MDA / Quest Vol 10 No 5 /Buying and Ordering from Canada

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QUEST Volume 10, Number 5, SEPT./OCT. 2003

BUYING & ORDERING FROM CANADA

General Information

Brand name, U.S.-made, FDA-approved medications are sold abroad for far less than in the United States, meaning consumers can save a lot of money by buying back U.S. drugs from foreign sources over the Internet. There are two big concerns safety and legality and no clear-cut answers on either score.

Safety standards vary widely when youre roaming the world drug market. By the time a U.S.-made medication ends up on a Thai Web site, for instance, it could be just fine or expired, mislabeled, contaminated or counterfeit. In addition, export versions of some U.S.-manufactured drugs are made to different standards or in different dosages than the requirements for domestic consumption.

Canada, with a prescription regulatory system similar to this countrys, has become the drugstore of choice for many Yanks over a million last year. Due to Canadian price regulations and the strong buying power of the U.S. dollar, consumers save from 30 percent to 90 percent on brand name drugs. (Generic drugs usually are cheaper to buy in the United States, however. A generic here averages about 74 percent less than the brand name drug, versus only 38 percent less in Canada, according to a report by Forbes magazine.)

Theres no safety reason not to buy from accredited Canadian pharmacies, says Greg Carter, director of MDAs clinic at the University of Washington in Seattle. "Theyre the same damn drugs!" Canada has a rigorous review system for both imported and exported drugs, "and one of the best safety records in the world," says a spokesperson for the Canadian health ministry, Health Canada.

Buying from Canada is cheap and safe but is it legal? Well no.

Prescription drugs even those originally made here — may not be carried or mailed into this country. But the FDA has "enforcement discretion" and is willing to turn a blind eye in some circumstances.

On a practical level, this means that licensed Canadian pharmacies following good practices (see "Warnings and Guidelines," below) currently are shipping to U.S. buyers with impunity and buyers arent being targeted by authorities.

So far, FDA crackdown measures have been aimed at questionable online pharmacies and storefront operations that place Internet orders for customers wanting to buy from Canada.

Recent congressional support for consumer access to Canadian drugs is unlikely to make importation "legal," due to difficulties with certifying that the imported drugs are safe but it may help keep the border guards looking the other way.

Warnings and Guidelines

Look for the name, street address, telephone number and license number of the foreign pharmacy that fills orders for the Web site.
Foreign pharmacies should require a U.S. prescription and a health history questionnaire.
You shouldnt be charged for confiscated shipments.
For safety and peace of mind, look for prescriptions shipped in the original, unopened, sealed, manufacturers packages, advises Discount Drugs Depot (www.discountdrugsdepot.com). They add that if you still feel unsure, ask to have the pharmacist call your doctor.

Canadian Resources

For more information about the U.S. position on imported drugs, go to www.fda.gov or call 1-888-INFO-FDA [(888) 463-6332].

An easy-to-read explanation of Canadas drug regulatory laws can be found at: "Guidance Document on Commercial Importation and Exportation of Drugs in Dosage Form under the Food and Drugs Act," www.hc-sc.gc.ca/hpfb-dgpsa/inspectorate/new_e.html. Call (613) 952-8175 to request a copy from Health Canada.

SPOTLIGHT

Thomas S. French was a practicing U.S. plastic surgeon before being sidelined by amyotrophic lateral sclerosis in 1996. He and his wife, Jacqueline, of Barnard, Vt., started Two Nations Rx (www.twonationsrx.com) to bring price relief to American consumers.

Outside of an occasional border delay, French says none of his customers have had any legal problems with their Canadian orders.

Not all drugs are available in Canadian pharmacies. Narcotics and controlled substances cant be shipped across the border. (For example, Provigil, a drug used by people with myotonic dystrophy to combat daytime sleepiness, isnt available.) Two Nations Rx wont ship fragile medications, ones requiring refrigeration, or ones "we consider habit-forming or detrimental to a patients health when purchased from a pharmacy rather than in their place of residence."

BRAND NAME PRICES IN CANADA, ONLINE & WITH DISCOUNT CARD
Drug	Usage	DISCOUNT DRUGS DEPOT(Canada) $15 shipping per order	TWO NATIONS Rx(Canada) $15 shipping per order	DRUGSTORE .com(USA) $1.49 shipping per order	COSTCO (online) (USA)free shipping	NONPROFIT WAREHOUSE (U.S. discount card mail order site, ScripPharmacy.com) free shipping
CELEBREX 200 mg 90-100 capsules	Arthritis; in testing as an ALS treatment	$126.93 (100)	$136.11 (100)	$211.99 (90)	$244.27 (100)	$241.45 (100)
FOSAMAX 10 mg 90-100 tablets	Osteoporosis(an effect of neuromuscular disease and steroid use)	$153.97 (90)	$126.69 (90)	$191.98 (90)	$221.19 (100)	$185.00 (90)
Total Includes shipping		$295.90 (190 pills)	$277.80 (190 pills)	$405.46 (180 pills)	$465.46 (200 pills)	$426.45 (190 pills)

GENERIC PRICES IN CANADA, ONLINE & WITH DISCOUNT CARD
Drug	Usage	DISCOUNT DRUGS DEPOT(Canada) $15 shipping per order	TWO NATIONS Rx(Canada) $15 shipping per order	DRUGSTORE .com(USA) $1.49 shipping per order	COSTCO (online) (USA) free shipping	NONPROFIT WAREHOUSE (U.S. discount card mail order site, ScripPharmacy.com) free shipping
Prozac 10 mg 90-100 capsules	Depression	$115.32(100)	$106.59(100)	$84.99(90)	$18.09(100)	$132.52(90)
PREDNISONE 5 mg 90-100 tablets	Autoimmune diseases;Duchenne MD	$15.98(100)	Doesnt carry; site says "cheaper in U.S."	$8.10(90)	$8.30(100)(only has 10 mg)	$4.59(90)
Total Includes shipping		$146.30 (200 pills)	No comparison possible due to missing drug	$94.58 (180 pills)	$26.39 (200 pills) (larger dose Prednisone)	$137.11 (180 pills)

All prices are in U.S. dollars.

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