Some consumers who order medication from safe international pharmacies are finding themselves unable to use their VISA credit cards. We hope that doesn’t interfere with their ability to access safe and affordable medication. What’s going on?

Essentially, in taking actions to stop rogue online pharmacies from selling medication, VISA’s online pharmacy policy ends up discriminating against consumers seeking affordable medication from safe international online pharmacies. It appears that VISA has adopted the online pharmacy worldview of LegitScript, a verification service that categorizes safe international online pharmacies as “unapproved” (but not “rogue”) and teams up with big pharmaceutical companies and U.S. chain pharmacies!  VISA’s policy may set a precedent for more credit card payment processors; discontinued service to rogue pharmacy websites is good, but if service is discontinued to safe international online pharmacies, including ones approved by PharmacyChecker.com, that’s bad. (more…)

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Nexium OTC or Prescription Nexium: Singing the Generic Blues as Esomeprazole Magnesium Stays Purple

Last June we wrote about how Americans taking Nexium – AstraZeneca’s multibillion dollar proton pump inhibitor that treats gastro esophageal reflux disease (GERD) – were losing out on savings due to the FDA’s postponement of a generic version in the U.S. market. Well, it looks like they’re going to wait even longer to find generic copies of the Purple Pill at local pharmacies (and the generic versions probably won’t be purple!). Initially, Indian pharmaceutical company Ranbaxy held exclusive marketing approval to sell generic Nexium in the U.S., but they were banned from actually selling it due to poor manufacturing practices. Well, last week the FDA revoked both Ranbaxy’s approval and its marketing exclusivity for generic Nexium. That might be good for the Purple Pill’s profits (say it fast) – but it leaves consumers singing the blues.

Cash paying Americans are left with the following domestic options: Prescription-strength (40 mg), Nexium or Nexium OTC (20 mg). Prescription-strength Nexium will run you about $600 for 60 pills. That’s a ridiculous price. It’s only $70 to get 126 capsules of Nexium OTC! So, can you just buy Nexium OTC instead of prescription-strength Nexium and just take two pills?

You might be able to, but you need to ask your doctor, pharmacist, or other healthcare provider. I asked my local pharmacist if I could just take OTC Nexium instead, and without hesitation she said I could, but that it may not be as effective and that it comes as a tablet rather than a capsule. The OTC version also has different inactive ingredients, I was told, so if you are allergic to any of those, you should stick with the 40 mg version. She suggested OTC Nexium if I couldn’t make a trip to my doctor or if my insurance didn’t cover prescription Nexium. Even if Nexium is covered, it might be a tier 2 or 3 drug, which could result in your co-pay being higher than the OTC cost.

We’d feel remiss in not reminding you that there are a plethora of proton pump inhibitors on the U.S. market, many that come at a much lower price tag.

But if you need to stick with prescription-strength 40 mg Nexium, it is available from international online pharmacies: 60 pills would be about $50, so it’s actually a better deal than Nexium OTC in the U.S. It’s worth noting that just like the OTC 20 mg pill, the 40 mg purple pill is sold as a tablet, not a capsule, in many foreign markets. You can view our comparisons of Nexium prices.

Hopefully we see these delays sorted out, and a generic version of 40 mg Nexium finally come to market in America. Until then, Nexium OTC at your local drugstore or ordering from an international online pharmacy may be your best options to avoid the drug price blues.

 

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A Letter to the ICANN Community

Today, the Wall Street Journal reported on the subject s of rogue online pharmacies and the Internet Corporation for Assigned Names and Numbers (ICANN). The gist of the article is that ICANN is not doing enough to stop dangerous pharmacy websites. There is reason to believe that ICANN could do more but it could also do too much to the detriment of consumers who cannot afford medication locally. There’s an appropriate middle ground for getting rid of rogue pharmacy sites, but not overreaching and ending online access to safe and affordable medication. Willfully ending such access threatens the public health and treads on global norms relating to human rights and access to medications.

Earlier this month I attended an ICANN conference for the first time, which was in Los Angeles. We’ve written on several occasions about the application by the National Association of Boards of Pharmacy (NABP) to ICANN to operate a new generic top level domain (gTLD) called “.pharmacy”. To remind many of our readers, gTLDs are the endings of websites, such as .com, .org, .gov, .edu, .int, etc. The bottom line here is that we and many others believe that NABP, if its application is successful, will use its new ICANN-conferred legitimacy to stifle competition, mislead the public about online pharmacies, and in doing so curtail access by Americans and consumers worldwide to safe and affordable medication online.

I met many dedicated, interesting and well-informed people at the ICANN conference, including those serving within the ICANN community and others following it closely. To follow up with them I wrote the following letter.

(more…)

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The Online Pharmacy Propaganda Show — In the Lion’s Den Part II

Drug Companies Front and Center at PSM Interchange Conference

Drug Companies Front and Center at PSM Interchange Conference

Two weeks ago I brought you some highlights of the PhRMA-led Partnership for Safe Medicines (PSM) Interchange propaganda show, which was held on September 18th. Look over to the left. See that picture. Those logos of big pharmaceutical companies make it abundantly clear who is pushing the distorted message of PSM about personal drug importation and online pharmacies.

I’m not joking about the word “propaganda” applied to the PSM event. The online Merriam Webster dictionary provides the following definition for that word: “ideas or statements that are often false or exaggerated and that are spread in order to help a cause, a political leader, a government, etc.” In this case, as I see it, the “cause” of PSM is the commercial agenda of the pharmaceutical and U.S. pharmacy industries cynically couched behind terms of patient safety. A central message of PSM is that Americans are risking their lives buying medication online from other countries and that there is no way to do so safely. Those are false and exaggerated messages that are potentially leading lawmakers and regulators to overreact and scare Americans from a potential lifeline of affordable prescription drugs. Evidence shows that this has been PhRMA’s communications strategy for more than a decade. (more…)

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The Lion’s Den of Big Pharma’s Online Pharmacy Propaganda: 2+2=5

male_lionIn George Orwell’s famous novel 1984, published in 1949, we find a future in which totalitarian, one-party rule has run amuck on a global scale. It is a world in which whatever “The Party” (think Communist or Nazis) states is a fact must be believed, regardless of the obtuse logic and propagandistic origins of that so called “fact.” The quintessential and frightening example provided by Orwell is the notion that 2+2=5 if The Party Say’s so. When I attended the Partnership for Safe Medicines (PSM) conference last week, it felt as if many people were willing to believe absurd notions about online pharmacies. Most positions espoused at PSM’s conference support the following fallacious statement: IF an online pharmacy is not based in the U.S. and sells prescription drugs to the U.S. THEN it is dangerous. They essentially put on a show in which different people in a myriad of ways communicate that 2+2=5.

The event, called the PSM Interchange, is a Lion’s Den with many people who are directly paid by drug companies, indirectly paid by drug companies, U.S. pharmacies or their trade groups, or those who would like to be paid by the aforementioned entities someday, either directly or indirectly. PSM’s stated mission, “working together to protect the safety of your prescription drugs,” is, it seems, a smoke screen for big drug companies working together to keep drug prices as high as possible in their most cherished market – America. (more…)

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TechDirt Founder Mike Masnick Hits the Nail on the Online Pharmacy Head

In writing about the web domain company EasyDNS’ online pharmacy policy, Mike Masnick, founder of award-winning technology and business innovation blog Techdirt, makes the following observation:

“Fake and dangerous drugs from rogue pharmacies are a real (if relatively small) problem. Legitimate foreign pharmacies selling into the US at cheaper prices are a made up problem by US drug companies. But those US drug companies like to take the “small” problem, and blame it on any non-US pharmacy in an attempt to block out the competition.”

Thank you Mike for expressing that so clearly! The essence of TechDirt is to “analyze and offer insight into news stories about changes in government policy, technology and legal issues that affect companies’ ability to innovate and grow.” Innovation via the Internet has allowed consumers who can’t afford their medicine domestically to access it through foreign pharmacies. The pharmaceutical industry and its well-funded agents are getting away with murder by pressuring online “gatekeepers” such as domain registrars, search engines, and credit card companies to disallow service to pharmacies that American consumers have come to rely on.

To some in the public health community and in government, Mike’s expression of rogue online pharmacies as a “relatively small” problem” may come across as flippant and even naïve – but it cuts much deeper than that. The question is relative to what? If he means relative to the public health crisis of high drug prices in America then Mike is entirely correct: rogue online pharmacies are a small problem compared to high drug prices in America. Far more Americans are getting sick and/or dying because they can’t afford medication at home than they are from dangerous online pharmacy purchases.

That does not excuse the actions of rogue pharmacy websites that endanger the health of consumers. That’s precisely why EasyDNS’ decision to only provide service to online pharmacies if they are approved by LegitScript or PharmacyChecker is visionary. It does not let dangerous pharmacy websites exist, but it refuses to succumb to a protectionist, anti-consumer, big pharma initiative to snuff out innovative business models – safe international online pharmacy – that hinder their profit-making machine and grossly disadvantage consumers.

Rock on TechDirt!

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EasyDI’m writing this blog post to say thank you to a domain registrar called EasyDNS and its CEO, Mark Jeftovic, and to talk about what’s up with registrars and online pharmacies, as it could affect your online access to safe and affordable medication. EasyDNS’s new online pharmacy policy denies service to rogue online pharmacies but not safe online pharmacies.  It will accomplish this policy by providing service to online pharmacies only if they are approved by LegitScript or PharmacyChecker.

In short, domain registrars are companies that help people obtain website names; names such as www.rxrights.org, www.doctorswithoutborders.org, www.WebMD.com, www.nytimes.com, etc.  The most popular of these registrars in America is Go Daddy. If all registrars deny service to a person or a company, such as a rogue online pharmacy, then it cannot reach the public. If all registrars deny service to safe online pharmacies with very low drug prices then the public will not have access to them.

Our friends at RxRights gave a strong shout out to EasyDNS this week as well.

You might be thinking that this is no big deal. Who wouldn’t want to stop rogue pharmacy sites but allow safe, low-cost online pharmacies to operate? Well, earlier this year the National Association of Boards of Pharmacy (NABP) sent letters out to 200 registrars telling them to take down websites that NABP doesn’t recommend. No matter how safe it might be, the NABP does not recommend any international online pharmacy that sells to Americans, instead unfairly calling them rogue sites.

Popular Internet freedom blog Techdirt published an article about NABP called, “Pharmacy Group Lies To Registrars: If We Complain About A Site, It Must Be Taken Down No Questions Asked.”  It wrote: “The NABP is basically an organization designed to artificially inflate the price of drugs in the US, cynically using highly questionable claims to pretend that they’re focused on ‘public safety.’”

For the record, there is not a single reported death by a person who ordered from an international online pharmacy, ones that NABP calls “rogue,” that requires a valid prescription and fills orders through licensed pharmacies. The industry has been around for about fifteen years now. (more…)

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In online pharmacy news, the major story today is that FedEx was indicted for distributing controlled prescription drugs for Internet pharmacies to people who did not have valid prescriptions. FedEx claims it is not guilty and that its indictment and potential prosecution threaten a key principle of its business ethics and federal law: don’t open the mail. FedEx also says that for years they have asked the DEA for a list of targeted illegal online pharmacies but have not received one and that it cannot be expected to act as a law enforcement agency. The U.S. Department of Justice alleges that FedEx specifically “conspired” with two online pharmacies selling controlled drugs without proper prescriptions.

I’m departing from this media hot topic (better you read it in Bloomberg, USA Today, etc) to give you some backstory on controlled drugs and Internet sales. Our blog’s usual focus is on consumers seeking non-controlled prescription drugs online, and the PharmacyChecker.com Verification bans online pharmacies that sell controlled without a valid prescription, and all international online pharmacies that sell controlled drugs into the U.S. However, some Americans try to obtain prescription narcotics and other controlled drugs without a prescription online, which can turn out deadly. (more…)

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In our recent public comments to the U.S. Food and Drug administration, we invoked your concerns with new FDA regulations to implement Section 708 of the Food and Drug Administration Safety and Innovation Act (FDASIA) for destroying safe (and affordable) medications imported for personal use. We issued a press release on the issue as well. Here are three of almost 2000 comments:

Morton Ross, Palm Harbor, FL 2014-04-03, “The Meds I take daily, are the difference between ‘Life and Death’. I cannot afford the higher prices at local pharmacies.”

Darilyn Schlie, Fort Worth, TX 2014-04-03, “Without the ability to go outside the US, I will not be able to afford the medication I need.”

James Marshall, Nashville, TN 2014-04-03, “I have emphysema and could not afford my medications if not for being able to order some of them from outside the USA.”

We need more voices! Working with RxRights.org, you can send a message to the Secretary of Health and Human Services stating your concerns, asking that she prevent morally unjust and dangerous refusals and destructions of imported drugs for personal use. The messaging process is easy and together we can win this!

The situation is not dire…yet. The regulation has not taken effect and it’s uncertain what its impact will actually be. Currently, the conventional wisdom holds that the chances of your prescription order being detained by U.S. Customs is less than 1%. What we don’t know is if the new regulations will change that dramatically.

What we do know is that FDA issued a proposed rule in May to implement Section 708, which is deceptively called “Destruction of Adulterated, Misbranded, or Counterfeit Drugs Offered for Import.” Destroying adulterated and counterfeit drugs sounds like a good plan but many, if not most, ‘misbranded drugs’ sold in foreign pharmacies are actually the same drugs you can buy at your local pharmacy just with different labeling and packaging. Though sometimes manufactured in a plant not registered with the FDA, they are manufactured in plants registered with another drug regulatory authority. Or they might be a generic version of a brand name drug that is approved in the U.S. but not yet off-patent here. These examples of real, safe and effective medications are usually deemed ‘misbranded’ or ‘unapproved’ by FDA. For more on this see my New York Times op-ed.

To Congress’ credit, before Section 708 goes into effect, regulations must be drafted requiring that consumers, 1) receive notification that their prescription drug orders have been refused import and 2) are provided “appropriate due process” to defend their drug imports before they are destroyed. Unfortunately, as I read it, FDA’s proposed rule did not assure consumers “appropriate” due process. In our comments we proposed that FDA clearly explain to consumers why their drug imports were refused and exactly how consumers can provide testimony to prevent the FDA from destroying their imported drugs. In the final rule, consumers should be able to successfully defend refused drug imports of safe and prescribed medication to have them released not destroyed. They need those medications to safeguard their health, and sometimes even lives.

We also proposed a revision to FDA’s personal drug importation policy so that safe personally imported medication from certain countries with very strong pharmaceutical regulations and pharmacy standards would not be detained or refused. We also recommended continuing actions to shutdown dangerous rouge pharmacy sites but not obtusely conflating them with safe international online pharmacies.

See below to learn more and advocate.

Petition the Government!

Comments by Americans concerned with Section 708

Comments by PharmacyChecker.com to the FDA on Section 708

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Each year, FDA participates in Pangea, a global operation that identifies and shuts down rogue Internet pharmacies, seizes allegedly dangerous medication, and arrests those responsible. We like that Pangea takes actions against rogue online pharmacies that threaten the public health. However, media stories about Pangea can frighten the American public away from safe online sources of affordable prescription medication because they often assert that foreign online pharmacies are all dangerous, which is absurd.

Thankfully, Dan Mangan of CNBC News reminded Americans last week that there are safe international online pharmacies. His article, “Patients cross borders for online deals on medication” explains that PharmacyChecker.com was created to help consumers avoid fake online pharmacies and have peace of mind when shopping for medication internationally. Lee Graczyk, head of RxRights.org, let them know why this is so important: “For some folks, this is the most viable way for them to fill their prescription at a price they can afford.”

The article points out that despite Federal restrictions, Americans purchase medication from outside the United States for personal use. Though the FDA does advise against personal drug importation (wrongly in our opinion), its enforcement is focused on large scale drug importation of medication by doctors, providers, or wholesalers, not individuals. In fact, FDA has never prosecuted anyone for importing medication for personal use. The article also brings up Maine’s recent law that removed state restrictions on personal drug importation. A similar bill was introduced in the South Carolina legislature.

Residents of these states want to facilitate drug importation to help people like Bill. As Mr. Mangan reports, Bill, a resident of New York City, was prescribed Copaxone for macular degeneration. Because Copaxone is not FDA-approved for that condition, Medicare didn’t cover it, leaving him with a ridiculously high out-of-pocket cost. At the suggestion of his doctor, Bill used a Canadian pharmacy. Instead of paying about $5,000 for a 28-day supply, he paid $1,200.

We’re happy with Mr. Mangan’s reporting, as coverage of crackdowns against dangerous pharmacy websites should include balanced information. His coverage included information collected from both supporters for and against personal drug importation and international online pharmacies, and he should be applauded for doing so.

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