Scoring Illegal Drugs with a Prescription
I have a friend, let’s call him Bob. He lost his job a couple of years ago. That meant he lost his health insurance. He needs a prescription medication, Lamictal, for a seizure disorder. If he doesn’t take his pill every day, it’s not safe for him to drive. This makes life difficult for him in Texas, where viable public transport options are as rare as men who ask for directions.
I have another friend, Monique. She doesn’t have health insurance even though she has a job as a technical writer. That’s because she’s a contractor. It wasn’t a problem until recently, because she was married and got coverage through her husband. But they divorced and now she’s in trouble, because she’s a diabetic. She needs insulin or she will die.
The problem for both Bob and Monique — the drugs they need are expensive. Lamictal costs Bob over $300 for a month’s supply in the United States. Bob could afford it if he was working, but he’s not. Monique’s situation is even more grim. Her medication costs her $1200 a month, which is a third of her take-home pay. She needs the drug to live.
What is ironic, the researchers who discovered insulin in 1921 (Banting, Best and Collip) sold their patent to the University of Toronto for $1 each. They didn’t want to profit from other peoples’ pain. True humanitarians, they tried to gift their life saving drug to the world. Unfortunately for diabetics, drug companies see insulin as a profit center.
Don’t get me wrong. I get that manufacturers need to make a profit. So do researchers, doctors and HMO administrators. They need to live too. They can’t give drugs away for free and still buy groceries and pay rent.
However, what explanation do we have for the fact that my friend could get her medication in Canada for 36% of what American pharmacies charge?
However, what explanation do we have for the fact that Lantus costs almost 70% less in Canada than it does in the US? Canadian pharmacists somehow manage to make a profit despite this price differential. This is not surprising since the drug costs less than $20 to make, according to an article in the Washington Post on January 7, 2019, linked here.
What did my friends do?
Monique ordered her drugs online from a Canadian pharmacy. While insulin does not require a prescription in Canada, she was informed that since it requires a ‘scrip in the US, she would need to provide one. So she Fax’ed her prescription to them. They called her doctor to make sure it was legit, and then shipped her the medication she needed in 90 day increments. This reduced her costs dramatically.
Unfortunately, it is illegal; however, it is rare for the FDA to prosecute people like her. She told me that though she is ordering the drugs from Canada, when she gets a shipment, it seems the insulin is actually made in Asia from the packing labels. Which is probably one reason she has to order her medication at least 2 weeks in advance.
Despite the inconvenience of having to plan ahead and pay for a 90 day supply up front, Monique is willing to risk jail time by getting her drugs from Canada.
Bob, meanwhile, was getting his drugs from Mexico for a while. He knew a guy who had a cousin there. The cousin was willing to meet Bob at the border and, for a small fee, take him to a Mexican pharmacy in Nuevo Laredo. Bob drove the 7 hours round trip once a month to buy his medication. Because he had a prescription, border patrol did not stop him.
I asked Bob if going to Mexico to get his pills was worth it. He pointed out that, since he wasn’t working, it was no problem for him to spend a day driving. Gas cost him less than $25; throw in a fast food meal and the fee to the cousin, and the total was still less than $50. The medication itself cost him about $50 in Mexico, vs. the $330 it cost in the US. And it’s not like Mexican drugs are any less safe or effective. Bob figured, even if he went with the US government’s rate of $0.35 a mile, the total cost of his trip was still less than $100 plus the cost of the meds, which resulted in him saving over 50%.
Since then, Bob has stopped making the trip to Mexico, because he discovered GoodRx. He now pays $70 for his medication at his local HEB grocery store. Monique however still gets her insulin from Canada.
Which begs the question — why is it illegal for Americans to import generic drugs from other first world countries? I get that the USDA was put in place to keep us safe, but are drugs any less safe in Canada or Germany or France? Or Indonesia or Brazil? If an American wants to import a prescribed medication from another country and he or she is willing to do so with full knowledge of any possible risks — why is it illegal?
Mitt Romney addressed this issue during his failed Presidential campaign. He talked about using free markets to bring down insurance prices by allowing people to cross state lines to shop for plans. Allowing people to cross borders to buy medications is a logical corollary to this.
Meanwhile, according to this fascinating Medium article published in May, there are bio-hackers who, as part of the Open Insulin Project, are trying to provide insulin to people for close to free.
If this project takes off, will the government allow it?
While the government might claim importation restrictions on drugs are due to public safety issues, if we follow the money trail, it seems suggestive that something else is afoot. History is littered with examples where life-saving procedures or substances were not allowed to the masses because it might have interfered with the profit stream of powerful groups.
I hope that if the bio-hackers do succeed, they are allowed to freely help those like my friend Monique. Her life should not be held hostage to the whims of government bureaucrats and pharmaceutical executives.