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Fewer Americans Importing Medications in 2016: Good or Bad? Oh, and Happy New Year!

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Times Squaer Crowd New Year's Eve
As we move out of 2015 and into 2016 with a strong wave of hostility rising throughout the country about high drug prices, what I’m about to report may seem incongruous. Fewer Americans seem to be buying lower cost medications from other countries. For the past few years, largely based on data from the CDC in 2013, I’ve published the number five million as the approximate number of Americans who, due to high drug prices, import medication annually for personal use. But a newer CDC report published in 2015 (that I recently came across) puts that number closer to four million, a 20% decrease.

If drug prices are going up, and Americans are fed up with prescription costs, wouldn’t you expect more people to be buying lower cost medications from outside the country? With fewer Americans buying medication internationally, potentially one million, how many of them are simply not taking prescribed medication? Are our most trusted authorities scaring Americans away from obtaining lower cost medications from other countries, or has affordable access improved over the past few years?

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“High Drug Prices Are Killing Americans” While LegitScript’s John Horton Gloats

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While PharmacyChecker.com is not taking sides in the presidential election, last Saturday, the Huffington Post published an op-ed by presidential candidate Bernie Sanders entitled “High Drug Prices Are Killing Americans” that we agree with. Senator Sanders believes that the U.S. government should make it easier for Americans to import lower cost medications from other countries.  He writes: “Americans should be able to do this online or by mail, provided they have the proper prescription from a physician.”  Polls show that most Americans feel the same way.

In contrast, John Horton, the founder of LegitScript.com, was busy this week trying to achieve the opposite – keeping the U.S. a captive drug market by scaring Americans away from safe and affordable international online pharmacies. Mr. Horton appeared to gleefully report that a safe international online pharmacy operated from Canada, TotalCareMart.com, was “ordered to be shut down” by the College of Pharmacy in Manitoba. As usual, however, Mr. Horton misrepresented the facts, skipping details that are important to consumers.

TotalCareMart.com, as it notes on its website, “is not itself a pharmacy, but a prescription referral service.” It refers orders to licensed pharmacies in Canada and other countries, and helps Americans fill their prescriptions at lower cost. We know this is true because PharmacyChecker verifies the licenses of the pharmacies TotalCareMart.com uses. So what’s the current fuss about?

According to an article in CBC News, the College of Pharmacists in Manitoba recently sent TotalCareMart.com a letter to discontinue its marketing efforts, accusing  the website of  “suggesting” that – in its print advertising in the U.S. – it is a Canadian pharmacy, rather than a prescription referral service, through which orders placed online are filled in Canadian and other pharmacies. If that’s the case, we would agree that any such advertising should be clearer.  As noted above, on its website, TotalCareMart.com appears to accurately describe itself. Another complaint is that the website advertises certain popular brand name medications (Zetia, Benicar, and Lexapro) using their U.S. names, when, in Canada, these medications are sold under different names, which may violate Canadian prescription drug marketing laws – even though TotalCareMart.com does not market those products to Canadians. From the perspective of an American consumer this would not seem to be a concern.

The regulatory and legal issues at hand are technical and involve the definition of a “pharmacy,” marketing laws, and potentially conflicting legal jurisdictions. But the bottom line is that TotalCareMart.com is a safe international online pharmacy and the regulatory actions described above do not remotely show otherwise.

In addition to the spin on the CBC news story, Mr. Horton took the opportunity to continue his incessant campaign of trying to embarrass and disparage PharmacyChecker.com, so I will address his “concerns.”

LegitScript published a screenshot of PharmacyChecker’s seal profile for TotalCareMart.com. Due to an administrative glitch (about which we are embarrassed, but have corrected) the profile read “last verified’ in 11/21/2011, but rest assured that our last regularly scheduled verification was on 8/12/2015. The pharmacy in Canada which TotalCareMart.com uses, Westview Pharmacy, continues to be licensed by the Manitoba College of Pharmacists — the same regulator that sent the letter to TotalCareMart.com: you can check the license yourself.

Mr. Horton also criticizes our policy of not always publishing the names of the bricks-and-mortar pharmacies through which international online pharmacies fill orders. We do this for a very good reason, one that benefits consumers: Pharmaceutical companies have a history of cutting supplies to pharmacies outside the U.S. that sell their products at lower prices to Americans! We don’t want drug companies to stop consumers from getting prescribed medications at lower cost. What’s funny, however, is that LegitScript has made a big deal about “outing” the name of a pharmacy we kept confidential only to discover that it’s a licensed pharmacy in Canada. Thanks!

We agree that online pharmacies (and big multinational pharmaceutical companies) should be truthful and as transparent as possible about what they do and how they portray themselves. That’s why, for over 10 years, PharmacyChecker.com has required Canadian online pharmacies to disclose the countries in which they partner with local pharmacies and they must identify the specific pharmacies to us. We then verify the licenses of these pharmacies before an online pharmacy can be a member of our Verification Program.  If you look at our site, you’ll notice we list the countries to which an online pharmacy refers orders. We’re not sure what Mr. Horton is talking about when he writes that we “concede” that “other verified dispensing pharmacies” used by TotalDrugMart.com are in “New Zealand, Turkey, Singapore, Canada, United Kingdom and New Zealand” – referring to the information PharmacyChecker.com publishes in TotalDrugMart.com’s Seal Profile. Thank you, Mr. Horton, for finally saying what you know: we don’t help online pharmacies pretend their “Canadian” but provide information to consumers so that they know what’s up.  For newcomers to this issue: we have a blog post that will be very instructive: “So you Want to Buy Cheap Medicine From an Actual Canadian Pharmacy?”

Mr. Horton loves to highlight that a very small number of mostly U.S. online pharmacies, which were once approved in our program, were found or accused of selling controlled drugs without valid prescriptions. What he fails to mention is that most were not in our program at the time that they were charged and none has been in our program for years (since 2010). Yes, licensed pharmacies and pharmacists (and big pharmaceutical companies) break the rules sometimes, on and offline – and they need to pay the consequences commensurate with the harm they have done. But which pharmacy seems to have the worst track record of fueling the addiction epidemic? I believe that award goes to none other than LegitScript-approved Walgreens! Walgreens had to pay $80 million in 2013 to make charges go away that it illegally sold controlled drugs, including opiate-based medications into the black market. [This is not to disparage the thousands of good people and pharmacists who work for Walgreens but to show LegitScript’s hypocrisy.]

Prescription drug abuse is a serious problem and no laughing matter.  The sad truth is that of the of 41,340 annual deadly drug overdoses, 22,810 were caused by legal, often highly addictive opiate-based, pharmaceuticals. It’s a serious epidemic, and while vigilance and enforcement are critical, according to the U.S. Drug Enforcement Agency, the Internet causes a tiny fraction of the problem. Our program excludes international online pharmacies that sell controlled drugs into the U.S. at all.

Seriously and sadly, if the FDA and/or Canadian regulators decide to, they can probably figure out a way to shut down the safest international online pharmacies. Of course, that may lead Americans seeking affordable medication into a minefield of rogue online pharmacies (over 30,000 according to LegitScript). Is that really what Mr. Horton wants? But, as I have written before, and shared with elected leaders, shutting down safe international online pharmacies is bad for public health.

Our 12 years of publishing online pharmacy verification and pricing information, and my advocacy, has made PharmacyChecker.com a prime target of Pharma-front groups and their lobbyists. They have misled journalists to believe all kinds of misinformation. They also point out that PharmacyChecker.com is a business not a non-profit group — and about that they are correct: We are proud to have started and to run a small American business that, unlike LegitScript, doesn’t rely on taxpayer’s money ($5.2 million) or mislead Americans. PharmacyChecker helps Americans find information about the most affordable and safe online pharmacy options. As Senator Sanders says, “High Drug Prices Are Killing Americans” and we’re glad to be part of the solution, not the problem.

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PharmacyChecker.com Updates Information about How to Avoid Rogue Online Pharmacies

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Stay safe while shopping for affordable medications online

Stay safe while shopping for affordable medications online

Americans sometimes want to know if rogue online pharmacies, especially foreign ones, REALLY sell bad medication or if it’s just one big conspiracy by the evil pharmaceutical industry to scare Americans away from saving a lot of money. Well, as critical of big pharma’s efforts to scare consumers away from lower cost and safe medication as I have been, the answer is, REALLY, yes. The dangers of buying a fake or otherwise harmful medication online from a foreign or domestic source, or even a real medication when you are not under the supervision of your healthcare provider, are real and serious.

What we know better than most is that consumers, empowered with the right information, can pay a lot less for medication by shopping online, internationally, and also avoid rogue online pharmacies. The right online pharmacy can save a person’s life and their finances because it sells safe medication at much lower cost than a local pharmacy – but the wrong online pharmacy could kill you.

We’ve updated our website’s content about rogue online pharmacies to better inform consumers, healthcare providers, and regulators who want to avoid such sites and teach others how to do so as well. We do give a list of rogue online pharmacies but it is far from comprehensive. Other companies and organizations spend a lot of effort compiling lists and identifying rogue online pharmacy sites (with tens of thousands of websites, many defunct): PharmacyChecker.com is in the business of verifying and identifying the safest and most affordable online pharmacies, not listing the thousands of rogue ones.

As we explain in the updated section of our website, when looking to buy meds online, the best way to avoid a rogue online pharmacy is to stick with websites approved by PharmacyChecker.com and other noted certification and verification organizations, specifically the National Association of Boards of Pharmacies (NABP), LegitScript, and the Canadian International Pharmacy Association (CIPA). NABP’s VIPPS and LegitScript’s verification program validate safe and legal online pharmacies, but in a variety of ways wrongly conflate rogue sites with safe international online pharmacies, which can actually mislead consumers (see Rx Rights’ report on NABP and Techdirt’s description of LegitScript’s practices). That’s where the pharmaceutical industry conspiracy stuff comes in! CIPA’s online pharmacy standards are similar to, but not the same as, PharmacyChecker.com’s, and many of their members are also approved in our program – but we can’t vouch for those that are not. Regardless of the differences, all of us want to see consumers avoid dangerous drug-selling websites often referred to as rogue online pharmacies – and some of us also want to maximize your online access to safe and affordable medication!

Photo Credit: © Peterhermesfurian | Dreamstime.comPoison Pill Package Skull Photo

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How to Shut Down Dangerous Rogue Online Pharmacies without Curtailing Online Access to Safe and Affordable Medication

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There are potentially tens of thousands of dangerous pharmacy websites, sometimes referred to as “rogue online pharmacies,” polluting the Internet and endangering the health of consumers worldwide. There are a much smaller group of safe domestic online pharmacies. Then there are an even smaller group of safe international online pharmacies, ones that we have verified, that sell many medications at much lower cost. However, when Americans purchase from these international online pharmacies (often because they can’t afford medication domestically) and import safe and effective medications, they are under most circumstances violating U.S. laws, which poses a quandary for regulators, public health officials, and even some people working over at Big Pharma. What’s right and wrong? How do we get rid of the rogues without overreaching and endangering public health by stopping Americans from obtaining safe medication internationally over the Internet?

In our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

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Online Pharmacies, Personal Drug Importation and Public Health: How Many Americans Are Buying Medication Online From Dangerous Websites?

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25%, 20%, 10%, 5%, 2%, 1%?

A few years back, the FDA published the results of a survey from 2012 that showed 23% of Internet users purchase medication online. That number has been used by a variety of groups funded by pharmaceutical companies and U.S. pharmacy corporations, and apparently the Government Accountability Office, to imply that a quarter of the U.S. population is buying medication from dangerous rogue online pharmacy sites. The number is probably lower than 2%, which is still too high but it’s important that the public and our elected leaders face and tackle the online pharmacy problems that really exist, not fake ones that distort public perception and serve entrenched business interests…and lead to fewer Americans getting medicines they need.

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health
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