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Sen. Nelson Wants Answers from FDA on Actions Against Affordable Rx Imports in Florida

Sen. Nelson.

Standing up for his constituents on drug prices

Last month, I blogged about the FDA Office of Criminal Investigations’ sending agents with search warrants to pharmacy storefronts in Florida that help older people buy more affordable medications from Canada and other countries. The FDA tried unsuccessfully to get one of the stores’ owners, Bill Hepscher, who runs Canadian MedStore, to sign a statement acknowledging that reimportation of prescription drugs is illegal. The Florida pharmacy storefront story was first reported in Kaiser Health News.

Yesterday, Senator Bill Nelson (D-FL) sent a letter to FDA Commissioner Scott Gottlieb demanding to know why some prescription orders coming from Canada and other countries were seized, and inquiring why the FDA raided the storefront offices.

Clearly, Sen. Nelson understands the technical illegality of personal drug imports and the need to protect people from counterfeit drugs and Fentanyl. However, his letter underscores his confusion about why the FDA is stopping people from getting non-controlled, regular prescription drugs now. He wants to know specifically if there is a change in FDA’s overall enforcement policy.

I’ve been warning about the serious public health ramifications of overzealous FDA enforcement on access to affordable medication for a long time. In 2015, I wrote a report about online pharmacies and personal drug importation, and sent it to the Senate Committee on Health, Education, Labor and Pensions and the House Committee on Energy and Commerce.

Back in 2006, Senator Nelson played the leading role in ending stepped-up enforcement efforts by U.S. Customs and Border Patrol (more…)

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FDA Actions Against Canadian Pharmacy Storefronts in Florida

Florida PharmacyNovember 20, 2017 — Kaiser Health News reported that the FDA Office of Criminal Investigations sent agents and search warrants to several companies in Florida — often referred to as pharmacy storefronts — because they help Americans place orders and fill prescriptions with pharmacies located in Canada in addition to other countries.

Read the full story here: FDA Raids Florida Stores That Consumers Use to Buy Drugs from Canada

The FDA has a lot of regulatory latitude to shape its enforcement agenda. Its efforts against counterfeit drug sales, opioid pushers (including drug companies), and rogue websites can greatly protect public health. However, we know that FDA/OCI has a history of actions more focused on protecting the profits of pharmaceutical companies.

PharmacyChecker.com opposes enforcement actions that target the safest international pharmacy options, whether via online pharmacies or storefronts, on which many Americans have come to rely because they can’t afford medications locally.

FDA has informed storefront operators that prescription drug importation is illegal and that they could face fines or jailtime for helping Americans buy lower-cost medication. (more…)

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What FDA Commissioner Gottlieb’s Mission on Drug Prices Says about Importation

FDA Commissioner Scott Gottlieb, MD

This week, FDA Commissioner Scott Gottlieb said something revolutionary about the role of the FDA. For many years, the agency has maintained that its sole focus when it comes to regulating drugs is to ensure their safety and efficacy, but that drug prices are beyond its purview. In remarks pertaining to the FDA’s new initiative to speed up generic drug approvals of complex  pharmaceuticals, Gottlieb stated that “if consumers are priced out of the drugs they need, that’s a public health concern that FDA should address.”

To those who support safe importation of lower-cost medications, that statement was the shot heard around the world. Indeed, drug prices are a public health concern. If we’re using logic, reason, and commonsense, it becomes untenable from a public policy and health perspective, grounded in basic medical ethics, to prohibit or even discourage importation of lawfully-manufactured medication by individuals who can’t afford it locally. (more…)

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Topical Pain Medications Much Cheaper Outside the US

When it comes to the topic of pain medication these days, we usually read about prescription opioid abuse, which tragically claims tens of thousands of lives each year. According to a recent article in the New York Times, while the landscape of dangers is different, we should also be concerned about every day, over-the-counter pain medication. NSAIDs (nonsteroidal anti-inflammatory drugs) are common pain relievers you may keep around the house to relieve an occasional headache, toothache or post-workout soreness. They are also used to treat fever, arthritis, menstrual pain, migraines and inflammation. Aspirin, ibuprofen, and naproxen are among the over-the-counter NSAIDs you’re probably most familiar with.

Particularly for those with a history of coronary artery disease, NSAIDs can cause serious health issues because they can clog your blood vessels. For others, NSAIDs can do harm to your digestive tracts. Other side effects, according to the article, include, “ulcers, bleeding, kidney failure and, in rare cases, liver failure.”

It appears that topical formulations, such as ointments, perhaps have minimal or fewer side effects. Here’s the rub…(pun absolutely intended)

(more…)

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FDA Cannot Ensure the Safety of Medications Purchased from Canadian Pharmacies but can Health Canada?

Mostly.

Let’s get into semantics. The word “ensure” is defined as to secure or guarantee, to make sure or certain, or to make secure or safe, as from harm. I submit that the FDA cannot ensure the safety of Canadian OR U.S. drugs, but that doesn’t mean they are not safe and effective

 

Pharmaceutical Regulation in Canada

The precise communications of the U.S. Food and Drug Administration have changed over the years on why it’s illegal for Americans to buy medications from Canada by personally importing them. Often the implication is that the agency cannot “ensure” or “guarantee” the safety of medications sold in Canadian pharmacies – and that’s why it’s illegal. Additionally, another reason used by the FDA  is that the drugs sold in Canada may not be approved by the FDA. These are not good arguments against buying lower cost medications from Canada because the Therapeutic Products Directorate of Health Canada, the FDA’s counterpart, is responsible for regulating the prescription drugs sold in Canadian pharmacies. Like the U.S., Canada has very strict rules to help ensure drug safety.

Neither country can guarantee the safety, efficacy and quality of medications in the two countries. However, their regulatory mechanisms have proven more than adequate, if not superior, so that patients buying medications will almost always obtain a properly manufactured medication. (more…)

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Can four FDA commissioners be wrong about drug Importation?

Yes. Last week, the four most recent commissioners of the U.S. Food and Drug Administration sent an open letter to Congress declaring that an importation bill, The Affordable and Safe Prescription Drug Importation Act, introduced by Senators Bernie Sanders, Cory Booker, and Bob Casey, if passed, would jeopardize consumer safety. The bill, as described here, provides for an extensive oversight role for the FDA to help individuals and pharmacies import lower cost medications from Canada.

Don’t get me wrong: the former FDA leaders make pertinent points about regulatory issues implicated in reforming our importation laws, which should be noted – and then used to implement new regulations to expand importation from Canada – not used to pretend safe importation is impossible.

Thankfully, when the Washington Post covered this last week, they included something I said to the reporter: “The Internet has been a lifeline of affordable medicines, imported for personal use by using safe international online pharmacies that require valid prescriptions…” And if I had more to say… (more…)

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