PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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New PharmacyChecker Slideshow Shows How to Take Advantage of Lower Drug Prices Abroad

Millions of American consumers are buying medication online from pharmacies outside the U.S. at much lower prices than at home but some are not doing it safely.  Since 2003, we at PharmacyChecker.com have been checking the credentials of online pharmacies to help you stay safe, as well as making it easy for you to compare and find the lowest drug prices.  For those who may be unfamiliar with how we do this, we’ve created a slideshow.

The slideshow explains that the main reason many drug prices are lower online is because drugs are often much less expensive outside the United States. It’s that plain and simple. People can save as much as 95% on their medications. And while the U.S. FDA discourages people from getting their medication this way and generally considers it not to be legal, no one has ever been prosecuted for purchasing medication for themselves this way.

Unfortunately, the overwhelming majority of websites selling medication are not verified for safety, don’t require a prescription, and may sell counterfeit, adulterated and expired medication. In contrast, medications ordered from online pharmacies verified by PharmacyChecker.com are dispensed from licensed pharmacies that require valid prescriptions and meet high safety standards.

I hope the slideshow is helpful and encourage you to share it with others.

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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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Never-ending Gleevec Drug Price Increases Are Prime Example of Market Failure and Greed

Gleevec 400 mg tablets

Gleevec 400 mg tablets.  photo adapted from [CC BY-SA 3.0], Patrick Pelletier via Wikimedia Commons

An article in the Washington Post yesterday covered the steep rise in the cost of a cancer medication called Gleevec, drug company Novartis’ brand name for imatinib, which is incredibly successful in treating people with chronic myeloid leukemia (CML). Despite its concern with public perception over price at the time, Novartis charged $26,400/year when the drug hit the market in 2001. With today’s price for Gleevec now $126,000/year it seems any concerns by Novartis have gone by the wayside (or did they really exist at all?). One would think and hope that new, similar products would bring down – or at least slow increases of – the price of Gleevec. After all, competition is supposed to drive down prices.

Not in the pharmaceutical industry, at least not until a drug goes off patent. The launch of therapeutically equivalent brand medications to treat CML actually coincided with Gleevec’s steepest price increases. Bristol-Myers Squibb launched Sprycel (dasatinib) in 2006 and Novartis launched a second generation drug called Tasinga (nilotinib) in 2007, both at much higher prices than Gleevec. In 2007, the monthly prices for Gleevec, Sprycel and Tasinga were $3,757, $5,477 and $6,929, respectively. The details can be found in the Post’s article but essentially Gleevec started to play “catch up” to its competitors.

In 2007, the price of Gleevec was 46% less than Tasinga. By 2014, the discount had shrunk to 12% with Gleevec’s price at $8,156/month compared to Tasinga’s price of $9,300/month. Let’s keep in mind that the newer drugs were shown to treat people that Gleevec could not treat, which would soften the argument that these are truly competing products. But soon after their introduction, Sprycel and Tasinga were found to successfully treat people with newly diagnosed cases of CML, to more directly compete with Gleevec, yet the latter’s price soared!

Source: Graph below from the Washington Post.

Graph - increase in Gleevec Rising drug prices New drugs treating chronic myeloid leukemia were introduced at prices higher than Gleevec's. their prices have gradually risen since, and Gleevec's price has increased at a greater clip.

One source cited in the post’s article summed it up perfectly. A hematologist from the University of Chicago, Richard Larson, stated: “Ordinarily, you might think with three equally effective drugs on the market, the price should go down through competition, but it’s been a failure of the competitive pricing process.”

While the Washington Post’s article delved into the problem of out of pocket costs for Gleevec, it didn’t hammer home that the suffering in America is extreme when it comes to Gleevec’s drug price (and other medication prices as well). Gleevec is not a new topic on these blog pages, which has solicited comments from people and families crushed by drug costs. Yes, the irony is glaring: cancer medications that alleviate suffering also create suffering, too, in the form of cancer patients facing bankruptcy, feeling guilt, and causing anxiety.

It’s not just market failure – it is greed, too. I’ll let one American, Penny Kincaid, a commenter on this blog, bring it home:

“I guess I am luckier than many on Gleevec. I am paying 5% of the cost each month but the cost keeps going up. Our lives depend on this drug but still the cost is obscene. They praise themselves for creating [these] drugs for patients with [CML] but still we are forced to pay and many go broke. It is the cancer patient who has to pay up or die and they keep raising the cost. This is just wrong in so many ways and here we have the creators wanting to deny us the generic because they want that big money to keep rolling in. They should be ashamed of themselves.”

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Does Criticizing Big Pharma Actually Help Bring Down Drug Prices? Is Real Change Possible?

Pills with Twenty Dollar Bills

Photo by Chris Potter

Unfortunately, public scrutiny about high drug prices doesn’t usually lead to legislative fixes, such as passing legislation that would allow Medicare to negotiate drug prices with the pharmaceutical industry and expand the practice of safe personal drug importation so more consumers access lower prices from foreign pharmacies. On the other hand, a New York Times article – “Even Talking About Reducing Drug Prices Can Reduce Drug Prices” – suggests, well, that “talking about” drug prices can reduce them, because pharma executives get scared that if they don’t moderate drug prices, more permanent and progressive fixes will finally happen.

(more…)

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Pirfenidone: Why Is It $94,000 in the U.S., But $2,000 Elsewhere?

In the article “I.P.F., Not Aging, Could Be Causing Breathlessness” in the New York Times this week, columnist Jane Brody explains that the drug Esbriet (pirfenidone) can “slow the loss of lung function and significantly reduce deaths” from an incurable lung disease called idiopathic pulmonary fibrosis, or I.P.F.

The article notes that Esbriet was approved in the U.S. in 2014 and now 14,000 people have begun treatment, which costs $94,000 per year. The article also notes that the drug has been available for several years in other parts of the world (including Japan, India, Europe and Canada).

What the article does not mention is that this incredible drug can be purchased at just a fraction of the cost through many online pharmacies which dispense it from licensed pharmacies outside the U.S – where the cost is only about $2,000 per year, rather than $94,000 per year.

The standard dose of Esbriet is 801 mg per day – 3 capsules, each containing 267 mg of pirfenidone, according to the NIH website DailyMed. Outside the U.S., pirfenidone is sold as 200 mg capsules (so 4 capsules would provide a similar dose – 800 mg). In the U.S., the price of each 267 mg capsule (without any discount) comes out to about $85, while a 200 mg capsule from outside the U.S. costs about $1.50 (prices listed at http://www.pharmacychecker.com/generic/price-comparison/pirfenidone/200+mg/)

Why must Americans (and our government programs) pay 40 to 50 times more than to get this drug in the U.S. than from elsewhere?

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