Americans are speaking out against the provisions of a new law signed by President Obama on July 9th that will hinder their access to safe and affordable medication. In a news story last week on a Minneapolis-St. Paul NBC affiliate, Kare 11, we learn about Minnesotans who could be negatively affected by Section 708 of Food and Drug Administration Innovation and Safety Act, which allows for the seizure and destruction of personally imported medication.
Rico Anderson imports his prescription medicine for Crohn’s disease from Canada, paying $135 for a one month supply. In the U.S., this medicine would cost over $700 a month. That’s almost $7,000 dollars in annual savings. In contemplating having to face higher U.S. prices, Mr. Rico lamented that: “if it gets to a point where you’re deciding if you have to buy your medicine or pay your mortgage or put food on your table what are you going to do?”
The NBC report features Lee Graczyk, lead organizer of RxRights, a prescription affordability advocacy group. Days before the law passed Mr. Graczyk emphasized both the economic and health costs that result from unaffordable medication: “People are using this option because they cannot afford to buy the medications here. If this law passes, they can’t afford to buy the medications and stop taking the medications, they not only put their health at risk, but as a nation, it’s going to cost us more money.”
Visit RxRights.org to learn how Americans can fight back and protect their access to safe personal prescription drug importation from verified online pharmacies.
To compare prices on prescription medication from Canada and other foreign countries visit PharmacyChecker.com.
Americans die and get sicker every day because they can’t afford their medications.
The Patient Protection and Affordable Care Act will help provide health insurance for millions of Americans, reducing the cost of their medications. But we’re not there yet! We’ve compiled statistics – see below – on the negative health effects of prescription non-adherence due to cost. Our country needs greater access to safe and affordable medication now, including through verified international online pharmacies that offer far lower prices on essential medications.
Here are the stats:
25 million Americans report becoming sicker because they are not taking medication due to its cost. 1
An estimated 150 million prescriptions go unfilled each year due to prescription costs.2,3
125,000 deaths occur per year among patients with heart disease due to prescription non-adherence. And that’s just for heart disease. The number of deaths per year among all conditions due to cost-related non-adherence is unknown. 4
Americans who skip medication due to cost are almost twice as likely to experience a significant decline in overall health over 2 years of follow up.5
USA Today/Kaiser Family Foundation/ Harvard School of Public Health Health Care Costs Survey, 2005. 20% of survey respondents report not filling a prescription due to cost; and 54% of those said their condition got worse as a result. Extrapolated to the 2012 population of adults 18 and older, (234,564,071), that is 25 million.
McCarthy R. The Price You Pay for the Drug Not Taken. Business Health 1998. Reports that 20% of prescriptions go unfilled, and 15% of those go unfilled because the drug costs are too high.
IMS National Prescription Audit PLUS reports 4.024 billion prescriptions dispensed in 2011. If 80% of prescriptions written are dispensed, then 5.03 billion prescriptions were written. 15% of 20% of 5.03 billion is around 150 million prescriptions forgone due to cost.
McCarthy, R. The Price You Pay for the Drug Not Taken.Business Health 1998. Quote from Daniel Gerner, chairman at the time of Healthcare Compliance Packaging Council.
Heisler et. al, The Health Effects of Restricting Prescription Medication Use Because of Cost. Medical Care, Volume 42, Number 7, July 2004
UPDATE: the video showing Senator’s Snowe’s floor remarks is no longer available. Please consult the congressional record for this date to read Senator Snowe’s full remarks.
In support of Senator John McCain’s amendment to facilitate safe personal drug importation from credentialed online pharmacies, Senator Olympia Snowe spoke comprehensively, passionately and honestly about the issue. Though the amendment did not pass, Americans interested in online pharmacies and drug affordability should be aware of some of Ms. Snowe’s most pertinent points in support of personal drug importation. The full senate floor presentation is available for viewing as well.
“Americans are facing tremendous increases in prescription drug prices for far too long and I think it’s at a point in which Congress should address this issue,” said Senator Snowe. “In 2010 AARP found that retail prices for the most popular brand name drugs increased 41.5% while the consumer price index rose just 13%. In other words the cost of prescription drugs rose more than three times as much as the inflation rate.”
Senator Snowe wisely reminded her colleagues that most of “America’s” drug products are already manufactured overseas. Senator Snowe points out that the very medications America consumes come from manufacturing facilities in over 50 countries and “not all of those facilities are even inspected….”
We need a more competitive pharmaceutical market. Senator Snowe points out (by quoting a former Pfizer CEO) that more competition from imported medication will lead to lower prices, higher quality products, and more innovation.
The amendment is far more modest than previous drug importation bills and only calls for the Secretary of Health and Human Services (HHS) to make a list of approved online pharmacies for personal drug importation but it would not allow for greater “wholesale” drug importation. PharmacyChecker.com already provides such a list that consumers can freely access. Ironically, while Senator Snowe didn’t mention it, the Secretary of Health and Human Services, Kathleen Sebelius, actually published such a list when she was governor of Kansas for a state drug importation program.
For those interested in learning more about why personal drug importation should be made more available to Americans please watch Senator Snowe’s floor remarks.
Senator John McCain (R-AZ) introduced an amendment to the Pharmaceutical Drug User Fee Act authorization bill that would create explicitly legal access to and facilitate safe and affordable medicine from Canadian pharmacies through a government list of online pharmacies. Sen. McCain should be applauded for continuing his efforts on this issue. Unfortunately, the amendment was voted down 43 to 54.
In his floor statements, predicting his amendment’s failure, Senator McCain communicated that too many of our elected representatives are beholden to the pharmaceutical industry. For that reason, we can expect future legislative actions to curb access to safe personal drug imports. Due to FDA’s current regulatory practices, Americans are not prevented from obtaining needed medications from verified international online pharmacies.
CBS News On Online Pharmacies and Drugs Safety
In a recent article, CBS News informs American consumers on critical issues of drug safety. When it comes to ordering prescription drugs online, especially from outside the United States, the article is clear that Americans should only shop from properly credentialed online pharmacies, such as those approved by PharmacyChecker.com.
Americans should take other precautions as well. For instance, you should only take prescription medications prescribed to you from your doctor. Check expiration dates to make sure your prescription product is still effective. Before taking medication, look at it closely for any indication something is not right, including disintegration or discoloration.
Online pharmacies discussed by world leaders at G8 summits
Leaders from the world’s most advanced economies discussed online pharmacies at the recent G8 conference. The topics discussed also included economic growth and development, food and nutrition, and international security. Global health experts criticized the G8’s agreement, as published in the Camp David Declaration, for an over-emphasis on intellectual property protection in its section that mentioned drug safety.
Americans who buy medication safely from properly credentialed international online pharmacies should be concerned about high level talks that address this issue. The pharmaceutical industry’s anti-consumerist positions on intellectual property rights are often overrepresented in such international organizations, and the industry seeks global action to shutdown safe international online pharmacies.
On the other hand, looking at the glass half-full, the Camp David Declaration makes clear that public safety – not intellectual property rights – are the goal in fighting rogue online pharmacies and counterfeit drugs: “To protect public health and consumer safety, we also commit to exchange information on rogue internet pharmacy sites in accordance with national law and share best practices on combating counterfeit medical products.”
We strongly support international actions to thwart the sale of dangerous medications online to protect both American and global patients. In fact, PharmacyChecker.com has been dedicated for almost a decade to evaluating online pharmacies in order to provide information about those that sell safe and affordable medication.
Americans need and deserve the freedom to buy medications that are safe and affordable. This is not only true as a matter of right and wrong; it’s a public health issue since about 48 million Americans don’t fill prescriptions due to cost. Online pharmacies offer an important outlet for affordable medication. That’s the good news. The bad news is that some Americans are forced to use online pharmacies when they would rather not; and others who need them are discouraged from doing so. What’s going on here?
According to a recent L.A. Times article, “Consumer Confidential: Fewer choices on buying medications,” more and more Americans are being forced by pharmacy benefit managers (PBMs) to purchase their medication through domestic online pharmacies. Traditionally, PBMs acted as middlemen between health insurance companies, drug companies, and pharmacies. The third party relationship between PBM and pharmacy is deteriorating and the online pharmacies being forced upon Americans are often owned and operated by the PBM! This stands in contrast to the international marketplace.
When it comes to buying medication from Canada and other international pharmacies, despite its technical illegality, Americans feel free to choose which online pharmacy they wish to shop from. We write “technically” because, due to its internal policy guidance on enforcement priorities, the FDA does not appear to prosecute individuals for buying foreign, non-controlled medication for their personal use. Still, the FDA discourages Americans from using all non-US online pharmacies, even safe ones.
Independent studies have shown that credentialed international online pharmacies can and do offer a safe shopping experience through which Americans can best afford their medication. This takes the wind out of the sails of safety-related arguments put forward by the pharmaceutical industry — which profits greatly from high American drug prices — against personal drug importation. But there are other criticisms of personal drug importation that have to do with economics.
Foreign pharmacies are cheaper because other governments negotiate with pharmaceutical companies to control drug prices for all their citizens, something the U.S. government does not do. Thus, personal drug importation is criticized for “importing” drug price controls and spoiling our “free market” in pharmaceuticals. But is our pharmaceutical market truly free?
In the LA Times article mentioned above, Jerry Lacy, who played Humphrey Bogart in “Play it Again Sam,” commented on his actor union’s arrangement with one of the largest PBM’s, Medco, which serves over 65 million people. “It’s like extortion…you do it their way or they won’t pay.” Mr. Lacy drew this conclusion after discovering he could only fill his prescriptions at the pharmacy of his choice twice at the insured (lower) price but then would have to buy from Medco’s online pharmacy or pay full (a higher) price elsewhere.
A letter to the editor by Chief Medical Officer of Express Scripts, another PBM, called “Letters: What Drugs Cost, and Why,” claims that PBM’s do provide choices. Well, maybe somewhat; but this is only partially true because the individual’s choice is not preserved. The employer or insurer chooses the option – not the individual. William Hale, in another letter to the LA Times editor, writes that he had to buy 90-day supplies for his medication from his PBM, even though his doctor would often change medication or dosage before the end of the 90 day supply. As a result, he has hundreds of unused pills and has ended up spending more than he would have if his PBM allowed him to purchase 30-day supplies from his local pharmacy. [For an excellent analysis about the free market for companies but not consumers read: “Inside The Secret World of Drug Company Rebates.”]
With foreign governments negotiating for lower prices in order to reign in government budgets, pharmaceutical companies seek higher profits from higher drug prices in the American “not-so-free” market..The American pharmaceutical market victimizes the millions of American consumers who are forced each year to pay more and more than their foreign counterparts for the same brand name medication or suffer the health consequences due to not taking prescribed medication. One way Americans seek justice is through international online pharmacies.
If considering online personal drug importation or any online pharmacy, experts have advised consumers to avoid online pharmacies that are not credentialed by reputable third parties, such as PharmacyChecker.com or VIPPS. But using common sense, Americans can and do make wise decisions about buying drugs online. For generic drugs, U.S. online pharmacies are often less expensive than non-US online pharmacies. The complete opposite is true for brand name drugs. Due to price competition among international online pharmacies (and of course foreign price controls), Americans can acquire from abroad the same medications sold here at an 80% discount.
By herding more of their members to their own pharmacies obviously PBMs can offer lower prices than local pharmacies; but this price reduction is not due to a “free market.” The only pharmaceutical market that is meaningful to most Americans is the one that provides them a safe prescription medication at the lowest price. Ironically it is often non-US online pharmacies that offer them such freedom.
In their blog yesterday, our friends at RxRights.org, an advocacy group dedicated to helping Americans afford needed prescription medication, applauded Senator McCain’s (R-AZ) amendment to the Food and Drug Administration Safety and Innovation Act to greater facilitate safe and legal personal drug importation of prescription medications from verified Canadian pharmacies. Despite Senator McCain’s emphasis on verification and product authenticity, and co-sponsor Al Franken’s (D-MN) statement on this bill’s role in reducing overall healthcare spending, the amendment failed in a 12-9 vote in the Senate Committee on Health, Education, and Labor and Pensions.
Those against the bill cited drug product safety issues and concerns over the anonymity of the internet. Most vociferously, Senator Barbara Mikulski (D-MD) claimed that even with the bill consumers would still not know where there drugs were coming from, failing to recognize or understand that the solution to this problem is written in the amendment, which calls for a verification process that would identify safe online pharmacies. Just such a program was adopted by Kathleen Sebelius, now Secretary of the Department of Health and Human Services, when she was Governor of Kansas.
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