Harvard doctors and public health experts recommend using the website PharmacyChecker.com to find international online pharmacies to order more affordable prescription drugs for personal importation when domestic savings strategies fail. They offer this advice in a new article in the Journal of the American Medical Association.
Article Review
The article, Strategies to Help Patients Navigate High Prescription Drug Costs, offers very digestible and evidence-driven guidance for clinicians to better assist their patients with the tangled web of drug pricing in America. As the article notes, three in ten American adults struggle to afford prescription drugs. That is about 80 million people. The article states that “cost-related medication nonadherence is associated with worse clinical outcomes.” In layperson’s terms, that means people get sick and die because they can’t afford their meds. These strategies help reduce these bad health outcomes.
Personal drug importation through an international online pharmacy is not the first line of defense, but it is a lifeline because prescription drugs cost far less outside the United States. Citing a study by the Rand Corporation, the authors state that brand-name drug prices are 2-3 times higher on average in the U.S. than in other countries. The Rand Corporation study finds that for “brand-name originator drugs the prices are actually 4.22 times higher in the U.S. than in other countries.
When the other strategies discussed in the article are unavailable, the authors recommend considering international online pharmacies for cash-paying purchases to access the lower prices in foreign pharmacies. The authors state that, “PharmacyChecker is an independent organization that verifies international online pharmacies and allows patients to compare prices across pharmacies.”
Overall, the article addresses how to help people with private, government, or no health insurance. The strategies offered are summarized below.
Drug manufacturer co-pay coupons help lower out-of-pocket costs for privately insured patients by paying for some or all of the co-payment on expensive brand-name drugs.
Manufacturer or non-profit organization-sponsored patient assistance programs offer no-cost or low-cost assistance to lower-income individuals who have no health insurance or are underinsured, in that their insurance does not cover the medication they need.
Pharmacy discount cards and coupons are freely accessible on sites like GoodRx and RxSaver. They can provide steep discounts on most generic drugs for purchases outside of insurance.
Direct-to-consumer pharmacies, usually online, offer low generic drug prices for purchases made outside insurance plans. Popular destinations include Costco, Costplusdrugs, Healthwarehouse, and Walmart.
Medicaid. For low-income individuals who qualify, Medicaid offers extremely comprehensive coverage for prescription drugs.
Real-time prescription benefit tools are software applications that analyze a patient’s health insurance coverage and prescription requirements “by linking electronic health records with patients’ prescription benefits information.”
The article’s authors and affiliations are below.
Authors: Hussain S. Lalani, MD, MPH, MSc; Catherine S. Hwang, MD, MSPH; Aaron S. Kesselheim, MD, JD, MPH; Benjamin N. Rome, MD, MPH
Author Affiliations: Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts (Lalani, Hwang, Kesselheim, Rome); Harvard Medical School, Boston, Massachusetts (Lalani, Hwang, Kesselheim, Rome).
Editorial and Analysis
I’ve read dozens of these medical journal articles over the past two decades. Combining academic rigor with commonsense and helpful visuals, this is the most straightforward and comprehensive for health practitioners, policymakers, caregivers, and the public.
On the legality of personal drug importation, the article states, “It is illegal to import a drug that is unapproved in the US, but the FDA permits patients to purchase FDA-approved drugs internationally as long as they are for personal use, for treatment of a serious condition, and the quantity does not exceed a 3-month supply.” The authors cite the FDA’s personal importation policy.
Additionally, federal law (separate from the FDA’s policy) states that regulators “should permit” individuals to import prescription drugs that otherwise might violate the law so long as the drugs do not pose an “unreasonable risk.” Federal law also does not specifically prohibit the importation of FDA-approved prescription drugs for personal use, but it does prohibit them for commercial use without authorization from the manufacturer.
This article properly categorized the international online pharmacy access option as a lifeline for Americans who have run out of domestic savings options. As David Mitchell, founder of Patients for Affordable Drugs, stated for Politico: personal drug importation “is like a safety valve.”
