A client recently visited my office, ecstatic that a new
prescription medication that cures hepatitis C is available for his wife. He
came in to find out if his shiny new 2017 health care policy (his fourth in
four years) covers the drug. After checking for him I found out that the
medication is not yet approved for coverage. “But that’s OK I can check the
uninsured price for you at all of the local pharmacies.”
A quick check on my handy, dandy price checking app found
the best cost for the medication at a local pharmacy. Now, in order for the
medication to cure his wife’s disease she is required to take one dose per day
for twelve weeks. The drug is dispensed in four- week supplies, so she will
need three, four-week supplies. The best price that I could find? $32,138.80!
Times three refills, that’s only $96,416.40. And so, another client left my
office debating to himself, “Do I cure my wife’s disease or do I keep my home?”
This is an extreme example of the prescription drug issue
that particularly confronts those who are responsible for their own health care
and those who are 65 or older. No question about it, there are effective cures
to be had, but at what price?
Consequently, I am regularly asked by our clients, “Is it
legal to obtain my prescription medications from other countries?” The answer
is “Technically, no.”
Here is the official position on that question from the U.S.
Food & Drug Administration:
“In most circumstances, it is illegal for individuals to
import drugs into the United States for personal use. This is because drugs
from other countries that are available for purchase by individuals often have
not been approved by FDA for use and sale in the United States. For example, if
a drug is approved by Health Canada (FDA’s counterpart in Canada) but has not
been approved by FDA, it is an unapproved drug in the United States and,
therefore, illegal to import. FDA cannot ensure the safety and effectiveness of
drugs that it has not approved.
FDA, however, has a policy explaining that it typically does
not object to personal imports of drugs that FDA has not approved under certain
circumstances, including the following situation:
The drug is for
use for a serious condition for which effective treatment is not available in
the United States;
There is no
commercialization or promotion of the drug to U.S. residents;
The drug is
considered not to represent an unreasonable risk;
The individual
importing the drug verifies in writing that it is for his or her own use, and
provides contact information for the doctor providing treatment or shows the
product is for the continuation of treatment begun in a foreign country; and
Generally, not more
than a 3-month supply of the drug is imported.”
So the real answer to the question is “No, but we’ll look
the other way if it’s just for you and it’s not a controlled substance.”
Doesn’t instill a lot of confidence in patients who are often desperate for
medication but strapped for money.
The pharmaceutical industry exercises a heavy hand on direct
consumer imports of drugs from other countries. A great deal of money is spent
by Pharma for the purpose of perpetuating fear and doubt among US consumers who
wish to source their medications from foreign countries. Although it is not
uncommon to reduce costs by 40% - 80% for identical medications from US
pharmacies many consumers are fearful of contaminants and counterfeit copies
from foreign countries.
Let’s face it the US pharmaceutical industry, with annual US
revenue of about $425 billion is extremely powerful. Here’s an interesting
statistic. The US pharmaceutical market accounts for roughly 40% of worldwide
sales but the US has only 5% of the world’s population. This tightly controlled
industry is one of the reasons that US per capita health spending is so high
and therefore health care premiums are also so high.
Not coincidentally, the US is the only country in the world
that allows consumer direct advertising of pharmaceuticals. But those same
consumers, of course, cannot acquire the medications that are advertised unless
they obtain a prescription from their prescriber. So, in terms of other cost
drivers of health care and health care premiums we have a pharma industry that
blasts consumers with high priced ads, and consumers who then need to pay for
doctor visits to obtain prescriptions, fill their prescriptions at US
pharmacies while paying inflated prices that are required in order to fund those
expensive prime time commercials. In fairness, the US pharma industry also
conducts most of the world’s pharmaceutical research…but it spends far more on
advertising and promotion than on research. And so, for these reasons, health care costs continue to rise through
the stratosphere.
Now, although every industrialized country in the world has
its own version of the FDA US consumers are still significantly blocked from
directly sourcing their drugs elsewhere. However, while consumers are blocked
from direct imports US pharmaceutical makers imported $92.5 billion in
medications in 2016. They process and package them in US-approved packaging and
sell them in pharmacies and distribute them in hospitals throughout the US.
There are those of you who will say that they feel safe and
protected from shady foreign sources of potentially dangerous drugs. And I am
not here to minimize those feelings but US consumers acquire hundreds of
billions worth of potentially “dangerous” goods from other countries every year
without encountering the roadblocks that exist for prescription medications. By
comparison to the entire US pharma business of $425 billion, by the best
sources I can identify, only about $3 billion in pharmaceuticals are sourced
from foreign countries directly by US consumers. That’s about 7/10 of one
percent of the US pharma industry’s value.
Here are some examples of other “potentially dangerous if
unregulated” products that are imported into the US and bought by consumers:
Foreign Vehicles
- $285 billion per year
Alcoholic
Beverages - $17.6 billion per
year
Firearms - About 4 million
firearms are imported each year. |
If
you assume an average value of $250 each that’s another $1 billion.
In every case of the products above the US has established
standards of safety, performance, and inspections. Some are able to be bought
directly by consumers, others, like vehicles, must be bought through dealers.
Unlike pharmaceuticals, however, the industries above do not fund or conduct
misinformation campaigns designed to instill fear and doubt in consumers about
foreign made products. For these reasons the consumer prices of these products
are on par with most other countries, much unlike pharmaceutical pricing in the
US and its far higher costs than nearly every other country in the world.
Are you angry yet? I hope so. Big pharma is one of the main
reasons that health care costs are so high and I hope that this article has
given you a little insight into how the system is rigged against you. If you’re
motivated to take action contact your congressional representatives and let
them know that it’s time that they revisited our laws and regulations and
brought our prescription costs in line with the rest of the world.
Thanks for reading.
Sincerely,
Alan Leafman, President
(800) 955-0418
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