This week Purdue Pharma settled with the state of Oklahoma for $270 million to avoid a trial charging the company with what I call opioid drug dealing. Purdue Pharma and members of the Sackler family–founders and managers of the company–are enmeshed in 1,600 cases throughout the U.S. They are accused of illegal marketing activities that led to over-prescribing and rampant distribution of Oxycontin, which paved the way for millions to the addiction of opioids, with hundreds of thousands dying over the last decade.
It was not just Purdue but many drug companies—and the entire
drug supply chain—that fueled the opioid death spiral. As drug companies and
their allies in the drug supply chain continue to use the opioid crisis as a
means to oppose prescription drug importation to lower drug prices in the U.S.,
we can only look on with amazement at their audacity.
International online pharmacies process orders for prescription drugs that are mailed across borders. That’s a simple definition for myriad websites, good, bad and in between, that can be found selling medicine on the Internet. Patients looking online for affordable medicine from another country want to know they will receive a lawfully-manufactured medicine that works. At PharmacyChecker, we believe we’ve developed a system of standards, rules and policies, for evaluating such websites to determine if they are safe and the businesses involved properly licensed. Those online pharmacies that are not only eligible but also willing to accept our monitoring and oversight are verified in our Verification Program. Verified means that an online pharmacy meets our online pharmacy standards of practice and agrees to our monitoring and oversight protocols. PharmacyChecker-verified online pharmacies are eligible to publish a PharmacyChecker seal on their websites and list their pharmacy information and prices on our website.
The day is designed to highlight a program that provides a safe and responsible method for patients to discard prescription medications from their homes and learn more about the risk of abuse with controlled prescription medications. The DEA website has a collection site locator, where Americans can find the exact location to discard their medications safely. The website also has a Substance Abuse and Mental Health Service (SAMHSA) Behavioral Health Treatment Services locator, it’s confidential and helps individuals find resources in their area.
The role of the Internet as a channel to obtain and misuse prescription narcotics is tiny.
A report published by the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the U.S. Centers for Disease Control and Prevention, blamed the Internet for 0.1% (one tenth of 1%) of all narcotic abuse. That data was from 2015. The latest such report, which is called the National Survey on Drug Use and Health has new data from 2017 that doesn’t even have a category for the Internet.
It’s hard to tell if the new number is lower or higher than 0.1%. While 0.1% appears to be statistically insignificant, people have died buying narcotic prescription drugs online and all channels of abuse need to be addressed.
Drug Companies Want to Hide Lower Drug Prices from Americans
According to the government’s survey, of the 11.1 million people who misused prescription opioids, here’s how they obtained them: 53.1% from a friend or relative; 36.6% from a doctor’s prescription; 5.7% from a drug dealer; and 4.6% some other way.
I don’t know why SAMHSA removed the Internet as a category but believe there are two possible answers:
One, the internet channel was statistically insignificant.
Two, the incredibly small percentage, 0.1%, did not fit the agenda of the pharmaceutical industry to blame the Internet for illegally obtained prescription narcotics.
The data showing that only 0.1% of Americans who abuse opioids get them online doesn’t justify the major crackdown on the Internet desired by the pharmaceutical industry.
Yes, drug companies can lobby Congress and federal agencies to have questions removed and added to research on matters that affect them. The FDA has never reported a person seriously sickened or killed by buying medicine internationally from an online pharmacy that requires a prescription. The safest international online pharmacies don’t sell opioid medicine or any controlled drugs.
What does the category “some other way” account for according to SAMHSA?
“Some other way includes write-in responses not already listed in this table or responses with insufficient information that could allow them to be placed in another category.”
That means they didn’t ask about the Internet, but people may have written it in. I’ll update this post when I find out more about it.
Consumer Advocacy
As drug companies continue to pressure Congress about stopping personal drug importation by censoring the Internet, it’s important for consumer advocates to stay on top of this data. As I wrote last week, if you look closely, the law, ironically, defends personal drug importation – even if it’s technically illegal.
Let’s beat the opioid crisis without stopping people from safe personal drug importation of non-opioid, non-controlled products.
EpiPen, the emergency epinephrine auto-injector medicine, is in short supply in the U.S. and other countries, such as the U.K. and Canada. Now, parents of kids who need to carry around EpiPen Jr. are not just worried about the cost of EpiPen but if they can get it at all. If you are considering buying EpiPen online, here’s my warning:
Only Buy EpiPen from Verified Online Pharmacies
When it comes to fast-acting, life-saving products, buying online from a rogue online pharmacy can turn out to be deadly. If you get a fake or expired product, then it might not work. Enough said. The message is clear: do NOT buy from an online pharmacy that isn’t one associated with your neighborhood pharmacy. If you decide to buy online, stick to online pharmacies that are verified. That includes online pharmacies verified by us, PharmacyChecker, or LegitScript, the National Association of Boards of Pharmacy VIPPS program, or the Canadian International Pharmacy Association.
When it comes to cost and availability, you may not have to look internationally for savings. In the U.S., there’s a generic version made by the same company that makes the brand version, and it’s much less expensive. According to GoodRx, you can buy the generic with a discount coupon for almost half the price of the brand-name sold at Canadian online pharmacies: $125. The brand version in the U.S. is over $600!
Where are all the EpiPens?
According to Market Watch, manufacturing problems are causing EpiPen supply problems. The generic drug company, Mylan, has the license to market and sell EpiPen in the U.S. and Canada, but the brand-name drug company, Pfizer, owns and runs the plant that makes the drug. To make a very long story short, the FDA has cited problems with Pfizer’s protocols for assembling the drug. Pfizer is trying to up its game, but the process is taking some time.
There are epinephrine alternatives to EpiPen, brand and generic. They include Adrenally and Auvi-Q, which might be more affordable. Consumer Reports has a good article on these products, although I’m not sure about their current availability.
The Market Watch article suggests that you can still get the product, but they make it seem a lot more challenging than it should be. If you choose to buy it online, whether for availability or cost, stick to verified sites.
I write this post about insulin with ambivalence and frustration, but also hope. The diabetes patient and activist community is rightfully seething, screaming at the top of their lungs about high insulin costs in America. One young man stands out in my mind. He recently died because he could not afford his insulin, and now his mother bravely speaks out about her son’s death—an example of why drug prices are a national crisis.
In a March article in Insulin Nation, the journalist/editor Audrey Farley and I discussed the issue of buying more affordable insulin online from pharmacies located in Canada and the U.K. She found that many of her readers were doing so and wanted to let them know how to go about it safely.
One carton of Lantus Solostar (5 pens of 3ml each), a long-acting insulin made by Sanofi Aventis in Germany, goes for about $430 at a CVS in Brooklyn, New York. At Rexall Drugs in Toronto, the price is $84.99. That’s 80% less. Until recently, a small number of Canadian pharmacies in our Verification Program sold it for about $180. The online Canadian price is higher because of the fees associated with special packaging and shipping – but it’s still 56% less than the U.S. price. For those prices, Americans living with diabetes could save a couple of thousand dollars a year; and those who can’t afford it here at all could stay alive.
Insulin is a temperature-sensitive medication and, because of that, requires significant precautions when shipping. To prevent it from degrading requires special packaging. Effective patient communication is also necessary. Because of our recent updates to our refrigerated medications policy, one that places stricter requirements on pharmacies in the PharmacyChecker Verification Program, most will likely choose not to sell insulin to Americans— at least not for a while. Here’s why… (more…)
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EpiPen, the emergency epinephrine auto-injector medicine, is in short supply in the U.S. and other countries, such as the U.K. and Canada. Now, parents of kids who need to carry around EpiPen Jr. are not just worried about the 
I write this post about insulin with ambivalence and frustration, but also hope. The diabetes patient and activist community is rightfully seething, screaming at the top of their lungs about high insulin costs in America. One young man stands out in my mind. He recently died because he could not afford his insulin, and now his mother 