A couple of news articles from the state of Maine have me wondering if more Mainers are going to start importing medication from international online pharmacies. Maine is the only state that has, through the passage of a law, removed state restrictions on personal drug importation from pharmacies in a number of countries.

An article from the Sun Journal highlights a survey designed to track the impact of the Affordable Care Act in Maine (and perhaps these findings will apply to other states, too). Both low and middle-income Maine adults are struggling with medical bills. Surprisingly, 35% of middle-income adults had problems paying bills, compared to 32% of low-income adults. Budget cuts in the state have led to thousands of residents losing Medicaid coverage, so it is likely that the numbers will worsen for low-income adults.

Speaking of budget cuts, Maine Governor Paul LePage did not choose to expand another state program, Mainecare, which helps low-income residents pay healthcare providers. Samantha Edwards, writing for WLBZ, notes that residents who were in these programs are now looking elsewhere for assistance, especially for prescription drugs. The cuts to state programs are forcing municipalities to cover the costs. Rindy Folger, of Bangor Health and Community Services, said, “Since January 1st, we have seen over seventy-five people who we have never seen before who are now coming in looking for help with their medications…Monthly right now we are paying about $9,500 in prescriptions which, over the course of the year, is a significant amount of money for the Bangor taxpayers to have to pay.”

If municipalities like Bangor are going to be picking up the tab for medication, it might be wise for them (or the state) to implement prescription drug importation programs. Portland saved $200,000 a year on health care when it served prescriptions to its employees through PortlandMeds, a prescription drug importation program. It’s very possible – and reasonable – that more municipalities will implement these programs if the Maine’s healthcare cuts continue.

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This article summarizes good things and bad that are happening online with drug prices and savings, economics, legislation, politics, and even ethics that relate to access by Americans to more affordable medication offered by safe international online pharmacies. If you’re a consumer – especially an American consumer facing high drug costs – you should read this. When you’re done (or even right now!) we recommend joining RxRights to help play a role in making medication more affordable for all Americans.

Next year, we’re planning to focus more attention on local Americans pharmacies: what they’re doing right, wrong, and in between, and how you can save and take advantage of their in-store opportunities to improve your health! But for now, the international online pharmacy report…

The Good

The money Americans could save on brand name drugs by shopping at safe international online pharmacies continued to increase in 2013. In 2011 , we reported potential savings of 80%, then a mind-boggling 85% in 2012, and now 87.6% in 2013! Savings have proliferated because America’s trading partners, such as Australia, Canada, the states of the European Union, New Zealand, the United Kingdom, and Turkey, generally, have kept brand drug prices stable, whereas in America they increased by an estimated 13% last year.

The pricing data referred to above is from our prescription drug price savings research released this past September. In that report we looked at popular prescription drugs that are not always covered by health insurance plans, including new plans offered as a result of Obamacare. An extreme example of savings is on the drug Abilify 10 mg, a medication prescribed for depression; $9,007.08 could be saved annually by purchasing the drug from the lowest-cost online pharmacy verified by PharmacyChecker.com compared with a retail pharmacy in New York City.  A more common example of potential annual savings from international pharmacies is the $3,935.28 savings on Spiriva Handihaler 18 mcg. Drug prices are out of control in the U.S., especially for those with no domestic generic alternative, and access to international online pharmacies is as urgent as ever.

It would, of course, be better if Americans could find more reasonable prices on brand name drugs at their local pharmacies.


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For 15 weeks, we tracked prices among U.S. and foreign pharmacies on popular drugs manufactured in in the U.S. (including Puerto Rico). Our analysis found that these medications were an average 76% less expensive from the lowest-cost PharmacyChecker.com-approved international pharmacy than a local U.S. pharmacy in New York City. Even when medications were available as generics, such as Singluair and Urocit-K, the prices for the brand name abroad were cheaper than the generic in the U.S.

Just for the record, prescription drugs manufactured under government regulation in many other countries are just as safe as those made here. Critics of international online pharmacies (mostly people connected to drug companies or big chain pharmacy interests) often mention poor foreign manufacturing practices, especially for generic drugs, outside the U.S. to scare Americans from ordering medication internationally.  But so many FDA-approved drugs currently sold in U.S. pharmacies are imported – 40% according to the FDA – and many are generics. As our vice president Gabriel Levitt said, “We looked only at brand name medications manufactured in the U.S., not because they’re any safer than those made elsewhere, but because we found it so compelling that the same drugs made here are about 76% less expensive abroad.”

For more information, read our recent press release.

Average Savings Buying from an International Online Pharmacy for Brand Name Medications Manufactured in America*


Drug Local U.S. Pharmacy Price Lowest International PharmacyChecker.com Listed Price Percent Savings
Acuvail 0.45% – 30 vials+ $249 $65 74%
Cardura XL 4 mg – 90 pills $285 $67 76%
Crestor 40 mg – 90 pills+ $680 $140 79%
Cymbalta 60 mg – 90 pills+ $879 $116 87%
Invega 6 mg – 90 pills $1,932 $580 70%
Janumet 50/500 mg – 180 pills+ $1,050 $172 84%
Lotemax 0.5% – 5 ml $188 $30 84%
Lumigan 0.03% – 2.5 ml $114 $22 81%
Pataday 0.2% – 2.5 ml $161 $34 79%
Pulmicort 0.25 mg/2ml – 60 respules $698 $117 83%
Restasis 0.05% – 60 Vials $394 $116 71%
Singulair Granules 4 mg – 90 pills+ $732 $176 76%
Strattera 25 mg – 90 caps+ $828 $311 63%
Tarceva 100 mg – 30 pills $6,531 $1,949 70%
Urocit-K 10 meq – 90 pills++ $146 $57 61%
Average Savings 76%
* Includes manufacturing in Puerto Rico, Local U.S. Pharmacy Prices found at a New York City Rite-Aid
+price calculated from 84 pills.
++price calculated from 100 pills.

Last week on the Leonard Lopate Show on WNYC public radio, Elisabeth Rosenthal of the New York Times talked about the high cost of medications in America and how Americans genuinely need foreign pharmacies to afford their prescribed medication. According to the U.S. Centers for Disease Control and Prevention about five million Americans personally import medication.  Many search online to do so and must avoid scams and bad pharmacies.  When asked how consumers can know what they are getting online, Ms. Rosenthal said, “That’s the concern FDA has about allowing imports…So you have to be a little careful about where you buy from. There’s something called PharmacyChecker.com, which vets overseas pharmacies, which many people have told me is very useful.”

We’re very pleased that highly respected media outlets and journalists are covering the health crisis caused by drug prices, informing the public of personal drug importation’s role as a lifeline for Americans, and discussing the need for changes to U.S. laws.


Buying medication from international online pharmacies received prime attention today in a New York Times article called, “As Drug Costs Rise, Bending The Law Is One Remedy.”  The article highlights the prohibitive costs of drugs in the U.S. and also that buying medication online from abroad is a necessary lifeline. And it’s safe, too. Stephen Barrett, M.D., founder of Quack Watch, told the New York Times that he uses PharmacyChecker.com to choose online pharmacies.

Personally importing medication is technically “bending the law” as the New York Times reports (and as PharmacyChecker communicates on its website), but the federal government permits it to the extent that over 99% of international prescription orders reach customers. Furthermore, the FDA states that its enforcement and investigative work is focused on illegal wholesale importation and it has never prosecuted someone for buying medication from Canada or elsewhere for their own use. The FDA has rightfully shutdown rogue online pharmacies but never a reputable online pharmacy, such as those approved in the PharmacyChecker.com program.

Elisabeth Rosenthal, the author of the New York Times article, is responsible for an excellent on-going series about the relatively high cost of healthcare in the U.S. compared to other countries, and what Americans are doing to make sure they get the treatments they need. She’s written about the cost of colonoscopies, pregnancy, joint replacement, and medications. When it comes to medication, the problem is of epic proportions with tens of millions of Americans going without medication due to cost. Hopefully this reporting will encourage our leaders, both at the state and federal levels, to make it even easier for Americans to buy medication from Canada and other countries.

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PharmacyCheckerBlog has reported on the potential effects of the Affordable Care Act (Obamacare) with respect to drug prices and access to medication. Our friends at RxRights.org provide an excellent discussion of this topic as it applies to seniors on Medicare Part D, and more specifically how personal drug importation will remain an important channel to medicine for those slipping through the cracks. Read their post here.

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Maine Passes Law Facilitating Greater Access to Safe and Affordable International Pharmacies

PharmacyChecker.com posted the following press release today. Click here to read it on PharmacyChecker.com

Maine Becomes First State to Legalize Prescription Drug Importation

— PharmacyChecker.com Applauds Historic Law and Helps Consumers to Shop Safely for Medication —

White Plains, New York – Thursday, June 27, 2013 – Today, Maine became the first state to legalize the importation of prescription drugs by individuals, allowing its residents to reduce the cost of obtaining expensive prescription medications by as much as 90%.

“Americans have accessed medication internationally for over the past decade but federal prohibitions on personal drug importation, while not enforced against individuals, have deterred millions. With that regulatory weight lifted in Maine and with proper guidance, more Americans will have access to safe and affordable medication,” said Gabriel Levitt, vice president of PharmacyChecker.com, a consumer website which evaluates the credentials of online pharmacies and provides drug price comparisons.

The Maine legislature overwhelmingly voted in favor of the law, which permits its residents to personally import prescription medication from licensed pharmacies in Australia, Canada, New Zealand, and the United Kingdom. Maine’s House voted 107-37 in favor of the bill, with seven members absent; the Senate voted 30-4, with one member excused. The bill became law at midnight last night in the absence of a veto or signature by Governor Paul LePage. The bill, LD 171, “An Act To Facilitate the Personal Importation of Prescription Drugs from International Mail Order Prescription Pharmacies,” passed as amendment S-241.

Although several states adopted state-run drug importation programs almost a decade ago, most fell by the wayside because state governments did not widely market the programs. The State of the Kansas, under then Governor Kathleen Sebelius, provided a state web page helping residents access verified international pharmacies online. Ms. Sebelius is now Secretary of Health and Human Services. Maine, however, becomes the first state to formally legalize direct personal drug importation.

Research from the Commonwealth Fund has shown that 50 million Americans are not getting needed medication due to the high price of medications at U.S. pharmacies. “The State of Maine has resoundingly declared that this state of affairs is unacceptable,” added Mr. Levitt.

Founded by Tod Cooperman, M.D. in 2003, PharmacyChecker.com helps consumers safely save money on medication by identifying the lowest drug prices from reputable online pharmacies. It independently checks the credentials of online pharmacies and pharmacy discount cards providing easy comparisons of drug prices. PharmacyChecker.com, based in New York, is privately held with no ownership in or from companies that sell or distribute pharmacy products.

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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.


Americans Speak Up in RxRights Video Testimonials About International Online Pharmacies

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.

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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.

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