The Ins and Outs of Buying
Legal Drugs Across Borders

By Tara Parker-Pope, The Wall Street Journal

 October 22, 2002

Dozens of Canadian pharmacies offer drastic savings for Americans willing to buy their drugs over the Internet. The practice is technically prohibited by the Food and Drug Administration, but the reality is that the agency rarely cracks down. Canadian drug retailer RXNorth.com¹ says that only 1% of the 1,500 prescription drug orders it ships daily to the U.S. are confiscated at the border and returned to the company. Anything that comes back is simply repackaged and resent.

On paper, the FDA's rules are clear: Only a drug maker can import drugs. In certain situations, individuals can import a 90-day supply of a drug that isn't approved for sale in the U.S., if the U.S. doctor wants the patient to have it.

But in practice, the FDA's stance is much murkier. The vast majority of drugs that Americans are buying from Canadian pharmacies are approved for sale in the U.S. -- just at much higher prices. Because of the disparity between what the FDA says and what it actually permits, most customers don't think they are breaking the law.

Suzanne Dollar, who works for a Christian ministry in San Antonio, says her own doctor told her it was a "great idea" to shop at a Canadian online pharmacy. By doing so, she has helped her 84-year-old mother save nearly $1,000 a year. "I figured if my own doctor was OK with it, then it must be OK," she says.

The practice of shopping for drugs north of the border just got an unexpected boost with the decision by a Texas health-claims processor, SPC Global Technologies, to offer about 20,000 people in its clients' programs a way to obtain drugs in Canada. An FDA official has indicated SPC most likely isn't in violation of the law because the consumer, not the firm, is actually buying the drugs (see article⁵).

While other companies are also trying to make it easier for Americans to buy cheaper drugs from Canada, the move by SPC takes things a step further. By handling the paperwork and paying for the drugs, SPC is essentially brokering the purchase, making it much less cumbersome to get the cheaper prescriptions.

Several Web sites tell shoppers that the Medicine Equity and Drug Safety Act, passed by Congress in 2000, allows prescription drugs from foreign countries to be sold to Americans. But the bill hasn't taken effect because the secretary of Health and Human Services, Tommy Thompson, as well as his Clinton-era predecessor, have said adequate safety measures can't be assured.

Yet, with the FDA clearly looking the other way, sales of prescription drugs from Canada are soaring, and it is easy to see why. The cholesterol-lowering drug Zocor, for instance, costs $327.86 for a three-month supply from U.S.-based drugstore.com⁶; at hometownmeds.com⁷, based in Manitoba, the price plummets to $189.55. Brand-name drugs are so much cheaper in Canada because of government price caps and the weak currency.

Some Canadian pharmacies are even giving U.S. consumers tips on how to separate the legitimate businesses from the illegitimate ones. Paul Clark, chief executive of hometownmeds.com and a pharmacist in Manitoba, says Americans should buy only from a pharmacy that requires a prescription from a U.S. doctor. They should also ask whether they have the option of speaking directly with the pharmacist filling their prescription. He also suggests asking the pharmacy what country the drugs are coming from, and requesting a copy of the pharmacy's license.

Carol Carson, 56, of Kent, Wash., shops at hometownmeds.com for nearly a dozen drugs that she and her husband need, including the arthritis drug Vioxx and the heartburn medication Prilosec. The drugs arrive in about five days and she saves some $300 a month.

Jerry Perlman of Tucson, Ariz., shops at a different place, tcds.com¹⁰, the Web site for the Canadian Drug Store Inc. The 63-year old saves about $100 a month, and says many people he knows buy their drugs from the same site.

"I called up my senator and our congressman," he says. "None of them have a problem with people spending less money on prescriptions."

The FDA says Americans who shop at Canadian pharmacies are taking a risk because the drugs fall outside its purview and therefore the agency can't guarantee their safety. The reality, however, is that buying from a Canadian pharmacy is often just as safe as buying from one in the U.S. One obvious sign: The drugs often come in the manufacturers' original packaging.

Canadian regulators also are beginning to pay more attention to the industry. In Ontario, regulators recently filed charges against The Canadian Drug Store claiming it was unlawfully operating an unaccredited pharmacy, staffed by unregistered pharmacists. The case is still pending, and the site is still operating. Founder Billy Shawn notes that the firm is simply an agent for a licensed pharmacy in British Columbia. Drugs purchased through the site carry the label and phone number of the Garden City Pharmacy, and consumers can call and talk to the pharmacist directly.

Not everyone who checks out a Canadian pharmacy decides it is a good deal, though. Roz Janowski, 58, of South Orange, N.J., checked out Canadian prices for two drug prescriptions, but discovered the $10 shipping charge ate up most of the savings. She also worries about shipping delays, and about "continuity" if U.S. or Canadian regulators ever decide to crack down. "By the time you add in shipping charges and you only have one or two prescriptions, it gets pretty close as to whether it's worth the bother," she says.