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When FDA-Approved Generics Fail: Brand Wellbutrin XL Antidepressant is Cheaper from Canada

When you lose count of how many folks have the same suspicion about a prescription medication, action is compulsory. Joe and Teresa Graedon, founders of The People’s Pharmacy, not only have an admirable track record of telling health consumers how it is, but also listening to those in their readership. Years ago, they took on the Food and Drug Administration in regards to Budeprion XL distributed by Teva Pharmaceuticals, the supposed generic equivalent to the popular antidepressant, Wellbutrin XL. Many readers complained that it just wasn’t cutting it compared to the brand name version. In fact, many people reported that when they were switched to the Teva generic Wellbutrin XL, their depression returned. 

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Amazon Pharmacy is going international. Will that lower drug prices?

Amazon Pharmacy recently registered trademarks in Australia, Canada, and the United Kingdom but has not announced its stated plans for these registrations. For those of you who did not know that there is an Amazon Pharmacy, now you do. Amazon acquired online pharmacy PillPack in 2018 as part of its push into pharmaceutical sales. Pillpack specializes in the delivery of prescription drug orders in specially-tailored packages to meet the individual needs of patients. In its own words: “Our claim to fame is delivering medications pre-sorted into packets by time of day. And we’re very good at that.” As of the end of last year, Amazon began branding PillPack-related information with “Amazon Pharmacy.” Also noteworthy is that prior to its acquisition of PillPack, Amazon started to quietly obtain wholesale pharmacy licenses.

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Investing In The U.S. Health System By Lowering Drug Prices, Reducing, Out-of-Pocket Costs and Improving the Medicare Benefit

The following statement, recently published in the Congressional Record, was submitted by Gabriel Levitt on October 30, 2019, on behalf of PharmacyChecker and Prescription Justice, to the Committee on Ways and Means of the U.S. House of Representatives 116th Congress pertaining to a hearing entitled: “Investing In The U.S. Health System By Lowering Drug Prices, Reducing, Out-of-Pocket Costs and Improving the Medicare Benefit”.

“Investing In The U.S. Health System By Lowering Drug Prices, Reducing, Out-of-Pocket Costs and Improving the Medicare Benefit”

October 29, 2019

Gabriel Levitt

Co-founder and President, PharmacyChecker.com, 333 Mamaroneck Avenue, White Plains, NY 10605, 718-554-3067, gabriel.levitt@pharmacychecker.com

Founder and President, Prescription Justice, 3309 Robbins Road, #412, Springfield, Illinois 62704, gabriel@prescriptionjustice.org

Our company, PharmacyChecker.com verifies online pharmacies, and compares drug prices among those accredited in our online pharmacy Verification Program. Consumers, Americans and worldwide, access our website for free. Our website has received about 30 million visitors since we launched our virtual doors in 2003. Our niche is comparative pricing and the proper credentialing of international online pharmacies, which process prescription drug orders filled by licensed pharmacies in several countries, require valid prescriptions, and do not ship controlled drugs into the U.S. We also provide information about discounted U.S. pharmacy prices and patient assistance programs.  The information we provide helps people make the best decisions for themselves and their families when struggling with the cost of prescription drugs.[i]

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Helping Congress Learn More about Foreign Pharmacy Prices

A few weeks back, I wrote about the House Ways and Means Committee international drug price report, which very competently compared U.S. patented drug prices with 11 other countries. The report found that 79 drugs, ones that account for 60% of Medicare drug spending, are on average priced just under 75% lower internationally vs. the U.S. when looking at ex-factory, meaning wholesale prices.

I half-joked that the Committee was recommending looking abroad for lower drug prices. They were not focusing on drug importation. However, the Committee held a hearing yesterday in which foreign drug prices were central to the debate. The focus of the hearing was a bill, H.R. 3, Lower Drug Costs Now Act, which seeks to lower drug prices in Medicare by empowering Medicare to negotiate with drug companies prices on certain, generally very expensive drugs. There’s a backstop in the bill if the drug companies won’t negotiate in which drugs would be priced at 120% of the average price of six high-income countries. That’s called international reference pricing. The bottom line here is that Congress is now shining a bright light on how much more expensive the “same” drugs are in the U.S. vs. abroad.

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FDA Drafts Guidance to Allow Lower-Cost Foreign Drug Imports From Any Country

The FDA has finished draft guidance on one of two of the Trump administration’s drug importation policy ideas, referred to as Pathway II. The title of this post may seem like a joke for those of you who follow the issue of drug importation in America, but it is real. As a reminder, in August 2019 the administration took its support for drug importation a step further by stating its willingness to support state drug importation programs, Pathway I, and a new idea to give drug companies greater flexibility with their global drug supplies to offer better prices in the U.S, called Pathway II.

Earlier this week, the guidance on Pathway II was sent to the White House Office of Management and Budget (OMB), although I believe it’s not public yet. I found out about the submission to OMB here (BioCentury). It doesn’t relate – at least not directly – to personal drug importation, but it frees the hands of drug companies to sell their own foreign versions of FDA-approved drugs at lower prices in the U.S. market. Its indirect relation to personal drug importation is noted at the end of this post.

Some of this is guesswork. It’s not entirely clear to me what drugs are permissible under Pathway II and it won’t be until the draft guidance is made public.

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Trump’s Campaign Website’s Only Drug Prices Policy Was Importation

If you care about and follow the issue of drug prices, then this week was bizarre on the political scene. In a press conference with Rep. Adam Schiff (D-CA) at her side, Speaker of the House Nancy Pelosi (D-CA) was imploring the media not to focus only on impeachment but on drug prices, noting that she believes Congress and President Trump can continue to work together despite the friction.

Yesterday, Trump was courting seniors in Florida, extolling drug price reductions under his watch that kind of, you know, never really happened and promising to save Medicare from “socialism” (go figure, Medicare is already a huge government program). Bizarrely, he implied that Big Pharma might have something to do with the impeachment inquiry against him. Maybe his Secretary of Health and Human Services, former Eli Lilly Pres. Alex Azar, is in on the “coup”… just joking. 

In the haze of the political circus, something fundamental keeps getting lost. During Trump’s 2016 campaign, the only policy he put forward on his website to bring down drug prices was drug importation. See below screenshot:

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