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Helping Americans Get The Truth About Prescription Drug Savings
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Daraprim’s Cost is Bizarre: So Save 99.8% Buying from a UK Pharmacy

Martin Shkreli trying to look cool

Martin Shkreli, founder and chief executive of Turing Pharmaceuticals. Not that cool.

It’s no secret that Americans are unhappy with Big Pharma. Pharmaceutical companies regularly rank as one of the least loved industries, right up there (or down there) with Big Oil and Big Government. And while this has usually been expressed as contempt towards the industry as a whole, recently the negative spotlight is shining brightly on one man: Martin Shkreli, hedge fund investor and drug company entrepreneur.

Soon after his company Turing Pharmaceuticals purchased the marketing rights to the drug Daraprim, Shkreli raised the price of Daraprim from $13.50 per pill to $750.00 per pill in the U.S. market where Turing has exclusive marketing rights. But that only affects America! Thankfully, consumers can purchase Daraprim, marketed by GlaxoSmithKline in the UK, from a verified international online pharmacy for as low as only $1.53 per pill. A mere savings of 99.8%.

Daraprim is used to treat toxoplasmosis, a disease that results from infection with the Toxoplasma gondii parasite. This parasite is very common (in fact it’s been estimated that 22% of U.S. population have been exposed to it and it usually infects people who have eaten undercooked meat, raw vegetables, or have handled cat feces. In healthy people it usually only causes flu-like systems. However this disease can cause severe complications in people with compromised immune systems, such as those with HIV or cancer, including brain lesions and seizures. The disease can also be very harmful to women who are pregnant, leading to a stillborn child or a child born with birth defects.

It’s not rare for medications that treat a rare disease or a small patient population to be expensive. Moreover, it’s understandable that pharmaceutical companies want to recoup the extensive costs of developing a drug and make a profit, although Big Pharma’s lust for profits appears insatiable. But let’s take a deep breath…Daraprim is not some new wonder drug. It was originally developed and marketed by Burroughs Wellcome and patented back in 1953 (the patent expired in the 70s). A relatively inexpensive drug, it was long manufactured by GlaxoSmithKline, until that company sold the U.S. marketing rights to CorePharma in 2010. Impax Laboratories later bought CorePharma, and turned around and sold the rights to the drug to Turing.

At that point Mr. Shkreli and our friends at Turing decided to change how Daraprim was distributed. Hospitals, instead of going to a wholesaler, now had to order from Turing’s “Daraprim Direct” program. Patients, instead of going to their neighborhood pharmacy had to order from Walgreen’s Specialty Pharmacy. And since there is no approved generic in the United States, patients who need Daraprim face monopoly pricing, with no competition to Turing on the horizon.  Many people of all political stripes seem to be enraged over price gouging like this, because it seems like they’re getting the worst of corporate monopoly and government protectionism.

In order to get this medication, American consumers may need to look across the pond. As mentioned above, GlaxoSmithKline may have sold their U.S. marketing rights to Daraprim in 2010 but not in many countries around the world, such as England, where it’s sold for pennies to the pill!

It only seems fair, not to mention in the interest of public health, that an important drug like this, that’s listed on the World Health Organization’s List of Essential Medicines, should not be one subject to the twisted reality and bizarre rationalizing of hedge fund managers.

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Lower Cost Flovent Can Be a Breath of Fresh Air and Even Save Your Life

If not treated properly, the breathing condition known as asthma is deadly. In fact, the U.S. Centers for Disease Control and Prevention (CDC) reports that nine people die each day from asthma and in 2009 there were 3,388 deaths. Flovent is an inhaled corticosteroid that treats asthma.  Flovent not only makes breathing easier for asthma sufferers, it helps prevent severe attacks that can cause hospitalization.

But Flovent can be prohibitively expensive, especially if you are uninsured or your health insurance will not cover this medication.  Kids are often the victim of high asthma drug prices. A 3-month supply of Flovent Diskus (fluticasone propionate) 250 mcg inhalers costs around $778 at a local pharmacy.  Based on a typical dosage, that works out to $3,112 per year.  That’s a huge number considering the median family income in the U.S.  is about $52,000 a year –and of course tens of millions of families make due with much, much less. According to one academic study, failure to take your asthma medication often leads to “decreased quality of life, lost productivity, increased health care utilization, and even the risk of death.”

Pharmacy discount cards can help the situation.  With a discount card the price for a 3-month supply might drop down to $684 at a U.S. pharmacy for a 3-month supply, a savings of $131.

But the costs are far lower in other countries for the same medication. Instead of calling it Flovent Diskus, GlaxoSmithKline markets fluticasone propionate as Flixotide Discus, which is sold in licensed pharmacies throughout the world.  The foreign version of Flovent Diskus 250 mcg inhaler can be purchased online for about $123 for a 3-month supply or $492 a year. That’s a potential discount of about 84% and a savings of $2619 per year off the price of Flovent Diskus sold in the U.S.!

According to the CDC, about one in 10 children have asthma.  It’s a serious but treatable condition.  There are effective medications like Flovent Diskus, which is approved for children as young as four years old.   My son suffered from cold-induced asthma as a smaller child and it’s scary, and that’s why this particular condition makes me so mad. Parents often can’t afford asthma medications and sometimes must bring their kids to the hospital when their asthma flares up. I think that’s unforgivable and that no parent should have to watch their child suffer, and yet they do from the high cost of medications in the U.S.

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Indian Medications Sold at U.S. Pharmacies and Online: What Americans Should Know

Americans may be concerned by recent reports in the media about the safety of medications made in India (e.g., the New York Times article “Medicines in India Set off Safety Worries”). Problems with Indian drugs should be neither overlooked nor overstated. In this post we try to put this into perspective for American consumers who purchase Indian medication at their local pharmacies, whether they are aware it’s from India or not, or directly from an Indian pharmacy by ordering online.

Over the past decade, prescription medicine made in India has been sold in large quantities in U.S. pharmacies. Today, according to the FDA, Indian medications make up about 33% of all prescriptions filled here.  In fact, Walmart’s ability to offer a $4 generic drug program was initially due to importing and selling medicines  from the Indian drug companies Ranbaxy and Cipla. However, last year Ranbaxy was found to be making false claims to the U.S. Food and Drug Administration and exporting medications to the United States that did not comply with FDA’s regulations.  The FDA fined Ranbaxy $500 million and banned importation of its products made in India.

It’s important to note that well-known brand name pharmaceutical companies, based in the U.S. and other rich countries, also have serious manufacturing problems. GlaxoSmithKline was fined $750 million for knowingly selling adulterated prescription medication that ended up in local U.S. pharmacies. In 2010, Eli Lilly was sent a warning letter from the FDA for violations of good manufacturing practices.  Those are two examples of many.

The FDA’s discovery of more problems at Indian manufacturing plants is not necessarily due to new health risks associated with Indian drugs. In the past, the FDA could not afford to conduct regular inspections of many, if not most, foreign drug manufacturing facilities. Greater funding under a new law has enabled more FDA scrutiny of Indian drug companies, which has led to increasing regulatory enforcement by FDA. A major problem is that the Indian counterpart to the FDA, the Central Drug Standard Control Organization, needs to do a better job regulating drug safety. In fact, FDA Commissioner Margaret Hamburg recently travelled to India to engage her counterparts in a plan to improve regulatory oversight of drug manufacturers. We applaud her initiatives with India.

Another issue in India is that some Indian manufacturers make less quality, lower cost medicines for sale to poorer countries and to poorer segments of the population within India. This two-tier system is sad but true.

So where does that leave you as a consumer?

Notwithstanding the greater scrutiny by FDA in India, Indian medications sold to Americans are generally of high quality, whether purchased at a U.S. pharmacy or from a PharmacyChecker-approved online pharmacy dispensing from India.  To be approved within the program, an Indian pharmacy must only dispense medications manufactured in plants which are 1) approved by FDA or by  other strong regulatory authorities such as those in Canada and the UK; 2) operated by the largest and best Indian drug manufacturers who are known to most consistently sell high quality medication; or 3) approved by Indian regulators and inspected by qualified American personnel to meet FDA standards of Good Manufacturing Practices. In addition, every Indian pharmacy approved by has been inspected by an American pharmacist with special expertise in international mail-order pharmacy safety, and its pharmacy license has been verified with regulatory authorities in India.

As we’ve written before, international online pharmacies are not just “Canadian pharmacies.” Most of the reputable ones originated in Canada but are now partnered with pharmacies in several countries, including India. Other verified and safe international pharmacies are located in Australia, New Zealand, and the United Kingdom. There are even pharmacies created specifically for international mail-order pharmacy services on island nations. The ones approved in the Verification Program meet very high standards.

Where you order from should be based on the best information available and we strive to provide it. India has become the top supplier of generic medications worldwide but not all their medications are created equal.

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