The greed of pharmaceutical companies has become overbearing: not only their price gouging, but rampant public relations and lobbying campaigns attempt to muzzle the majority of Americans who demand lower drug prices.
There is profound frustration and anger reverberating throughout the diabetic community due to the skyrocketing prices of insulin in the United States. Pharmaceutical companies like Novo Nordisk, Eli Lilly and Sanofi are charging out-of-reach prices for insulin medications necessary for diabetics’ survival.
On September 9th, 2017, over forty people gathered outside of Eli Lilly headquarters in Indianapolis to make a statement on behalf of American citizens living with diabetes and, in actuality, all Americans who face the highest drug prices in the world.
Both opioid abuse and the high price of medication have wreaked hell on Americans and their families, and now two very different bills in Congress that affect drug importation aim to alleviate these crises. However, if the pharmaceutical industry has its way, the bill meant to address the opioid problem will worsen the catastrophe of inflated drug prices in the United States by threatening American access to lower cost medication imported from Canada and other countries.
While the high cost of prescription medication is often attributed to the greed of pharmaceutical companies, fewer people are aware that that same avarice aided in causing the epidemic of opioid abuse. Decades ago, drug companies successfully pushed for looser prescribing rules for opioids, which encouraged providers to overprescribe them to their patients.
According to the Centers for Disease Control and Prevention (CDC), 33,091 Americans died in 2015 from overdosing on opioid drugs, but high drug prices can kill, too. Approximately 45 million Americans did not fill a prescription last year due to soaring costs of medication. When people fail to take prescribed medication it frequently leads to illness and too often, worse, death. The CDC estimates that 125,000 people die each year because they are not taking the necessary medications for chronic conditions.
In 2015, the CDC reported synthetic opioid overdose as the cause of death of 9,580 people, a 72.8 percent increase from 2014. Many of these cases are tied directly to fentanyl. Granted, some deaths can be attributed to lawfully manufactured fentanyl, but the CDC believes that illicitly manufactured fentanyl, which is also used to make counterfeit prescription narcotics including imitation Vicodin and Oxycontin, is the real culprit.
The STOP Act’s language targets the United States Postal Service, through which the fentanyl is coming in, and this is at the heart of the problem.
Under current law, commercial carriers, such as Federal Express and UPS, must provide U.S. Customs and Border Protection, the agency responsible for policing imported goods, advance electronic data about incoming deliveries. That data makes it easier to stop illegal imports, which include illegal fentanyl from China, but also safe prescription medication from Canada.
The USPS does not receive advance electronic data at its international mail centers as uniformly as private carriers, which means fentanyl can be delivered by the USPS. The STOP Act would force USPS to demand advance electronic data from foreign postal services, like Canada Post, and operate similarly to private carriers – making it potentially much easier to stop the fentanyl imports. The twist is that safe and more affordable medication purchased by Americans can also be stopped this way. The bill should be amended to prevent that.
While the scourge of illegal opioid importation is something we should stop, importation of affordable, non-narcotic prescription medication is a lifeline for millions of families. Despite federal restrictions, about 19 million Americans have imported medication for personal use due to high prescription drug prices in the U.S. The practice is prohibited under most circumstances, but individuals are not prosecuted.
The bill would also prohibit importation of controlled drugs, such as prescription narcotics, whether lawfully manufactured or fake. Earlier this month, a coalition of non-profit organizations signed on to a letter to Congress supporting the importation bill and those Americans who currently need to import lower cost medication.
Killing the Sanders importation bill, a goal of the pharmaceutical industry, is just the latest chapter in its long campaign to scare people and politicians about importation. A key strategy is to conflate importation of real medicine with that of counterfeit drugs and narcotics, as well as safe international online pharmacies with rogue ones.
Organizations funded by drug companies are promoting the STOP Act, noting it will protect people from not just fentanyl, but counterfeit drugs online. They are conspicuously silent (but they know) that the proposed rules could also curtail imports of genuine medication ordered online from other countries.
There are rogue online pharmacies that are dangerous and sell counterfeit drugs, but they can be avoided with public education and targeting by regulatory and law enforcement actions. For those who buy from properly verified international online pharmacies, personal importation can be equally as safe as walking in your local pharmacy. The safest international online pharmacies all require valid prescriptions, do not sell controlled medications, and do not sell opioids. Their prescription drug prices are often 70 percent lower than in the U.S., and this access to affordable medication is something that should not face roadblocks by the USPS.
Although pharmaceutical companies did not cause illegal importation of dangerous synthetic opioids, their efforts to promote loose prescribing of narcotics fanned those flames. Clearly, skyrocketing medication prices at home have led Americans to illegally obtain lower cost medications from international pharmacies.
We must not restrict imports of safe and affordable medication in an effort to stop illegal opioid trafficking. Allowing the STOP Act to become law in its current form, while a gift to Big Pharma, could prevent many Americans from getting the medication they need.
Gabriel Levitt is president of PharmacyChecker.com, a company which verifies online pharmacies and lists drug price comparisons, and founder of Prescription Justice, a non-profit organization dedicated to ending the crisis of high drug prices in America. Financial disclosure: PharmacyChecker derives revenues from its Pharmacy Verification and Listing Programs.
The economist and drug safety expert Roger Bate, PhD, affiliated with the American Enterprise Institute, published a short article this week, the title of which says it all: “Credentialed online pharmacies are so safe that peer review literature is no longer interested in results showing it.” The gist is that he and colleagues have been testing medications for several years, since 2008, as mystery shoppers ordering online domestically here in the U.S. and internationally for import. The research shreds the myths of the drug companies by presenting peer-reviewed data to derive what are called “facts” about the Internet and importation. The main fact proved is that importing medications, ones ordered online, can be equally safe as U.S. pharmacies.
In the studies from 2008-2016, 822 online medication orders were tested: 275 medications from 22 international online pharmacies verified by PharmacyChecker.com (12 of which are also verified by the Canadian International Pharmacy Association); 127 medications from eight U.S.-only online pharmacies verified by the National Association of Boards of Pharmacy and/or LegitScript.com, and the rest from websites with no verification.
Verified U.S. pharmacies sold zero counterfeits but one (out of 127) order of generic Cipro was substandard. Verified international pharmacies sold zero counterfeits but one (out of 275) order of generic Cipro was substandard. On a percentage basis, the PharmacyChecker.com-verified websites performed best (but that’s nitpicking). And for those of you thinking, well, one was substandard…that same medication is available at your local Walgreens or CVS. Read the research.
In contrast, online pharmacies with no verification (Dr. Bate calls it “credentialing”) sold eight counterfeits and 16 substandard drugs (out of 332 tested).
How about prices? When it came to brand name drug prices, the studies showed that credentialed international pharmacies were about 60% cheaper. (more…)
A product of the RightsCon Conference, the completion of the Brussels Principles on Medication Sales over the Internet was announced last month. Those principles invoke international human rights law in defending the online sale and purchase of affordable medications that are imported by consumers. Many countries view access to healthcare and by extension to essential medications as a human right, which is reflected in recent declarations by the United Nations Human Rights Council.
I happen to be a very patriotic American, one who believes in global cooperation, human rights law and the work of the United Nations as being good for our country. I respect that many Americans are turned off by or concerned about globalization, international agreements or the UN and we can disagree on that. But you know what, we don’t need global human rights law to make our case against Big Pharma and its price gouging: we have our Founding Fathers and national notions of liberty to rely on.
In considering the spirit of the July 4th holiday, it’s worth remembering that the rights of life, liberty and the pursuit of happiness in the Declaration of Independence do not guarantee us access to all we want or economic equality. I believe, however, that those rights include the freedom to purchase medication at a price we can afford and any laws that prevent us from doing so violate those rights.
Those sacred rights enshrined in the Declaration of Independence, according to the Founding Fathers, were not granted to us by government (or international organizations). They are divine rights. Think about that the next time you consider buying lower cost imported medication from Canada.
Amidst Washington’s vapid attempt at “solving” healthcare, Americans continue dealing with the everyday obstacles that come with prioritizing our families’ health, and all the while, prescription drug costs just keep rising. Minority communities are particularly at risk.
The crisis of rising drug costs expands beyond minority groups, but studies show that Hispanics are more likely to forgo filling a prescription due to cost than the population at large. Worse, as immigrants increasingly fear leaving their homes, undocumented immigrants will be less likely to get needed medications. Wherever you stand on the immigration issue, this trend is unacceptable and must be combatted by educating all people about lower cost drugs available abroad, but some people are getting this wrong…
In a recent op-ed written by Garfield Clunie and Richard Williams and published in Morning Consult, a well-meaning yet dangerous claim is made—that “if [Congress permits the importation of prescription medicines from other countries], the United States government will actually be promoting the use of counterfeit and unsafe medications.” This is simply false. (more…)