afford medicine at their local pharmacies from accessing medicine online internationally, which has been shown to be safe if done properly. Real pharmacies in Canada and other countries sell the same medication sold here for much lower prices. Misinformation becomes a public health threat when it discourages people from finding viable ways of accessing needed medication. BeSafeRx has a new database program that enables consumers to check the license of a U.S. pharmacy found online. That’s nice, but the program reinforces the message that Americans should only buy from U.S. pharmacies, never over the Internet from foreign pharmacies. What is the FDA’s logic?

Here is an excerpt from the FDA’s website on importing prescription drugs:

FDA cannot ensure the safety and effectiveness of products that are not FDA-approved and come from unknown sources and foreign locations, or that may not have been manufactured under proper conditions. These unknowns put patient’s health at risk if they cannot be sure of the products identity, purity, and source. For these reasons, FDA recommends only obtaining medicines from legal sources in the U.S.

Just because the FDA does not vouch for prescription medication sold in other countries does not mean that prescription medications sold abroad are less safe than those sold domestically. There are other national drug regulatory authorities to help safeguard medication. For example, Health Canada’s Therapeutic Products Directorate approves and regulates drugs in Canada in almost exactly the same way the FDA does here. Americans who order medication from safe international online pharmacies, such as those verified by PharmacyChecker.com, receive medication regulated under the authority of a foreign country.

Millions of Americans who have safely purchased prescription medication online from a foreign pharmacy simply do not believe the FDA and many are starting to speak up on why they need to personally import medication. They deserve the FDA’s undivided attention.

The new FDA database is only helpful if you need to check the license of a U.S. pharmacy found online with prices you can afford. If you can’t afford to pay a pharmacy’s prices, the safety of its medications are irrelevant.

With tens of millions of Americans forgoing prescribed medication each year due to cost, the FDA should spend more time trying to help people find safe AND affordable medication, and less time scaring them away from it.

New York’s Medication Spending Problem: How Much Are You Wasting?

On April 25, 2013, in Drug Prices, Medication non-adherence, Saving Money on Prescription Drugs, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

New research by Express Scripts shows that our nation is wasting $418 billion dollars annually on excess medication-related expenses. To our dismay, our home state of New York was near the top of the list of wasters, spending an extra $1,411 per resident due to our failure to purchase the lowest priced medicine, use the most cost effective pharmacy, and – worst of all – properly take medication.

Not surprisingly, one of the main problems identified by Express Scripts was failure to use a generic substitute for brand name medicine. However, not all brand name medicines have generic counterparts! Many New Yorkers (and people from other states, too) turn to online pharmacies to save. In fact, by ordering many brand medications from verified international online pharmacies, New Yorkers and all Americans could save well over $1,411 annually.

As examples, check out the savings on Advair Diskus, Abilify, and Crestor below. For prices on other brand name medications from verified online pharmacies, compare drug prices on PharmacyChecker.com.

Advair Diskus:
Advair Diskus is one of the most popular maintenance medications for asthma and chronic obstructive pulmonary disease. Savings on a three-month supply by ordering internationally online instead of a local pharmacy in New York City are $1,184. Over the course of a year, that’s $4,736!

Three-Month Supply of Advair Diskus (250-50mcg) Cost

	Price	Savings over Local Pharmacy	Percent Savings
Local NY Pharmacy:	$2,214	–	–
International Online Pharmacy	$330	$1,184	81%

Local pharmacy in New York City, International Online Pharmacy price as found on PharmacyChecker.com. Prices collected 10/24/2012

Abilify:
Abilify, used to treat schizophrenia, bipolar I disorder, major depressive disorder, and other conditions, costs just over $2,200 for a 90-day supply. When ordered from a verified international online pharmacy, the price drops to $330. That’s $1,870 for three months of medicine. Over the year that’s $7,480. That’s the amount of medication-related wasted spending for over 5 New Yorkers.

Three-Month Supply of Abilify (10 mg) Cost

	Price	Savings over Local Pharmacy	Percent Savings
Local Pharmacy:	$2,214	–	–
International Online Pharmacy	$330	$1,184	81%

Local pharmacy in New York City, International Online Pharmacy price as found on PharmacyChecker.com. Prices collected 10/24/2012

Crestor:
Spending on Crestor, a medication used to treat conditions including hyperlipidemia, mixed dyslipidemia, and hypertriglyceridemia, has increased by over 250% from 2007 to 2011, from $1.7 billion to $4.4 billion. So how big are the savings? For a three-month supply, you can save $580. Over the year, that’s $2,320.

Three-Month Supply of Crestor (10 mg) Cost

Program	Price	Savings over Local Pharmacy	Percent savings
U.S. Local Pharmacy	$632.97	—	—
International Online Pharmacy	$52.20	$580.77	92%

Local pharmacy in New York City, International Online Pharmacy price as found on PharmacyChecker.com. Prices collected 11/26/2012. International Online Pharmacy prices calculated from 84 pills.

Lexapro, Zoloft, and Prozac: The Best Savings

On April 18, 2013, in Drug Prices, Prescription Drug Reports, by Sam Werbalowsky

About 30 million Americans take anti-depressants,which mean that their prices greatly impact our national medicine bill. Belonging to a class known as selective serotonin reuptake inhibitors (SSRI’s), Lexapro, Zoloft, and Prozac are among the most popular brand name antidepressants available. While all three of these medications – and other SSRI’s – are available as generics, if you’re paying out-of-pocket, finding the best price isn’t usually as simple as walking into your local pharmacy…

Generic SSRI’s At My Local Pharmacy
Zoloft and Prozac have been available as generics since 2007 and 2001, respectively. The price for the brands are incredibly high – $558 for 90 pills of Zoloft (100 mg) and $720 for 90 pills of Prozac (10 mg). Luckily, the generic prices are much lower. Generic Zoloft, known as sertraline, is $146.97 at my local pharmacy for 90 pills. Generic Prozac – called fluoxetine – is only $15.99.

The $15.99 for 90 pills (10 mg) of fluoxetine, is a great deal, but it can still be beat!In my research, the price at most brick-and-mortar pharmacies using a drug coupon was between $15 and $17.Oneeven better price was through a U.S.-based online pharmacy, where it was $9.50 for 90 pills.

The real savings comes in the search for generic Zoloft. There is absolutely no need to pay $146.97 for 90 pills (100 mg), the price mentioned above at mylocal pharmacy. A drug discount card can reduce the price to around $65. And a drug coupon can bring it down to around $15 at many pharmacies in my neighborhood.That’s an 89% savings, and just over $500 saved annually.

When a generic is first introduced, there are usually only one or two companies making the product, so the price remains high:case in point, Lexapro (escitalopram). Ninety pills (10 mg)are$351.89. Using a discount card or drug coupon reduces the price to $38.46.However, Costco crushes the competition, selling it for around $11.40. That’s an amazing97% savings, and just over $1,350 annually.

Brand Name SSRI’s
If you need the brand name SSRI, the lowest prices are found internationally. Just make sure the pharmacy is verified by a third party, such as those listed on PharmacyChecker.com. The average savings on brand name Lexapro, Prozac, and Zoloft from international pharmaciesis 82%. View the savings chart below:

Savings on Lexapro (10 mg, 90 pills)

Pharmacy	Price	Savings
Local Pharmacy	$590.97	–
International Online Pharmacy	$84.60	$506.37
Annual Savings:$2,025.48

Costco.com price calculated from 100 pills

Savings on Prozac (10 mg, 90 pills)

Pharmacy	Price	Savings
Local Pharmacy	$720.00	–
International Online Pharmacy	$188.10	$531.90
Annual Savings: $2,127.60

Savings on Zoloft (100 mg, 90 pills)

Pharmacy	Price	Savings
Local Pharmacy	$558.00	–
International Online Pharmacy	$60.30	$497.70
Annual Savings: $1,990.80

The bottom line here is to check all of your options before buying generic or brand name antidepressants. Your best bets for generic Zoloft, Prozac, or Lexapro are definitely drug discount cards or coupons. You may want to print out a few different coupons and discount cards available on the internet and then bring them to a few pharmacies to compare prices. If you want or need the brand, international online pharmacies offer incredibly low prices and potentially thousands of dollars in savings each year.

Americans Speak Up in RxRights Video Testimonials About International Online Pharmacies

On April 11, 2013, in Advocacy, Online Pharmacies, Personal Drug Importation, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

We applaud RxRights.org for its critical advocacy efforts on behalf of Americans who are struggling to afford prescription medication, including recent actions to defend the truth about safe international online pharmacies and savings. One new blog post features three video testimonials from Americans who import their medication, and another explains the facts about international online pharmacies. Check out Gary’s story:

First, Gary and the other Americans who offered testimonials should be commended for having the courage to speak up about ordering medication from international online pharmacies and discussing their drug affordability problems.

Gary orders his diabetes medication from Canada so he doesn’t have to forgo other needed household goods. He has been buying medication from Canada for many years and has “never had the first bit of problems.” But the drug companies – and even the FDA – will lead you to believe that this is dangerous! So why is Gary so comfortable using international online pharmacies?

Well, the other blog post gives us the answer: The only real difference between medications sent by mail from a licensed international pharmacy and what you can find in a neighborhood pharmacy is the cost. In fact, you can save between 50 and 80 percent by ordering online internationally and receive the same exact medicine!

To view the other testimonials, click here.

To read more facts about international online pharmacies, visit this post.

The Price of Gleevec: A Tale of Two Supreme Courts

On April 5, 2013, in Drug Importation, Drug Prices, Politics, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

Americans interested in generic drug prices and pharmaceutical patent law have been closely following the U.S. Supreme Court as it hears arguments in a case over “pay-for-delay” – the practice of brand-name drug-makers seeking greater profits by paying off generic manufacturers to delay introduction of low-cost generic drugs. If “pay-for-delay” tactics are declared unconstitutional, then generics would reach pharmacy shelves faster, translating to lower prices for consumers, health insurers, and taxpayers.

The Court’s decision isn’t expected until June, but last Monday the Supreme Court of another country rendered another decision related to generics that may affect American prices. India’s Supreme Court ruled against the drug company Novartis’ patent claim on Gleevec, a cancer medication. Since India’s decision allows drug companies to continue manufacturing generic versions of Gleevec, called imatinib mesylate, prices will remain exceedingly low in India and low-income countries that import Indian pharmaceuticals.

So how much cheaper is generic Gleevec in Indian pharmacies than brand name Gleevec in American pharmacies? The New York Times reported that a one-year supply of brand name Gleevec in the U.S. is a staggering $70,000. The generic in India is only $2,500!

Additionally, even though Gleevec is under patent in other high-income countries like it is in the U.S., it is far less expensive internationally. At a local New York City pharmacy the price for 30 pills of Gleevec (400mg) is $6,980. The same brand name Gleevec (400 mg) from a Canadian pharmacy is just under $3,700. The same drug (but marketed by Novartis as Glivic), can be ordered online from Turkey for $2,979. That’s a potential savings of $4,000 a month! If you choose to buy Gleevec or any medication online, to protect your health, stick to verified online pharmacies, such as those approved by PharmacyChecker.com.

In the wake of the Indian Supreme Court’s decision, it would not be surprising if Novartis reacts by raising Gleevec prices here in America to bolster profits. Governments of other high-income countries probably won’t allow Novartis to raise prices on Gleevec, due to price controls. This is patently unfair to Americans, who should not have to pay so much more for the same medication than citizens of other high-income countries.

Opposition Mounts to Control by NABP of “.Pharmacy” Web Domain – Seen as Threat to Consumers Seeking Affordable Medication from Pharmacies Outside U.S.

On March 29, 2013, in Advocacy, Personal Drug Importation, Pharmaceutical Industry, by Gabriel Levitt, Vice President, PharmacyChecker.com

The National Association of Boards of Pharmacy (NABP) has applied to the Internet Corporation for Assigned Names and Numbers (ICANN) to operate the registry .Pharmacy (dot pharmacy). Opposition to the application is picking up steam. Many believe that NABP’s efforts will merely serve to protect U.S. pharmacy and pharmaceutical interests at the expense of the public health by barring competition from safe non-U.S., international online pharmacies, which sell the same prescription drugs sold in the U.S. at a much lower price. Not only is the NABP application to ICANN is funded by pharmaceutical companies, but NABP’s named “Partners” in the ICANN application include Eli Lilly, a large drug company and the National Association of Chain Drugstores, a trade association representing the largest American pharmacy chains.

Opposition to NABP’s application to ICANN for .Pharmacy Registry

Public Citizen Position on NABPs Application to ICANN for .Pharmacy

RxRights.org Position on NABPs Application to ICANN for.Pharmacy

PharmacyChecker.com Position on NABPs Application to ICANN for .Pharmacy

If given the power to oversee the registry for the .Pharmacy top-level domain, the NABP would decide which websites are permitted to use the .Pharmacy ending in their web address. It appears that the NABP’s proposed registry rules would prohibit registry to websites of safe international online pharmacies (such as websites run by licensed Canadian pharmacies) if they sell internationally to Americans. The lack of a “.Pharmacy” address by such pharmacies could frighten Americans away from using them. Considering that tens of millions of Americans don’t take medication due to high U.S. drug prices, discouraging or blocking access to affordable medication is unconscionable.

As recognized in a letter sent from RxRights.org to NABP, it does not have to be this way. The goal of providing a trusted marketplace for consumers who are searching online for safe and affordable medication can be served with a .Pharmacy website program. However, to provide the greatest benefit to consumers, ALL online pharmacies, U.S., Canadian, or otherwise, that sell authentic medication and require prescriptions should be eligible to obtain a .Pharmacy site, regardless of who they sell to. Unless the NABP agrees to adopt registry rules fostering an open and free Internet, one that maximizes access to safe and affordable medication, its application should be rejected by ICANN.

Feds Target American (Not International) Pharmacies in Prescription Narcotic Crackdown

On March 22, 2013, in Controlled Drugs, Online Pharmacies, by Gabriel Levitt, Vice President, PharmacyChecker.com

The ongoing federal government crackdown on U.S. pharmacy sales of narcotic prescription medications, most notably against Walgreens in Florida, serves to remind us that prescription drug abuse is a major health problem. But only a tiny fraction of illegal prescription narcotic sales take place online, less than 1% according to Agent Robert Hill of the U.S. Drug Enforcement Agency (.4% to be exact).

The DEA seeks to shutdown a major Walgreen’s distribution center in Jupiter, Florida. As part of its investigation of Walgreens, the DEA found that one of its pharmacies was supplied 3271 bottles of oxycodone, a highly abused narcotic, during a 40-day period in a town with less than 3000 people. It appears that Walgreens knew about supply abuses but did not heed the warnings until confronted by DEA. One email obtained during the investigation shows an employee confused about how the receiving pharmacy could ”even house this many bottles.”

Walgreens (Walgreens.com) is a member of the National Association of Boards of Pharmacy Verified Internet Pharmacy Practice Sites program and LegitScript.com.

The prescription drug abuse crisis in the United States is a domestic not international or “foreign pharmacy” distribution problem. In fact, reputable international online pharmacies, based in Canada or elsewhere, do not sell controlled substances to Americans. When it comes to the Internet, Americans should use extreme caution if ordering controlled substances online by only ordering from licensed U.S. pharmacies with the proper DEA registration and in compliance with the Ryan Haight Online Pharmacy Consumer Protection Act.

Tagged with: controlled substances • Oxycontin • prescription drug abuse • walgreens

Maine Legislation Aims To Facilitate Personal Drug Importation To Lower Costs

On March 14, 2013, in Drug Importation, Politics, Saving Money on Prescription Drugs, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

The personal drug importation saga continues in the State of Maine this this week as legislators consider a bill that would allow state residents to order prescription medication from foreign pharmacies. The bill follows in the wake of – and as a response to – Maine Attorney General William Schneider’s suspension of drug importation programs last September. Pressured by local pharmacies, Schneider argued that licensed foreign pharmacies could not sell to Maine residents because they were not licensed by Maine.

As the bill’s name makes clear, An Act to Ensure Consumer Choice in the Purchase of Prescription Drugs (LD 449) aims to preserve consumer choice and facilitate personal drug importation in order to bring down drug costs. This bill calls for legal personal importation from the following countries: Australia, Canada, Israel, Japan, New Zealand, Switzerland, South Africa, and any country in the European Union or European Economic Area.

According to a December poll conducted by the Press Herald, 92% of respondents felt that state residents should be allowed to purchase prescription drugs from Canada. LD 449 has support from Governor Paul LePage and the Maine State Employees Association. The City of Portland claims it saved $3.2 million through the importation program suspended by Attorney General Schneider.

The bill also has support from private employers. Scott Wellman, CFO of Hardwood Products Company, cited savings of $638,000 over the six years that the company’s employees imported medicine through CanaRx, a Canadian international mail-order pharmacy service.

The importation bill is noteworthy for declaring the existing legal impediments to importation an “emergency,” requiring that the legislation’s provisions take immediate effect. Maine’s legislators are taking a very progressive stance on personal drug importation, one that we’ll certainly continue to closely follow.