Where Has Your Prescription Been?

Published September 16, 2003

Americans are taking a lot of risk buying prescriptions from foreign countries through storefront operations or over the Internet. Matters are made even worse when elected representatives in Illinois are now attempting to legitimatize the purchase of reimported drugs.

Bad Example

Last July, Springfield, Massachusetts launched a program encouraging the city’s 20,000 employees and retirees to fax their prescription drug orders to a group of Ontario pharmacies and get their medications by return mail. The city expected to cut drug benefit spending by $4 million.

To test the safety of Springfield’s program, federal Food & Drug Administration officials ordered drugs, including insulin, from Michigan-based CanaRx under an assumed name and address. According to Peter Pitts, associate FDA commissioner for external affairs, the insulin loses effectiveness at higher temperatures and is supposed to be shipped overnight to ensure it remains chilled. The drugs arrived in the regular mail and at room temperature.

Canada, where government-mandated price controls lower drug costs, takes in $1 billion a year for prescription drug purchases from U.S. consumers alone. Thanks largely to the Internet, Americans are buying more drugs than ever before from Canada and at least 25 other countries, including Austria, China, Ireland, Italy, Israel, and Mexico.

The FDA repeatedly warns such drugs raise serious safety concerns since they could be counterfeit, contaminated, expired, mislabeled, or mishandled. The agency won’t vouch for the quality of reimported foreign drugs or those sold over the Internet, since there is no way to determine the origin of the drugs, their quality, their effectiveness, or if they endanger health.

The Real Issue

No one disputes the fact prescription drugs are more expensive in the U.S. than in other countries–a consequence, in part, of the massive investment in research and development made by the country’s pharmaceutical manufacturers. Other countries essentially free-ride off our pharmaceutical innovations and protections for intellectual property rights, leaving Americans to foot most of the bill.

The debate over drug reimportation and the higher price of prescription drugs in the U.S. has distracted the public, however, from a very important issue: the health risks counterfeit medications pose to Americans.

Consider these documented examples:

  • Turkey, 1993: A pharmacist tries to sell baking powder to a patient as a genuine prescription drug. He is arrested by police.
  • Haiti, 1996: At least 88 children die after taking counterfeit antipyretic syrup for relief of pain and fever.
  • Lebanon, 1998: Interpol, the international police agency, says an immense factory in the Bekaa Valley may be the world’s largest producer of counterfeit medication, including Viagra. An Israeli Health Ministry spokesperson told the Jerusalem Post, “According to experts, 80 percent of the Viagra sold world-wide on the black market is not the real drug. What is ironic is that the black-market pills cost twice the price of Viagra gotten by prescription.”
  • Kansas City, 2002: Authorities arrest a local pharmacist for diluting cancer drugs given to hundreds of patients while selling the medications at full price.
  • Florida, 2003: Concerns about the safety of drugs surfaced after prosecutors announced a grand jury had indicted 19 people on charges of watering down or selling fake prescription drugs to businesses selling prescription medications to consumers. The drugs are often prescribed for AIDS and cancer patients.
  • Nebraska, 2003: A counterfeit version of Pfizer’s Lipitor, the world’s top-selling cholesterol-lowering medication, was recently discovered after pharmacists and patients complained their medication tasted unusually bitter and dissolved too quickly.

Buyer Beware

Consumers who buy prescription drugs across borders or over the borderless Internet have no assurances those drugs are safe … or even that they will get the exact drug their doctor prescribed. No foreign source of prescription drugs accepts responsibility for harmful effects or deaths from reimported drugs.

The online prescription industry developed to fill perfectly legitimate needs, chief among them increased convenience and lower costs for consumers. But counterfeiting, criminal intent, deliberate misrepresentation, and patent and trademark infringement are reason enough to distrust any reimported prescriptions.

Your Options

Far safer alternatives exist to reduce the cost of medication:

  • Contact your local pharmacist and ask about the many discount and free drug plans available from America’s pharmaceutical companies.
  • Shop around in your community. No two drug stores charge the same price, and many are willing to sell prescription drugs in larger and less expensive, 60- to 90-day quantities.
  • Illinois veterans should contact the Veterans Administration at 800/827-1000 or go online http://www.va.gov.

Conrad F. Meier is senior fellow in health policy for The Heartland Institute. His email address is [email protected]

For further information, contact Heartland Public Affairs Director Greg Lackner, 312/377-4000, 773/489-6447, email [email protected]