It is a painful reality in America -- health care and prescription medications cost a bundle. Many Americans --
especially seniors who take multiple medications -- are tempted to buy cheap prescription medications in
Canada or over the Internet. But are these drugs safe?
The answer depends upon whom you ask.
THE OFFICIAL POINT OF VIEW
Under a law passed in 1987, it generally is illegal for anyone other than the manufacturer to import drugs into
the US. The US Food and Drug Administration (FDA) warns that imported medication may be outdated,
contaminated, counterfeit or contain too much or too little of the active ingredient.
Not surprisingly, pharmaceutical companies agree with this official point of view. Ironically, however, the fact
is that we already import a huge quantity of drugs from other countries. While drug manufacturers publicly
worry about the safety of medications from abroad, they have quietly relocated many of their own factories to
foreign shores to take advantage of cheaper labor costs. The difference is that these plants are considered
safe because they are inspected by the FDA.
PLAYING WITH FIRE
While everyone agrees that we want safe drugs, problems arise because of the pharmaceutical industry's
unbalanced pricing structure. American consumers currently pay the world's highest prices for drugs, while
price controls and shrewd bargaining compel manufacturers to sell the same drugs for far less money in
foreign markets. This makes imported drugs a great bargain.
Unfortunately, when you buy imported drugs that have not been inspected by the FDA, you're playing with fire,
says Dr. Jack Rosenberg, professor of pharmacy practice and pharmacology at the International Drug
Information Center of Long Island University. Ten percent of drugs worldwide are counterfeit, according to the
World Health Organization (WHO). Without FDA inspection, there is usually no way to tell whether a drug is
real or fake.
There also is no way to know how imported drugs have been stored. According to Dr. Rosenberg, in one
sting operation, the FDA discovered that a Canadian supplier mistakenly shipped insulin, which requires
refrigeration, at room temperature.
CONSUMERS SEEK A MORE ECONOMICAL ALTERNATIVE
Safe or not, legal or not, seniors in border states from Maine to Washington organize regular bus trips to
Canada to purchase prescription medications. In just one trip, they collectively save thousands of dollars.
Moreover, American consumers tend to trust the safety of Canadian drugs, which are regulated much like the
drugs in our own country. (This is clearly not the case with all imported medications.)
In a new trend that extends beyond individuals, several cities and states around the country also have
expressed interest in buying drugs from abroad. In open defiance of the FDA, the city of Springfield,
Massachusetts, now imports drugs from Canada for its workers and retirees, and at least two states --
Illinois and California -- are looking into the possibility of doing so as well.
Dr. Rosenberg is sympathetic to seniors coping with the high cost of drugs but emphasizes that the answer
is not to run to other countries. However, if you are set on visiting a Canadian pharmacy, he recommends that
you first check to see if it is accredited at www.napra.org, Canada's National Association of Pharmacy
Regulatory Authorities.
EXERCISE CARE ON THE INTERNET
Another tempting alternative is shopping on the Internet. Both domestic and imported drugs are available
on-line. If you spend much time on the Web, chances are you are already bombarded with E-mail
opportunities to buy prescription drugs.
On the Internet, it's "buyer beware." Although it's very tempting when you see an ad for a drug you're taking at
a significant discount, you must be careful, advises Dr. Rosenberg.
Which sites are safe? The FDA offers the following suggestions...
Check with the National Association of Boards of Pharmacy (www.nabp.net) or the Verified Internet Pharmacy
Practice Sites (VIPPS) (vipps.nabp.net/verify.asp) to determine whether the Web site is a licensed pharmacy
in good standing.
Don't use sites that offer to prescribe a prescription drug for the first time without verification that you have had
a physical exam or that will sell a prescription drug without a prescription.
Avoid sites that do not provide a US address and phone number to contact if there is a problem.
Steer clear of foreign sites, sites that advertise "new cures" or "amazing results" and sites that claim the
government or researchers have conspired to suppress a product.
SAFER ALTERNATIVES
Many states offer discounted-drug plans to seniors with limited incomes. Call your local office for the aging to
inquire about your particular state's policies. There are also options that guarantee health insurance to all
children of low-income parents. Contact your local or state authorities for details. Finally, if you are having
difficulty with prescription bills, talk to your doctor. Most pharmaceutical companies offer discounts to those
who can't otherwise afford their medications.
Canadian Pharmacies: Should You Use Them?
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