It was reported this week by The New York Times that a small pharmaceutical company purchased the rights to an old antiparasitic drug, Daraprim, and then jacked the price up from $13.50 to $750 per pill. News coverage has portrayed the villain in this story as the shrewd founder of Turing Pharmaceuticals, but the real villain, in my opinion, is our own government for creating a situation in which this can happen. The fact is that you can order this drug from licensed pharmacies in other countries, such as England, for about $6, according to prices listed on my site, PharmacyChecker.com. But -- and here's the rub -- you may be breaking the law if you do. So far, the government has not gone after people for doing this, but the screws are tightening.
You can get most brand name medications at a savings of about 80 percent from real pharmacies selling real medication outside the U.S., but our government has been doing nearly everything in its power (and, in my opinion, beyond its power) to keep you, and scare you, from doing that. Just a week ago, it was reported in The New York Times that a diabetes drug, Jardiance, also reduces the risk of dying from cardiovascular disease by 38 percent. That's terrific news, but this drug costs around $350 to $400 per month in the U.S., putting it out of reach for many Americans. A month's supply of the same drug can be purchased from licensed pharmacies outside the U.S. for as little as $110 but, again, you may be have to break the law to get it.
While pharmaceutical companies take advantage of the lower cost of goods and services all over the globe, U.S. consumers seeking medicine cannot -- at least not legally. Due to extensive lobbying by the pharmaceutical and pharmacy industries, our government has been doing just about all it can to keep Americans a captive market when it comes to medicine. Could a company get away with charging consumers $750 for a product that sells for $6 elsewhere if we had the kind of free market that exists for products like electronics, gasoline, and household items? Of course not.
Is there anything unsafe about filling your prescription at a licensed pharmacy in a country that has safeguards as good, or better, than our own? No. Do you think people in England, Canada, Australia or even Turkey or India are afraid to use their pharmacies? Of course not. In fact, about 5 million Americans buy medication internationally each year because of high costs in the U.S., according to research by the Commonwealth Fund (Health Affairs 2013), and there have been no reports of injury from drugs personally imported with a prescription. I'm very familiar with this, as I launched PharmacyChecker.com in 2003 to check the credentials of such pharmacies, helping Americans avoid rogue online pharmacies and find those which dispense only through licensed pharmacies which require valid prescriptions.
The Secretary of Health and Human Services, which oversees the FDA, has the ability to allow Americans to legally import medication, but has not done so, despite the fact that the U.S. Centers for Disease Control reports that nearly 1 in 10 American adults don't take their medications as prescribed because they can't afford to (HealthDay 2015). In fact, the former secretary, Kathleen Sebelius, instituted a personal drug importation program in Kansas when she was governor of that state, but she failed to change things nationally when she got to Washington. Even President Obama sought to allow personal drug importation (FDAlawblog 2009) but apparently later bowed to the demand of the pharmaceutical industry to scrap that idea in exchange for the industry's support of his health care plan (The New York Times 2012).
Making matters worse, in 2010 the White House Intellectual Property Enforcement Coordinator stated that her office was in discussions with Google, Go Daddy, American Express, and Microsoft about cracking down on online pharmacies (Politico 2010). This push from the White House lead to the creation of a private group called "The Center for Safe Online Pharmacies," which has now made it hard to impossible for you to use your credit card to purchase medication from online international pharmacies (you can pay by check) and has blocked online advertising by such pharmacies. Most recently, and audaciously, Microsoft's Bing just started popping up a warning when you search for non-U.S. online pharmacies, all of which Bing misguidedly calls "fake" pharmacies. While there are certainly rogue pharmacies to avoid online, there are also dozens that are real, safe, and affordable and these efforts mix the good with the bad and try to scare you away from any online pharmacy outside the U.S.
And things may soon get worse. On Sept. 15, the FDA announced a final rule in the Federal Register that expands its authority to destroy personally imported medication, real or fake. To rationalize the rule, it calculated the potential social benefit of destroying medications but, bizarrely, it refused to factor in the social cost of denying people needed medication because it was destroyed or not ordered at all out of fear of that it will be destroyed. I'm not aware of a single death or serious adverse event from a person buying medication from a foreign pharmacy online that requires a valid prescription, while there are millions of Americans for whom personal drug importation is a lifeline.
If any of this bothers you, then do something -- tell your friends, tell your congressperson, and ask the presidential candidates what they plan to do about it if elected. If you don't mind paying $750 for a pill that costs just a few dollars in the rest of the world, then do nothing.
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