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Helping Americans Get The Truth About Prescription Drug Savings
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NABP Changing Its Tune on Drug Importation?

For years, the National Association of Boards of Pharmacy (NABP) has opposed new drug importation proposals that would improve access to more affordable medication from Canada and other countries. Led by its executive director, Carmen Catizone, PharmD, the NABP’s efforts pertaining to drug importation have focused mostly on opposing online access to imported medications – meaning Americans getting cheaper meds from Canada and other countries. This is not surprising. NABP has received a lot of money from pharmaceutical companies for these efforts. Also, NABP represents U.S. pharmacy boards and the members of those boards often have financial interests in U.S. pharmacies. But here’s a surprise…

Earlier this week, an article in the Washington Post focused on various prescription drug importation programs offered by cities, counties and schools to lower pharmaceutical bills for retirees and municipalities. According to the article, the FDA may view these programs as illegal. The FDA recently raided some pharmacy storefronts in Florida but did not shut them down. Those programs help Americans—especially the elderly— order affordable medications from other countries. Operating for 10, some even 15 years without interruption, they continue to save millions of dollars a year.

Mr. Catizone had the last word in the article. (more…)

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Eli Lilly’s and Alex Azar’s Position on Importation is a Canard

Alex AzarThis week, President Trump potentially handed Big Pharma one of its greatest victories by appointing Alex Azar the new Secretary of Health and Human Services (HHS). Why? Until earlier this year, Alex Azar was the president of Eli Lilly USA and few people (companies are people?) on earth personify Big Pharma like Eli Lilly.

This matters to Americans who import lower cost medication to fill prescriptions because the FDA is an agency housed in HHS, and HHS has a lot of statutory power when it comes to importation of prescription drugs.

President Trump campaigned on making it legal for Americans to buy lower-cost medications from other countries, but Eli Lilly and Alex Azar are leading opponents of safe importation. In fact, Eli Lilly is perhaps the leader when it comes to hatching, or funding, strategic communications and lobbying campaigns to stop Americans from using safe, international online pharmacies. Its efforts through the non-profit group, Alliance for Safe Online Pharmacies—FUNDED BY ELI LILLY—have been frighteningly successful at fooling our elected officials and the public that international online pharmacies are inherently bad for Americans. They do so by conflating counterfeit drugs and even fentanyl abuse with safe international online pharmacies. As I see it, Eli Lilly’s narrative on online pharmacy and importation incorporates the most sinister aspects of fake news. Really. (more…)

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FDA Relinquishes Control to Foreign Drug Regulators

FDA Commissioner, Scott GottliebThis week, FDA Commissioner Scott Gottlieb announced that inspections by drug regulatory authorities of foreign manufacturing plants that export pharmaceuticals to the U.S. are sufficient to ensure the integrity of those products: meaning the FDA doesn’t also need to inspect them. The countries identified are Austria, Croatia, France, Italy, Malta, Spain, Sweden, and the United Kingdom. All are currently members of the European Union (the UK is soon Brexiting).

Although this has made headlines as an unprecedented practice, the FDA relying on inspections from foreign regulators is not an entirely new development. The FDA does not inspect all foreign plants that export medicine to the U.S. even though most pharmaceuticals sold in the U.S. are foreign-made.

So what’s with the big announcement then?

(more…)

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Why Pharma Is So Focused on Importation

Last weekend, Jay Hancock of Kaiser Health News wrote an article entitled “Everyone Says We Must Control Exorbitant Drug Prices. So, Why Don’t We?” I’ve been thinking about it all week, as it ubiquitously made the rounds among our community of activists, journalists, policy wonks, etc.—many passionate people that focus on drug pricing and viable solutions.

Mr. Hancock’s answer was most cogently provided by writing that momentum has slowed on drug prices: “amid rancorous debates over replacing Obamacare (…) stalled by roadblocks erected via lobbying and industry cash.” Yesterday, with the threat of Obamacare’s demise alleviated, it’s worth noting, Congressman Elijah Cummings (D-DE) called out President Trump’s inaction on drug prices and for flouting his campaign promises. I suspect there will be more hearings, and talk, and talk, and condemnation, more talk, and exasperation with Big Pharma, mostly from Democrats but also from Republicans.

While pharmaceutical company lobbying initiatives loom over Congress’ every move preventing legislation and regulatory reforms to actually help Americans, patients are forced to ration and tens of millions skip taking critical meds due to cost. Mr. Hancock gives a rundown of the policies on the table to tackle high drug prices: drug importation, transparency, Medicare drug price negotiations, improved generic availability and competition. (more…)

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Buying Insulin in Canada Without a Prescription (BTC)

With insulin prices skyrocketing, no wonder the diabetic community is taking to social media to network and share their experiences as they swap tips and tricks not only for moral support, but also financial.

This month, we received an interesting consumer comment via our Facebook page asking if we knew that Americans are driving to Canada to buy insulin without a prescription. Well, no. As our primary focus is mail-order pharmacy, it wasn’t on our radar. Nevertheless, it sparked our interest and we’d like to share our findings with the PharmacyChecker community.

After calling 20 pharmacies across Canada (specifically in the following cities: Québec City, Toronto, Alberta, Victoria, Winnipeg and Regina) the answer is clear: Americans can obtain insulin without a prescription in Canada. All pharmacists that I called reported—rather matter-of-factly—that you do not need a prescription for any insulin product, which would include Lantus Solostar, Humalog and Levemir. We specifically talked about Lantus Solostar, a popular, long-acting insulin. The price in Canada for a three-month supply of Lantus Solostar (3 ml) is currently around $447.00 while the average retail price in the U.S. is a staggering $1,160.39. Apparently, they practice what they preach: all patients—including Americans—do not need a prescription to obtain insulin in Canada. While a prescription is not needed, the drugs are available only from the pharmacist and must be retained within an area of the pharmacy where there is no public access and no opportunity for patient self-selection (also known in the U.S. as Behind the Counter (BTC).

There are some important nuances about insulin sales in Canada that might interest you. To start, insulin is not on the Health Canada Prescription Drug List. Health Canada—the regulatory agency in Canada that is comparable to the FDA in the United States—lists insulin as a Schedule II drug. The word “schedule” in the U.S. is used to identify those medications associated with greater potential for addiction, such as Ambien or Vicodin (a prescription opiate) and other controlled substnaces. The lexicon is confusingly different in Canada and important to explain here! In Canada, Schedule II drugs, while not as strictly regulated, do still require professional intervention from the pharmacist at the point of sale and possibly a referral to a practitioner. Click here for the drug schedules regulations in British Columbia.

And did you know that when you’re crossing the border, the U.S. Customs Border Patrol (CBP) is not allowed to stop the importation of FDA-approved medication from Canada for personal use – even though it’s technically prohibited? See: Public Law 115-31. Now you know!

Something to keep in mind for those Americans ordering medications from Canada (or from any other country) through a PharmacyChecker-verified online pharmacy: you must have a prescription if a prescription is required in the United States even if one is not required elsewhere!

So, in practice, insulin products can be sold in Canada without a prescription after consultation with a pharmacist. Sound great? It is! Nevertheless, be sure to give that friendly Canadian pharmacist a call to make sure they can help you before filling up your tank for that road trip to Toronto.

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The Myth of the Closed U.S. Drug Distribution System

By way of the craftiest of PR snakes, pharmaceutical companies infest the media, politicians, and consumers with the idea that if we expressly permit people to buy lower-cost medications from other countries, we break the “closed” pharmaceutical distribution system. This concept of a “closed” system is sadly overplayed and misleading.

The U.S. Food and Drug Administration (FDA) is one of the leading drug regulatory authorities, but as the pharmaceutical industry continues its propagandistic efforts against legalizing importation of lower-cost medication, the myth making has got to be called out.  You’ll have to forgive me for the lengthy post: I’ve chosen to include long quotes from experts—perhaps to offset my frustrated tone—but mostly to properly inform you what we’re up against.

The fact is, you can trust the safety and efficacy of medications sold in the U.S., but NOT more so than Canada or many other countries. People are not paying attention to the perpetual lies Big Pharma regurgitates on this issue. In a follow-up post, I’m going to discuss myriad ways that the FDA is doing a much better job, but, for the moment, excuse me while I blow off sufficient “What-the-hell-is-going-on?!” steam. (more…)

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