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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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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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Buying Valium Online To Save Money? Try the Generic at Your Local U.S. Pharmacy Instead

I like showing Americans who are searching online for affordable medication, often from foreign pharmacies, that their mom and pop pharmacy on Main Street U.S.A. can actually offer a better deal. It’s actually pretty common. The generic version of Valium, diazepam, which treats anxiety, is a perfect example. Bottom line: no need to buy online or from Canada to save money.

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

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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A New Non-Profit Is Born – Prescription Justice Action Group – To Help Americans If Their Meds Are Taken by the FDA

pjag_banner_med

Today, as the Obama administration hosted a “public” forum (think invitation only) about pharmaceutical innovation, access and affordability, I announced the formation of a non-profit organization dedicated to helping Americans get justice when it comes to prescription drug prices: Prescription Justice Action Group (PJAG). Whereas the administration’s public forum ignored personal drug importation, PJAG is providing guidance to Americans on what to do if their prescription drug orders are refused import by the FDA so they can try to have their medications released.

For about fifteen years, tens of millions of Americans have purchased medication from outside the U.S. –usually ordering it online. They do it because they want to save money or they really cannot afford the medication here at local pharmacies. The fact is that it has become a lifeline of lower cost medications for Americans.

But a new law – Section 708 of the Food and Drug Administration Safety and Innovation Act – gives the FDA expanded powers to destroy your personally imported medications, whether bought from a Canadian, Indian, Turkish or U.K. pharmacy. That doesn’t mean they will. It just means that they can. That law became effective over a month ago, and we haven’t heard of increased FDA seizures and destructions of international prescription orders.

The FDA has stated, and we have re-affirmed on our blog and main website, that under most circumstances it’s technically illegal to import prescription medication for personal use. But is it really? Is it always?

Section 708 allows the FDA to detain and potentially destroy your prescription order if it appears to be misbranded, unapproved, counterfeit or adulterated. If they take your adulterated or counterfeit drugs then the FDA has done their job. Misbranded or unapproved drugs, in contrast, could be entirely safe and effective medications, the same or foreign versions of the ones you buy in the U.S., but much less expensive. Under Section 708, you must be notified by the FDA if they take your prescription drug import, and you have 20 days to challenge them on their action. PJAG, in consultation with legal advisers, believes that you can make a good case that FDA should not destroy the medication but instead send it to you.

There are many dangerous online pharmacies out there from which you don’t want to buy or import medication. We call them rogue online pharmacies. But if you import a genuine, safe and effective medication, one that was purchased from a PharmacyChecker.com-approved online pharmacy and you get a notification from the FDA telling you that your prescription drug order is subject to destruction…PJAG!

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