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In Mexican border towns, big discount drugstores, as well as small pharmacies like this one in Tijuana, market their less expensive medicines to American tourists. Guillermo Arias/Bloomberg via Getty Images hide caption
Fenner is not the only one thinking like this. The U.S. government estimates that close to 1 million people in California alone cross to Mexico annually for health care, including to buy prescription drugs. And between 150,000 and 320,000 Americans list health care as a reason for traveling abroad each year. Cost savings is the most commonly cited reason.
According to the U.S. Food and Drug Administration, \"in most circumstances, it is illegal for individuals to import drugs into the United States for personal use.\" But the agency's website does provide guidance about when it could be allowed. And the U.S. Customs and Border Protection's website has a whole section on traveling with medications in its \"Know Before You Go\" guide.
A second major concern that comes up in any discussion of medical tourism is about the quality of that imported medicine. According to the FDA, the reason it's mostly illegal to import drugs is because the agency \"cannot ensure the safety and effectiveness\" of those drugs. In 2017, the World Health Organization estimated that 10 percent of drugs in developing countries were either substandard or falsified.
Canadian prices for many drugs range from 25% to 80% lower than those set for the same drugs by the US Congress and the manufacturers. Some US citizens already travel to Canada to buy the drugs or use the internet to import them. This proposal is designed to make it easier for Americans to get access to the drugs.
Even though insulin is not included among the drugs covered by the rule, the Trump administration Thursday issued a request for proposals seeking plans from private companies on how insulin could be safely brought in from other countries and made available to consumers at a lower cost than products here. The request specified it would have to be insulin that was once in the United States and sent to other nations before being brought back.
Nonetheless, officials said they are interested in studying options for consumers to benefit from importation. The administration Thursday issued another request for proposals to set up a system that would allow U.S. consumers to import drugs through local pharmacies, a senior HHS official said Friday on a call with reporters.
The administration envisions a system in which a Canadian-licensed wholesaler buys from a manufacturer of drugs approved for sale in Canada and exports the drugs to a U.S. wholesaler/importer under contract to a state.
The rule also makes clear that drug manufacturers will have to provide importers with documentation guaranteeing the medications are the same drugs as those already sold in the United States. HHS could set up regulations that require drugmakers to comply. Importers will have to send drugs to labs to certify their authenticity.
In its effort to temper the sky-high prices Americans pay for many vital medications, the Trump administration last month unveiled a plan that would legalize the importation of selected prescription drugs from countries where they sell for far less. But the plan addresses imports only at the wholesale level; it is silent about the transactions by millions of Americans who already buy their medications outside the United States.
Robin Cressman, who was diagnosed with Type 1 diabetes in 2012 and has become a vocal advocate for lower drug prices, says that even with insurance she was paying $7,000 a year out-of-pocket for the two insulin drugs she needs: Lantus and Humalog. At one point, her credit card debt hit $30,000, says Cressman, 34, of Thousand Oaks, Calif.
While on an outing in Tijuana, Mexico, last year, she popped into a few pharmacies to see if they stocked her medications. With little fanfare, she says, she was able to buy both drugs over the counter for less than 10% of what they cost her north of the border.
Levitt also recommends asking your doctor if there is a viable therapeutic alternative or a lower-cost generic drug. Recent research from PharmacyChecker shows that 88% of the most commonly prescribed generic drugs can be purchased more cheaply in the U.S. than from Canadian pharmacies.
When consumers find they are paying US$100 for a tier two option instead of $20 for a tier one option, they call their doctor and ask for a cheaper alternative. Manufacturers with a higher tiered drug have responded by creating prescription coupons instead of lowering the overall cost of the drug. When the consumer goes to the pharmacy, they pay $20 and the manufacturer pays the other $80 of their copay.
The Department of Health and Human Services in July announced a drug importation action plan outlining the parameters under which prescription drugs currently routed to Canada could make their way to U.S. consumers.
The plan requires that only manufacturing plants certified to manufacture drugs for the U.S. market be allowed; that the drugs go to U.S. pharmacies, directly or through a wholesaler; and that the drugs be labeled according to U.S. standards.
The most important would be the loss of an accurate way to track negative drug side effects after drugs reach the market. It would be impossible for the FDA to determine whether adverse events would be due to the U.S. version of the drug, poor quality of the manufacturer, storage or shipment of the drugs into the U.S.
Furthermore, controlled substances like opioids, biological products and drugs you inject or infuse in the body are excluded from pilot testing of imports. Biological drugs are among the most expensive drugs on the market, accounting for 45% of total drug spending in the U.S. in 2018.
A simple Internet search will turn up hundreds of Web sites that sell drugs. Some Internet pharmacies are legitimate, but many offer products and services that are dangerous. Some sell drugs that are not approved for use in Canada because of safety concerns. Some take advantage of people desperate for relief by offering \"miracle cures\" for serious illnesses like cancer. Many offer prescription drugs based on answers to an on-line questionnaire. These sites tell you they will save you the \"embarrassment\" of talking to your doctor about certain prescription drugs, such as Viagra, or drugs to prevent hair loss, or promote weight loss. What they do not tell you is that it is dangerous to take a prescription drug without being examined in person and monitored by a health care practitioner to make sure the drug is helping you.
Buying drugs from Internet pharmacies that do not provide a street address and telephone number may pose serious health risks. You have no way of knowing where these companies are located, where they get their drugs, what is in their drugs, or how to reach them if there is a problem. If you order from these sites, you may get counterfeit drugs with no active ingredients, drugs with the wrong ingredients, drugs with dangerous additives, or drugs past their expiry date. Even if these drugs do not harm you directly or immediately, your condition may get worse without effective treatment.
If you order prescription drugs without being examined and monitored by a health care practitioner, you may be misdiagnosed, and miss the opportunity to get an appropriate treatment that would help you. You may also put yourself at risk for drug interactions, or harmful side effects that a qualified health professional could better foresee. 59ce067264
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