A story last Friday on ABC News’s 20/20 featured the topic of counterfeit drugs, their dangers and where they’re being sold. The story was helpful in educating the public about the threat of counterfeit drugs but it really seemed to play along with a misleading narrative, one propagated by the drug companies, that foreign medications are the same as counterfeit drugs. I’ve debunked this nonsense before: affordable and safe medications sold from foreign pharmacies are not the same as counterfeit drugs. 

Also, as part of its feature on counterfeits, ABC’s website has a section called “How to Order Prescription Drugs Safely Online” that looks to the Alliance for Safe Online Pharmacies (ASOP) for useful consumer information.  ASOP is financed and operated by big corporate pharmaceutical interests that oppose personal drug importation from safe online pharmacies. If you have great health insurance that covers all of your medications, or lots of money to cover exceedingly high out of pocket prescription drug costs, then the recommendations of ASOP might work for you because they recommend big U.S. chain pharmacies, such as Walgreens and CVS, which charge the world’s highest prices for medication. Many other Americans actually NEED safe international online pharmacies, which ASOP would call unapproved or even “rogue.”

It its story, ABC investigative journalists tracked down people selling prescription medications on the street, from push carts, even in clothing stores – usually in relatively poor neighborhoods. Eventually those people were arrested, all for the viewing audience to see. According to the federal agents involved, some of the medications seized were counterfeit and people did not have to provide a prescription to buy prescription drugs. The story was very troubling. Indeed, it was a powerful indictment of our society, one in which drug prices are so outrageously high that people, such as undocumented immigrants without health insurance, look to street peddlers to find affordable medication.

ABC also covered what are known as “Storefront” pharmacies, which are located throughout the country, often in strip malls, where people go to buy medications from pharmacies in other countries by mail order. These storefronts usually have titles that include the words “Canada,” or “Canadian,” and “Drugs,” “meds,” “medicine,” “Rx,” etc., which indicate that a person can acquire medicine from Canada. ABC wanted to highlight that the medications ordered at these places often do not come from Canadian pharmacies but from other countries. ABC’s implication is that people are being misled. On the other hand, when watching the show, it appeared that storefront personnel did communicate that the orders would not come from Canada so I’m not clear on what’s going on here. We wrote a piece about online pharmacies related to this issue: “So You Want to Buy Cheap Medicine from an Actual Canadian Pharmacy. Here’s the Deal.”

We do not verify storefronts but we believe that some of them are essentially people and companies that help Americans place prescription drug orders from foreign pharmacies that require a valid prescription. In fact, through ABC’s mystery shopping (meaning purchasing prescription drugs from storefronts) they were required to submit valid prescriptions and did so. A few weeks later the journalists received four medications, two of them brand, Viagra and Zocor, coming from Singapore and the UK, and two generics, tadalafil (the brand version known as Cialis) and finasteride (the brand version known as Propecia), both Indian drug products.

The story made it seem as if the two generics were either substandard or counterfeit, as it was noted they contained “impurities” or “unknown ingredients”. What ABC News did not communicate is that the so-called “impurities” or “unknown ingredients” might be acceptable inactive ingredients, excipients, etc., just different from those in the brand versions sold in the U.S. This is normal: generic drugs in the U.S. often have different inactive ingredients from their brand name counterparts. When the Indian generics were chemically tested, ABC showed the results as “fail” but didn’t tell you that generics sold in U.S. pharmacies would likely have failed as well if given that same test because they are not the exact same as the brand in terms of inactive ingredients.

Also, when ABC reported that most of the medicines did not meet FDA standards, it didn’t explain that simply having a label designed for a different country automatically means it does not meet FDA standards, regardless of the medication’s actual safety. In short, foreign sourced medications are often safe and effective products, approved for sale in the countries from which they are dispensed – but not counterfeit or substandard.

It’s important to note that the generics received by the journalists came from India, and, as we’ve written about before, India does have more problems with low quality and counterfeit drugs than in the U.S. or other rich countries. At the same time, India is the largest source of generic medications, exporting across the globe to wealthy, middle income and poor countries. In fact, 40% of generics sold in U.S. pharmacies are from India.  It’s well known that the top Indian drug companies excel at making high quality, safe and effective prescription medications, but even among them problems exist, too.

On a closing note about ABC’s coverage of counterfeit drugs, I encourage our readers to look at the consumer comments section on ABC’s website.  People don’t believe the big drug company propaganda, or even our trusted regulatory authorities like the FDA. That bothers me because the FDA is right that there are rogue pharmacy operators out there, often online, but they’re wrong not to acknowledge the relative safety and public health benefits of safe international online pharmacies. Hopefully ABC will really investigate

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As you’ll discover below, the Obama administration’s policies to combat the manufacture and sale of counterfeit medications have a lot to do with furthering the agenda of the pharmaceutical industry in discouraging and curtailing online access by Americans to safe and affordable medication. Remember “The Deal” between the Obama administration and Big Pharma, in the form of the Pharmaceutical Researchers and Manufacturers of America (PhRMA), in which the Obama administration agreed to abandon supporting drug importation legal reform to lower drug prices for Americans if PhRMA would support Obamacare? I’ve always wondered how far that deal went.

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

(more…)

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There are potentially tens of thousands of dangerous pharmacy websites, sometimes referred to as “rogue online pharmacies,” polluting the Internet and endangering the health of consumers worldwide. There are a much smaller group of safe domestic online pharmacies. Then there are an even smaller group of safe international online pharmacies, ones that we have verified, that sell many medications at much lower cost. However, when Americans purchase from these international online pharmacies (often because they can’t afford medication domestically) and import safe and effective medications, they are under most circumstances violating U.S. laws, which poses a quandary for regulators, public health officials, and even some people working over at Big Pharma. What’s right and wrong? How do we get rid of the rogues without overreaching and endangering public health by stopping Americans from obtaining safe medication internationally over the Internet?

In our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

(more…)

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Well, here we go again, another bill that would formally legalize a practice that has been going on for decades: Americans importing meds from Canadian pharmacies, at the very least to cut down on their drug bills, and in some cases even to afford life-saving medicines. Sorry to sound cynical, but I’ve seen these bills before and Big Pharma is always behind their failure – but what about this time?

The bill, H.R. 2228, was introduced by Representative Chellie Pingree (D-ME) barely a week ago and co-sponsored by Dana Rohrabacher (R-CA), and is entitled “Safe and Affordable Drugs from Canada Act of 2015.” It seems to mirror legislation in the Senate, S. 122, introduced by Sens. John McCain (R-NV) and Amy Klobuchar (D-MN), which has the same title.

The bills are focused on Canadian pharmacies only, not the wider landscape of international online pharmacies, which are often based in Canada: ones that millions of Americans have benefited from for over a decade. If H.R. 2228 passes, the FDA would be required to publish a list of approved Canadian pharmacies from which Americans could legally import, for personal use, non-controlled, non-biologic, and non-temperature sensitive, prescription medications. That would include the majority of maintenance prescription drugs that Americans are currently importing for personal use.

I support this bill 100%. Even though our program is open to safe and licensed pharmacies in other countries, not just ones in Canada and the U.S., the new bill moves the public policy and economic justice needle in the right direction. The practice of international pharmacy began with Americans crossing the border to buy lower cost medications in Canada and then, with the advent of the Internet, buying through mail order. Current law, technically, bans the practice and, unjustly, views it as a criminal act – even though no one has been prosecuted for it. The new bill in the House and Senate would lift the unethical ban on buying lower cost medications for their own use from Canada. Amen and Word Up to that!

So head on over to RxRights.org to contact your elected representatives and let them know you want them to vote for the Safe and Affordable Drugs from Canada Act of 2015!

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Americans and others living in America used to see advertisements on Google for low-cost and safe international online pharmacies but now they don’t. That’s because, back in 2010, Google banned all non-U.S. online pharmacies, safe or otherwise, from its advertising platform that targets the United States and its people, a demographic urgently in need of lower drug prices! Why would they do that? Who does that benefit? Who does it hurt?

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

(more…)

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Buying Xarelto Online Could Save Your Life If the Price is Too High Locally

Sorry to sound macabre, but you could die if you don’t fill and adhere to your healthcare practitioner’s prescription for Xarelto (ravaroxaban). It is an anticoagulant, a medication that lowers the rate of blood clots and thereby lowers the risk of stroke. Especially if you were diagnosed with Atrial Fibrillation, a condition characterized by problems associated with irregular heart rate or rhythm, it’s likely that you were prescribed an anticoagulant, such as Xarelto, Pradaxa, or Warfarin. I’m talking about Xarelto because it’s a relatively new brand name drug, which is not available as a generic, and some people who need it might not be able to afford it. It is not necessarily the best anticoagulant out there for you. Alternative medications are available and in use.

If you don’t have insurance or your insurance does not cover Xarelto, then you could face the out-of-pocket costs, which are about $1,176 for a three-month supply of the 20mg pill. If you can afford that then consider yourself lucky. For those who cannot, you could try a Xarelto patient assistance program. Alternatively, ask your doctor or other healthcare provider, and do your own research about another anti-coagulant, such as Pradaxa and Warfarin, that could work for you.

If you do not qualify for a patient assistance program, and your healthcare provider insists on Xarelto, there are verified international online pharmacies that sell brand name Xarelto at a very low price. In fact, the lowest cost international option runs you $2.08/pill, which is $187.20 for 90 tablets. That’s a savings of 84% or almost $1,000 over three months, $4,000 over the course of a year, versus the cash price at some U.S. pharmacies.

For those interested in where your medications come from: the Xarelto 20mg you buy in the U.S. is manufactured in Puerto Rico, according to the U.S. label. Our research shows that the lowest cost international option for Xarelto was manufactured in Germany by Bayer Pharma AG.

I started this post noting the mortality risks of not taking prescribed medications. I’d like to now return to this public health issue not in order to inflame or dramatize but to remind consumers and health officials about the public crisis of high drug prices. Strokes often cause death. Not taking your prescribed anticoagulant can increase your chance of having a stroke. Thirty-five million Americans don’t fill a prescription each year due to high prices; if Xarelto was one of these medicines, then its high price may have prevented people from obtaining it. Some of those people, unfortunately, may have had strokes and passed away. The point here is to not ignore your healthcare provider’s prescription and advice. Follow-up quickly and fill your prescription. If you can’t afford it, then pursue all available options.

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Is it legal to order medications online? Yes. If you live in the U.S., you can legally order medications online for mail order, such as from Walgreens or CVS. Is it legal to order medications from an online pharmacy located in a foreign country – to personally import it? Technically, no; but people who import small quantities of prescription medication for their own use, according to the FDA, are not prosecuted for doing so. There are a lot of nuances and quirky details when it comes to laws and regulations that apply to online pharmacies. Some laws are there to protect your health and safety; others seem more bent on protecting the profits of big drug companies – and there’s a lot in between. It’s complicated.

So this week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

(more…)

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25%, 20%, 10%, 5%, 2%, 1%?

A few years back, the FDA published the results of a survey from 2012 that showed 23% of Internet users purchase medication online. That number has been used by a variety of groups funded by pharmaceutical companies and U.S. pharmacy corporations, and apparently the Government Accountability Office, to imply that a quarter of the U.S. population is buying medication from dangerous rogue online pharmacy sites. The number is probably lower than 2%, which is still too high but it’s important that the public and our elected leaders face and tackle the online pharmacy problems that really exist, not fake ones that distort public perception and serve entrenched business interests…and lead to fewer Americans getting medicines they need.

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health
(more…)

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Unused Medication – What Do You Do With It?

PharmacyChecker.com’s focus is on helping consumers find safe and affordable meds online while avoiding rogue pharmacy websites. But what do people do with unused medication? Leaving unused prescription drugs in medicine cabinets at home can leave them susceptible to abuse or accidental ingestion. Unused medication includes those products that you no longer need or that are expired. Disposal methods include bringing medication to “take-back” programs in your community, safely throwing in the trash, and even flushing meds down the toilet – but there are important guidelines to ensure safety.

Medication disposal is a particularly critical issue when it comes to controlled drugs, ones susceptible to abuse, because prescription drug abuse has reached epidemic proportions in the U.S. About seven million Americans abuse prescription drugs, often powerful narcotics, such as oxycodone and Adderall, almost twice the number found to abuse illegal drugs, such as heroin and cocaine. About 70% of first time abusers get the drugs from friends or relatives, including from their medicine cabinets!

The U.S. Food and Drug Administration (FDA) recommends following the disposal instructions on the label of the drug. Don’t flush your meds down the toilet except when instructed to do so. Your community will likely have drug “take-back” programs. Call your local government offices to find them. In the absence of instructions or take back programs, the FDA recommends throwing most medications away in the household trash. Mix loose medication in a sealable bag or container with an undesirable substance such as coffee grounds or litter. It’s also recommended that you remove or scratch out any information on the prescription label so that it’s unreadable.

The FDA recommends flushing narcotic pain relievers such as fentanyl patches, morphine, Demerol, Percocet, and OxyContin, among many others, as soon as they are no longer needed because of their high risk of abuse. There are environmental concerns related to flushing medication, such water contamination. However, according to the Environmental Pro¬tection Agency, scientists to date have found no evidence of adverse human health effects from pharmaceutical residues in the environment. FDA provides a complete list of medications for flushing here.

Before throwing disposing of any medication, the FDA also recommends removing the labels on pill bottles to remove any information others might use

Drug and regulatory authorities have recently stepped up options for prescription painkiller disposal to combat the addiction epidemic. In fact, a relatively new FDA rule now allows pharmacies, doctors’ offices, and hospitals to collect controlled substances from consumers. The DEA has launched a drug collection site database to help you find one. The public may find authorized collectors in their communities by calling the DEA Office of Diversion Control’s Registration Call Center at 1-800-882-9539

What about destroying your medication?

There are products on the market for consumers and healthcare providers for disposing of medications. We DO NOT ENDORSE them but here are a few that may meet your needs help you follow the advice noted above:

Medsaway Medication Disposal System

Pill Terminator

Disposing of your medication responsibly improves safety for you, your loved ones, and everyone else that may come into contact with it.

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What does the data actually show about the safety of buying medication online? Is it really dangerous to buy lower cost medication from a pharmacy in another country over the Internet? Do drug companies fund research in this area?

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health(more…)

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