September 20, 2005

Canadian Online Pharmacies a Better Deal for Meds

NEW YORK -- Americans could save hundreds or even thousands of dollars a year on brand-name prescription drugs if they use a Canadian Internet pharmacy instead of their local drug store, researchers reported Monday.

On average, their study found, Americans could save 24 percent on their prescriptions if they shopped at an online Canadian pharmacy rather than a U.S. drug chain. Depending on the type of drug and how many prescriptions a person has, the savings could add up to hundreds or thousands of dollars a year.

The findings, published in the Annals of Internal Medicine, add to the contentious issue of U.S. consumers' "importation" of medications from Canada, where the government sets price controls on prescriptions.

Faced with high drug prices at home, some Americans -- an estimated 2 million last year -- have been mail-ordering their prescriptions from Canadian online pharmacies. And some cities, counties and states have programs in place to help them do it.

It is generally assumed that brand-name drugs are cheaper in Canada. However, no study had actually compared prices at Canadian online outlets with those of large U.S. chain drug stores, according to authors of the new study, led by Dr. Mark J. Eisenberg of McGill University in Quebec.

In their comparison, the researchers found that the biggest deals were for the psychiatric drug Zyprexa -- $1,159 in yearly savings -- the diabetes medication Actos and the heartburn drug Nexium.

Certain widely used brand-name drugs -- including other heartburn medications and some cholesterol-lowering statin drugs -- were among those with the largest cost savings, at $600 to $700-plus per year.

Drug importation is technically illegal in the U.S., but individuals are allowed make small cross-boarder purchases of prescriptions for their own use. The U.S. Food and Drug Administration has come down against the practice, however, saying it cannot ensure the safety or quality of medications from foreign sources.

For their part, Canadian health officials have said the country must not become a cheap drug store for U.S. consumers. Earlier this year, Canada's health minister announced proposals to curb the nation's Internet pharmacy business; under the plan, officials would have the right to ban bulk exports of drugs when they thought it necessary to prevent a drug shortage in Canada. They would also require foreign customers to have some "relationship" with a Canadian doctor, though it's unclear what that will ultimately mean.

The new study compared prices for 44 top-selling brand-name drugs at 12 Canadian Internet pharmacies with those available on the Web sites of three major U.S. drug chains: CVS, Rite Aid and Walgreens.

Of the Canadian pharmacies, most were connected to drug stores with actual physical locations, while two were solely "intermediary" businesses that filled their orders through one or more independent pharmacies.

Eisenberg and his colleagues used an online company, pharmacychecker.com, which evaluates Canadian Internet pharmacies, to find sites that met key safety standards-including proper licensing of the supplying pharmacy and requirements that consumers submit a doctor's prescription.

Of the 44 drugs the researchers evaluated, 41 were cheaper at the Canadian pharmacies; the only exceptions were three drugs for impotence.

The study looked only at brand-name drugs because research has shown that generic versions of prescription medications are actually cheaper in the U.S.

Given that, Americans could opt for generics, if they're available, Eisenberg told Reuters Health. However, he added, many people are reluctant to take generics, and if they want brand names, they will "almost assuredly" save money by turning north of the border.

Experts do urge consumers to make sure they are buying from a legitimate pharmacy that requires a prescription from their doctor. Many bogus Web sites claiming to be Canadian outlets have been set up to lure Americans in search of cheaper drugs.

SOURCE: Annals of Internal Medicine, September 20, 2005.