Cutting Drug Costs, Part 2: Seeking out safe online options

Part two of a three-part series on ways to manage drug costs.

Writing this piece, on the problems and possibly a very effective solution to rising drug costs, has given me an epic, ethical headache.

The good news: Earlier this month, Bloomberg reported U.S. prosecutors are going after generic drug companies in “a sweeping criminal investigation into suspected price collusion.” They won’t name names, but I can easily guess three.

EpiPen, whose active ingredient epinephrine was isolated in 1901, went from $100 in 2007 to $609 in 2016. In 2013, a bottle of doxycycline, an antibiotic, went from $20 to $1,849 in seven months. About the same time, digoxin, a century-old heart medication derived from foxglove, went from 17 cents per pill to $1.18.

And that list doesn’t include generic drugs that have undergone minor facelifts and major price hikes. The albuterol inhaler, a must for asthmatics, is one such industry fairytale. Some of us might remember when a generic inhaler cost $5.

In the mid-2000s, a mandated phaseout of ozone-depleting chlorofluorocarbon gas (the inhaler propellant) thrust a golden goose into Big Pharma’s clutches. Why? Redesigning the inhaler, as minor as the changes may be, provided new patents – and a decade of name-my-own-price protection.  

Unfortunately, the substitute, hydrofluoroalkane (HFA), is a heat-trapping greenhouse gas. But no matter, by 2008, the new Cinderella inhaler debuted in a ball gown of impenetrable patents, expelled greenhouse gas and cost up to $60. 

Today an estimated 5 million Americans are looking to buy prescription drugs overseas.

Surprised? No.

Is it legal? No.

Does it save money? Well, I tried it out a few months ago. I picked a Canadian online pharmacy listed on   

Typing in a brand-name inhaler, I got the following results: the brand-name inhaler cost $56-$70 domestically. Online from Canada, the same inhaler cost $19-$38. A generic albuterol inhaler cost $13-$25. Not included was a flat fee of $10 for shipping. 

Filling out some basic health information, I faxed my son’s prescription. In a few hours, a pharmacy representative called and politely declined the prescription because – get this – the date was missing from the prescription. The date was missing!

Usually bureaucracy turns my face into some 50 shades of emotional incontinence. But this time, the "we must do everything by the book or we’d rather not do business with you" stickler removed any reservations I had about buying drugs from them.

I provided the date and in two weeks the inhalers arrived. They worked fine.

Here is my splitting headache: I respect the FDA, but if the choice is between breathing and eating, please follow these precautions:

1.  Only get drugs prescribed by your doctor.

2.  Use a pharmacy that insists on legitimate U.S. prescriptions – with perverse obsession.

3.  And never, ever dabble with pharmacies selling controlled substances (narcotics, sleeping pills, etc.). 

In this last election, one of the few issues both presidential candidates agreed on was “the importation of drugs from overseas” that are safe and of lower cost, according to the Kaiser Family Foundation. But I’m not holding my breath. The Center for Responsive Politics reported that the pharmaceutical industry spent $240 million last year alone in lobbying.

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Volume 8, Issue 23, Posted 9:38 AM, 11.29.2016