PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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LegitScript, John Horton, Lies, and the Mission to End Online Access to Safe and Affordable Medication

LegitScript is again disseminating misinformation to discredit PharmacyChecker.com and its mission to help consumers safely access affordable medication, and we can bet that the very powerful pharmaceutical company interests LegitScript allies with are enjoying its efforts.

This week, LegitScipt’s John Horton blogged with apparent glee about charges by the U.S Attorney’s Office for Western Pennsylvania implicating several Canadian individuals and their company, Quantum Solutions, for allegedly exporting wholesale quantities of medications manufactured for foreign markets to U.S. pharmacists between 2007 and 2011.

Horton makes the mistake of saying that the case involved charges against an internet pharmacy certified by PharmacyChecker, but this is not the case.  No online pharmacy is charged in the case, let alone any online pharmacy verified by PharmacyChecker.

Horton also states that the case involved the shipment of “bad” medicine, but there is nothing in the court documents indicating a problem with the quality of any of medications. Their labeling was apparently for the countries where they were being sold, which makes them “misbranded” if sold in the U.S. but not “bad” medicine. The drugs involved were expensive brand name drugs like Abilify, Zyprexa, and Plavix, costing hundreds of dollars per month in the U.S. but normally 80-90% lower in price outside the U.S. — which is likely what motivated the U.S. pharmacists to allegedly purchase the medication from abroad.

John Horton’s blog shows that in the world of online pharmacies, one party you can’t trust for reliable information is John Horton.

A very strange thing about the government’s filing in this case is an attachment listing website domains, a few of which are for international online pharmacies verified in our program.  There is no claim of wrongdoing by any of these sites. The filing explains that these website addresses are property which the U.S. government seeks to have forfeited by the defendants in the event of a conviction, as the addresses may have been purchased with proceeds of the alleged offense. Certainly there are other assets owned by the defendants that our government could seek, so why focus on these uninvolved websites? It would seem that if these websites were taken by the government, the public would lose access to several safe, low-cost pharmacies.

Not surprisingly, John Horton misrepresents at least one of these pharmacies as being “the subject of today’s criminal charges” (more lies). Horton goes further by posting this list of websites to his blog in what we see as an attempt to smear the reputations of these uninvolved sites and part of his ongoing tactics to scare Americans away from safe and affordable medication and keep us hostage to inflated drug prices at home.

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Your prescription is required to order from a PharmacyChecker-approved online pharmacy

PharmacyChecker.com-Approved Online Pharmacies will require your valid prescription.

Rx Required!!

Question. Do online pharmacies in the PharmacyChecker Verification Program require a prescription?

PharmacyChecker Answers: Absolutely. Under our program’s rule, all PharmacyChecker.com-approved online pharmacies must require a prescription for you to obtain medication that requires a prescription. This is just one of the many important standards which define our program.

Why is this so important? First, online pharmacies which don’t require a prescription are more likely to sell you a counterfeit or poor quality medication. Second, you should be under medical supervision when taking prescribed medication.

So, if you order from a PharmacyChecker-approved online pharmacy you’ll learn firsthand that you’d better have a script in hand!

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Xtandi is Expensive, But Here’s How to Get It for Less

Photo Credit: "Pills", © 2005 mattza, Flickr | CC-BY-SA | via Wylio

Photo Credit: “Pills”, © 2005 mattza, Flickr | CC-BY-SA | via Wylio

There has been a lot of news this week about the outrageously high cost of Xtandi, a drug for advanced prostate cancer. Although developed with funding from the U.S. National Institutes of Health (NIH), Xtandi (enzalutamide) is being sold to Americans at about four times the price at which it is sold in other countries.  In January, a petition was sent to have the U.S. government step in and require that Xtandi be priced more fairly for Americans. More recently, several congresspeople and senators, including Bernie Sanders, reiterated this request with their own letter to the Secretary of Health and Human Services and the Director of the NIH.

According to the petition, the Japanese company licensed to sell Xtandi, Astellas Pharma Inc., and its U.S. marketing partner, Medivation Inc. charge an average wholesale price of $88.48 per 40 mg capsule in the U.S. However, in Japan the price is just $26.37, in Australia, it is $23.46, and just across the border in Canada the price is only $20.12.

If you only had to take a few capsules of Xtandi for a short time, this might not be such a big deal. But a standard dose of Xtandi is 4 capsules per day for months at a time. That’s 120 pills per month. So the cost of just a one-month supply of 120 pills at the average wholesale price is $10,617. That’s right, over $10,000 per month! If you must get Xtandi and you don’t have insurance which covers it, what are you to do?

First, if you have no insurance or poor insurance and a household income of $100,000 or less, you can apply to get Xtandi for free through Astellas, which may also offer other financial support.

If that doesn’t work for you, another less expensive option (short of travelling to another country) would be to order Xtandi from a verified international online pharmacy, which will send the medication to you from a licensed pharmacy in another country, such as Canada. Currently, several PharmacyChecker.com-verified online pharmacies sell Xtandi for about $41 per 40 mg capsule – about half the cost in the U.S. If you prefer to get your medication from a U.S. pharmacy, many pharmacies offer or accept discount cards which can bring the cost down a little, but only to about $75 per capsule.

It is ridiculous that American taxpayers helped develop this drug but are charged the most to get it. Hopefully, things will change.

 

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How to Get a Paper Prescription When e-Prescribing Is Required

To save money on prescription drugs, it is often necessary to have a prescription in hand to send to an international online pharmacy or shop around at local pharmacies to compare their prices and discounts. However, some U.S. states, like New York, now require that most health professionals write prescriptions electronically, without giving you a paper prescription.

So are you out of luck if you need a paper prescription? Fortunately, not.

The rules, for example, in New York (where e-prescribing becomes mandatory on March 27, 2016) provide exceptions to allow written prescriptions. One of these is when the prescription is “to be dispensed by a pharmacy located outside the state.” Therefore, in New York, a doctor can still legally hand you a prescription if you intend to have it filled outside of New York. (You can read this for yourself in paragraph (c)(5) of Title 10 NYCRR Section 80.64).

The New York law also says that a doctor who gives you a written prescription is supposed to report the issuance of that prescription to the New York Department of Health within 48 hours. However, the law does not explain how this to be done, so I asked the Department of Health. My question was forwarded to a pharmacist consultant with the department who called me back this morning. He told me that if a written prescription is given to a patient under one of the exceptions, “there is currently no functionality for reporting that to the Department of Health.” Instead, he said “the fact that a written prescription was given should just be noted in the patient’s chart.”

I also asked the pharmacist if a doctor can give a patient a written prescription so they can shop it around to find an affordable price or discount. He said that that is acceptable “if it’s deemed necessary by the doctor.” Again, he said that this should be noted in the patient’s chart.

UPDATE: Shortly after publishing this blog post, the Department of Health updated its FAQ about e-Prescribing, changing its advice on this topic. It has created an email address (erx@health.ny.gov) to which a practitioner should send a message if a written prescription is given (see details in the FAQ in answers to Q139 to Q143). It would seem prudent to also make a note in the patient’s chart for the reason for the written prescription.

E-prescribing is practiced to some degree in all 50 states and 60% of all NY prescribers already e-prescribe. Minnesota has adopted a comprehensive e-prescribing program. But only NY, as of March 27th, will issue fines to prescribers who don’t follow the rules.

The e-prescribing laws were originally enacted to cut down on improper dispensing of controlled substances but are being extended to all prescriptions. The reasons given in New York are “to minimize medication errors” and “the integration of prescription records directly into the patient’s electronic medical record.” In addition, “Electronic prescribing has the potential to reduce prescription theft and forgery.” That’s all well and good, but it is also important that it does not interfere with the overall delivery of good medical care — which includes making sure that patients are able to afford their medicine.

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Blink Health — An Additional Tool in Finding the Lowest Drug Prices

The article “Taming Drug Prices by Pulling Back the Curtain Online” in the New York Times (February 10, 2016) features a new website, Blink Health, which shows reduced drug prices available through local U.S. pharmacies. Its limitation is that savings are mostly on generic drugs, which, for the most part, are already fairly inexpensive. Describing Blink and a similar site, GoodRx, the article notes that, “The sites cannot help much with brand-name drugs, which are made by a single manufacturer and carry prices that can be as high as hundreds of thousands of dollars.”

The article fails to mention that the largest pharmacy savings on the Internet are from international online pharmacies which can offer you the lowest prices worldwide. These prices can be found on PharmacyChecker.com, which “pulls back the curtain” even further than Blink Health and GoodRx by exposing the huge gap (often more than 80%) between drug prices in the U.S. and those in other countries — such as Australia, Canada, India, New Zealand, Turkey, and the UK. You can also find discounted local U.S. pharmacy prices on PharmacyChecker.com.

The table below shows the lowest prices on popular brand name drugs found on PharmacyChecker.com, BlinkHealth.com, and GoodRx.com in comparison to regular U.S. pharmacy pricing.

Lowest Prices and Greatest Savings on Brand Name Drugs Using PharmacyChecker, Blink Health, and GoodRx

Drug Name
(Strength and Quantity*)
PharmacyChecker
(PC)
Blink Health
(BH)
GoodRx
(GR)
Regular Price
at Local Pharmacy
Greatest Savings
Off Regular Price (Source)
Advair Diskus
(250-50; 180 doses )
$100.99Not Available$946.72$1,179.00 91% (PC)
Crestor
(10 mg; 90 pills)
$44.99$779.64$718.12$870.0095% (PC)
Eliquis
(5 mg; 180 pills)
$391.99$1,046.28 $961.67$1,141.00 66% (PC)
Januvia
(100 mg; 90 pills)
$101.15$1,139.64 $1,046.94 $1,290.00 92% (PC)
Xarelto
(20 mg; 90 pills)
$347.59$1,045.31 $960.81$1,141.00 70% (PC)

Prices as of February 10, 2016

* Quantity represents a standard 3 month supply.

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