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Online Pharmacies, Personal Drug Importation and Public Health: Executive Summary

Last week we wrote that we would present a new section of Gabe Levitt’s report on online pharmacies. This week, we are going to start off with the Executive Summary of the report. We’ve given a sample below, but you’ll have to visit to view the whole Executive Summary.

The U.S. government relies on the Government Accountability Office (GAO) for objective and independent research and analysis of government programs and policies that affect public health. GAO’s report entitled Internet Pharmacies: Federal Agencies and States Face Challenges Combatting Rogue Sites, Particularly Those Abroad (the “GAO report”) contains critical inaccuracies and omits important peer-reviewed research to the extent that lawmakers and their staffs will likely draw erroneous conclusions about international online pharmacies that could lead to overreaching and unnecessary enforcement actions that disadvantage consumers and threaten public health. The GAO report was written pursuant to Section 1127 of the Food and Drug Administration Safety and Innovation Act of 2012 (FDASIA), a law dedicated to protecting public health.

In contrast to the GAO report, the following holistic, consumer-focused, evidence-based analysis discusses online pharmacies within the important context of a health crisis caused by high drug prices in America, and can more appropriately guide lawmakers on how to protect the public from counterfeit or substandard medication. Legitimate public health concerns about rogue online pharmacies are being used to encourage legislative, regulatory, and private sector actions that curtail online access to safe and affordable medication. The consequence of overreach could be millions more Americans facing economic hardship or having to forgo prescribed medication, which studies show can lead to more sickness and death.

Fifty million Americans did not fill a prescription due to cost in 2012, according to the Commonwealth Fund. According to the Harvard School of Public Health, over half of Americans who do not take prescription medication due to cost report becoming sicker.1 That means potentially 25 million Americans become sicker each year because they can’t afford prescribed medication. According to the U.S. Centers for Disease Control and Prevention (CDC), about five million Americans buy prescription drugs from foreign sources each year for reasons of cost.  Additional estimates show that between four and five million Americans get their imported prescription drugs through international online pharmacies due to their lower prices.

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The Future of Online Pharmacy Drug Affordability in 2012 – A New Year’s Overview

Our blog was created on behalf of the American consumer, to inform Americans, and the larger community interested in public health, about issues relating to personal drug importation, online pharmacies and drug prices. The three issues are inextricably linked; Americans are able to personally import prescription drugs from safe online pharmacies at affordable drug prices. This has helped millions of Americans, most without health insurance and, or, pharmacy benefits, afford needed medication. In fact, many Americans personally import safe medication that they would otherwise go without if their only options were U.S. pharmacies. Stopping them from doing so would be unacceptable, unethical, and a threat to the public health, and yet we find that is precisely the outcome for 2012 sought by the pharmaceutical and U.S. pharmacy industries.

Under U.S. law it is, in most circumstances, illegal to personally import prescription medication. For over a decade now, Americans have nonetheless taken matters into their own hands by acquiring the non-controlled medication they need outside the United States; and the U.S. Food and Drug Administration has, for the most part, not stopped them. Throughout this period, the pharmaceutical industry has vigorously lobbied against personal drug importation to combat the price competition it brings, which means greater drug affordability for Americans but lower profits for pharmaceutical companies and sometimes U.S. pharmacies.

And their efforts have flourished. Over the past couple of years we have closely followed political, legislative and pharmaceutical industry initiatives to overhaul the status quo by bringing  an end to online access to affordable medication. At the crux of these anti-consumer efforts is their communications strategy of deceptively attempting to link safe international online pharmacies, which require a valid prescription, with rogue online pharmacies that sell dangerous medication and don’t require a prescription, as if they operate a single black market in deadly counterfeit drugs that needs shutting down. Through these efforts, they have scared Americans away from safe and affordable medication, but their final goal is actually stopping the trade all together.

While there are safe online pharmacies, domestic and foreign, there is a real danger of counterfeit and deadly drugs sold throughout the world, including the United States’ own supply, and through rogue online pharmacies, so let’s attack the true dangers! However, it is neither morally defensible nor necessary to prevent Americans from online access to safe international online pharmacies that sell genuine and affordable medication, often at an 80% discount.  

How loudly must we remind our leaders of the government’s own dire statistics? Twenty-five million Americans couldn’t afford to fill their prescription in 2009 (U.S. Centers for Disease Control and Prevention). Even worse, the Commonwealth Fund’s findings show that 48 million Americans did not fill a prescription in 2010 due to cost, a 66% increase in non-adherence since 2001 (see RxSOS). When people don’t take their medicine they can get sick and even die – and the reality is that too often they do.

Safe international online pharmacies may not be the long term solution to the emergency gripping the country in which so many go without needed medication due to cost, but for now such sites provide a lifeline for approximately one million Americans each year. Cutting that lifeline poses a danger to the public health and is just plain wrong.

In 2012 we hope our elected officials and policy-makers will have the courage to stop federal and legislative actions, mostly pushed by the pharmaceutical industry that would block online access to safe and affordable medication. Such leaders are desperately needed now by the tens of millions of Americans who can’t afford prescription drugs in the United States.  

To help protect online access to safe and affordable medication we encourage Americans to join and work with, a non-profit organization dedicated to this cause.

Wishing You A Healthy and Happy New Year.

Gabriel Levit
Vice President

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Average Americans Show Compassion for their Fellow Citizens Who Can’t Afford Medication – What About Our Elected Officials?

Two years ago, ABC News ran a segment (What Would You Do?) that showed Americans going out of their way to help strangers who could not afford their medication. Actors visited local pharmacies pretending they could not afford to pay for their much-needed prescription drugs – something that happens frequently in the U.S. Some people offered to help pay for part or all of the drug orders, and one man even left the pharmacy to get money from an ATM. In addition to financial assistance, these individuals also offered words of solidarity against the outrageous costs. Karen Wenberg (real person) told the woman (actress) she was helping: “Don’t be embarrassed. You know what? Medication is so f***ing expensive. There is no reason to be embarrassed… Sometimes we just pass on the good that’s been given to us.”

As we write this, Congress is marking up a new law, Stop Online Piracy Act (SOPA), one supported by the Obama administration that could effectively block Americans from acquiring safe and affordable medication from online pharmacies outside the U.S. As the government seeks to rein in spending, why do they want to stop consumers from getting non-tax-payer funded, affordable medication? When people go without medication, they can become sick or get sicker, putting a great burden on the health care system. To see what the government is doing, read’s guest post on techdirt. (more…)

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