PharmacyChecker Blog

High Drug Prices Disproportionately Causing African-Americans to Cut Back on Medication

On June 11, 2013, in Advocacy, Drug Prices, Medication non-adherence, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

The latest edition of NPR’s ongoing series, The View From Black America, focuses on Americans who live within fear of financial disaster due to high drug costs. In fact, one in four African-Americans struggle to afford medication, according to a national poll conducted by NPR, The Robert Wood Johnson Foundation, and the Harvard School of Public Health.

Mike Jackson is one of the millions of Americans whose response to high drug prices was to scale back his medication (in his case, insulin). Mr. Jackson stated, “Instead of taking 60 units twice a day, I was taking 30 units twice a day….The idea behind that was if I watched what I would eat and then stay with the 30 units — I would keep my blood sugar down enough that hopefully it would not be much of a problem.” His medication cost almost $500 per month.

Mr. Jackson ended up with numbness in his foot and toes, and nerve damage in his eyes, sure signs that his diabetes had gone out of control. A trip to the ophthalmologist only added to his medical bills.

Ashley Liggins had to choose whether to purchase food, gas, or medication to control her blood pressure. When the choice comes between medicine and other essentials, like food for your family, sometimes expensive medicine may be the first to go. And this this was the decision made by Ms. Liggins, leading her to reduce doses and borrow pills from her mother.

We will continue do document cases of Americans getting sicker due to high drug prices. To take action on bringing down drug prices consider joining RxRights.org.

To listen to the NPR segment, click here.

Americans Are Unique In Their Need for Personally Imported Medication from Online Pharmacies

On June 7, 2013, in Advocacy, Drug Importation, Personal Drug Importation, by Gabriel Levitt, Vice President, PharmacyChecker.com

Among citizens of high-income countries, Americans are exceptional in their struggle to afford medication. Citizens of Japan, for example, do not have to skip medication because of its price, or at least such instances are exceedingly rare. Compare that to 50 million Americans going without a prescription each year due to cost. It’s an obvious reason why so many Americans, relative to non-Americans, are searching online for prescription medication from other countries. Fortunately, they can compare drug prices among safe online pharmacies and avoid rogue sites.

For chronic conditions – even medically expensive ones like cancer and AIDS – citizens of high income countries, except America, almost never need to access an international online pharmacy because the medication at their local pharmacy is affordable. An excellent documentary on PBS shows just how affordable medical and pharmaceutical care is in Japan. This is not to endorse another countries’ healthcare system but to clearly identify and remind our readers that high drug prices as a barrier to care is a unique American crisis among rich countries.

When consumers outside America go online to buy medication, it’s usually to purchase lifestyle drugs, such as medication for erectile dysfunction or hair loss. Due to the nature of these products, some consumers would prefer anonymity by skipping the doctor’s visit to get a prescription and instead purchase them from rogue online pharmacies without a prescription. Rogue online pharmacies are more likely to sell counterfeit and substandard products, and making all consumers aware of this protects their health. Since cost is a barrier to medication for so many Americans, making them aware of lower cost alternatives internationally is good for their health, too.

How big are the overall price differences between countries? A chart from 2005 by the Organization for Economic Cooperation and Development (OECD), showing international drug price disparities, is very revealing. It shows that the U.S. spends about twice as much per person than the average for OECD countries. Since international drug price disparities have grown considerably since 2005 on brand name drugs, the disparity between American drug prices and international has grown more severe.

Drug prices are lower internationally primarily because foreign governments control pharmaceutical prices through a variety of policy interventions. For most prescription medications, particularly for maintenance conditions, this mitigates the need to seek out lower prices online internationally. In America the need persists more so than ever.

Opposition Grows to Pharma-Funded Application by NABP for .Pharmacy to ICANN

On May 30, 2013, in Advocacy, Drug Prices, Online Pharmacies, by Gabriel Levitt, Vice President, PharmacyChecker.com

More public interest and consumer groups are hopping on the bandwagon to defend online access to safe and affordable medication. As we reported a few weeks back, the National Association of Boards of Pharmacy (NABP) has applied to the Internet Corporation for Assigned Names and Numbers to administer a generic top level domain called “.Pharmacy” (dot pharmacy). NABP proposes to block all online pharmacies that fill orders internationally to Americans from obtaining a website that ends in .Pharmacy, including ones that are safe and approved by PharmacyChecker.com. NABP’s critics, identified below, view its application as an effort to curtail consumer purchases of lower cost medicine from outside the United States. One of their main concerns is that NABP’s application is funded by Merck and Eli Lilly – big pharma: a situation prone to major conflicts of interest.

To read more about this issue see our press release.

This NABP/ICANN issue can be very confusing so I offer the following explanation. ICANN is a non-profit organization that governs the world wide web system of domain names, such as .com, .org., and .edu. For a long time the available suffixes, called generic top-level domains (gTLDs) that could be used for website names have been limited. Last year ICANN opened up a process by which companies and organizations could apply to act as registry – administrators – for new names, such as .career, .casino, .charity, etc. In theory, this could open up new opportunities for innovation and development over the Internet. However, a pharma-funded initiative to make the rules and govern the Internet in an area as critical as the distribution of prescription medication will serve only to protect business interests to the detriment of consumers.

David Moon from Demand Progress, an Internet freedom group and lead organization in battling the Stop Online Piracy Act, sums it up perfectly: “From our direct experience with NABP and its allies in Internet policy disputes, there is ample cause to believe the applicant seeks to control .pharmacy to the detriment of free speech & access to safe and affordable medication for consumers.”

Here is a list of the groups and people who have voiced opposition and concern about NABP’s application for .Pharmacy:

Canadian International Pharmacy Association (Tim Smith, President)

Demand Progress (David Moon, Program Director)

Knowledge Ecology International – KEI (James Love, Director)

Mature Voices Minnesota (Robert E. Hines, Board Chair)

PharmacyChecker.com (Tod Cooperman, MD, President and Gabriel Levitt, Vice President)

Public Citizen (Peter Maybarduk, JD, Global Access to Medicines Program Director)

Ram Kamath, PharmD (PharmacyChecker.com, Director of Pharmacy Policy and International Verifications).

RxRights.org (Lee Graczyk, Lead Organizer)

TodaysSeniorsNetwork.com (Daniel Hines)

Doctors Advocate for Lower Drug Prices to Save Lives

On May 24, 2013, in Advocacy, Drug Prices, Pharmaceutical Industry, by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, PharmacyChecker.com

A group of over 100 doctors recently banded together to declare that “lower drug prices [are] a necessity to save the lives of patients who cannot afford them,” as written in their article in Blood, the medical journal published by the American Society of Hematology. We couldn’t agree with them more.

The doctors, experts in chronic myeloid leukemia, focused particularly on the drug Gleevec (imatinib), which costs around $100,000 annually per patient in the United States. Gleevec costs around $35,000 internationally.

There is nothing politically or economically radical about their position. In fact, they acknowledge the societal and political pressures that affect drug pricing, as well as the necessity of profits by drug companies to fund future research. They simply seek fair pricing.

Unfortunately, cancer medication prices are dramatically increasing and are not “fair.” To quote the Blood article: “imatinib may have set the pace for the rising cost of cancer drugs. Initially priced at nearly $30,000 per year when it was released in 2001, its price has now increased to $92,000 in 2012 (1), despite the fact that all research costs were accounted for in the original proposed price….”

Such protests can work; last year doctors at Sloan-Kettering Memorial Hospital pressured Sanofi into effectively halving Zaltrap’s initial market price of $11,000 by offering discounts. We hope that these precedents mobilize more doctors to hop on the bandwagon to further publicize that high drug prices in the U.S. are a serious threat to the public health.

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.