pills and Canadian Flag, from Canada

The FDA has a peculiar philosophy about drug importation. It allows pharmacy chains, drug wholesales, big box discount drug stores, nursing homes and lots of other drug distributors to purchase drugs from all over the world. Most generic drugs are imported, with China and India supplying both raw materials and finished pills. There have been huge scandals about fraud and quality control at many of these foreign plants. But if an American citizens want to buy brand name medications from Canadian online pharmacies the FDA warns that this is dangerous. Here is one reader’s question about this practice:

Q. My insurance company will no longer pay for two of my brand-name medications. I am allergic to certain fillers in generic drugs and thus cannot tolerate some.

I am thinking about ordering these two brand-name meds from Canada. I have perused Canadian pharmacy sites on the Internet and some look very good. I wonder if you might know of some Canadian pharmacies that people have had good luck with in relation to the quality of the medication received? We cannot afford to continue paying the outrageous US prices for these medications.

A. Although generic drugs must have the same active ingredient as the brand name equivalent, they often contain different binders, fillers and colors. This can cause serious problems for people who are allergic to such ingredients.

Canadian Online Pharmacies Represent Huge Savings:

Savings on brand name medicine purchased from a legitimate Canadian pharmacy can be dramatic. We asked an organization that carefully monitors Canadian and international pharmacies to do some cost comparisons. PharmacyChecker.com analyzed several common medications. They checked retails prices from a chain drugstore in New York City and compared them to Canadian online pharmacies. Here is what they found for some important brand name medications.

The average savings was 81% when purchased in Canada. The heart drug Lanoxin (digoxin) represented the greatest savings–94% but the drug is marketed by a different pharmaceutical company from the one in the U.S.

Here are some other examples from PharmacyChecker.com. Prices are for the same brand name products in Canada vs. a U.S.-based retail store in NYC for a three-month supply:

Tegretol (carbamazepine) 200 mg cost $2.87 per pill in U.S. $0.77 in Canada

Cleocin (clindamycin) 300 mg cost $24 per pill in U.S. vs. $3.38 in Canada

Catapres (clonidine) 0.1 mg cost $3.34 per pill in U.S. vs $0.45 in Canada

Lanoxin (digoxin) 0.125 mg cost $12.54 per pill in U.S. vs. $0.75 in Canada

Coumadin (warfarin) 5 mg cost $3.69 per pill in U.S. vs. $0.60 in Canada

Narrow Therapeutic Drugs:

All these drugs are considered “narrow therapeutic index” (NTI) drugs. That means the safe dose that works is very close to a toxic dose. This is why it is crucial that patients get a reliable dose that poses no risk of quality control problems or dosage variability. Many people feel that the FDA’s standards on such medications has historically been too lax. That is why some physicians specify the brand name product for NTI medications.

We will be writing more about narrow therapeutic index drugs and brand name price comparisons in future articles. Should you wish to learn which International pharmacies have passed muster with PharmacyChecker.com go to their website at this link.

Remember, we are talking about brand name drugs, not generics. In most cases the brand name medications were made by a major pharmaceutical manufacturer. The same exact pills that are shipped to the U.S. are shipped to Canada and other countries around the world. The same production line spits out these medications according to the original specifications submitted to the Food and Drug Administration.

Brand name pills are pricey in the U.S. because there are no brakes on what brand name companies can charge. In many other countries the government negotiates prices with the big brand name manufacturers, which is why the savings PharmacyChecker.com discovered for narrow therapeutic index drugs purchased in Canada was right around 80%. That is huge, especially when your brand name medicine is expensive and you cannot tolerate the generic.

Can You Trust All Canadian Online Pharmacy Websites?

Sadly, a nice website does not guarantee that an online pharmacy is truly Canadian. Fake online sites might sell counterfeit or substandard medicines.

We have prepared a Guide to Saving Money on Medicine that provides more details on the benefits and risks of shopping for medicines online. In it you will find our ten tips for saving money, including how to shop comparatively, bargain with the pharmacist and learn how to discover if you qualify for free medicine.

It is available electronically at PeoplesPharmacy.com. You can also visit PharmacyChecker.com for comparative pricing and verification strategies when shopping internationally.

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  1. Nancy
    Seattle WA

    I have taken Celebrex for many years (since it first came out). Up to 2 years ago I was paying about $287 copay for 3 months supply. Then all of a sudden it dropped to $30 for the same amount of meds!!! I asked the pharmacist what had happened and he admitted that Celebrex now had a generic and that is what I would be getting. I was leery about it but paid for it and left.

    Well, after 3 wks I had to call my insurance co. to see if I could switch over to brand-name as the generic did not work at all. Unbelievably they agreed to do it and I got back on the real stuff but at a higher copay than before. Finally last year my insurance broker and I figured out that getting my Celebrex from Dr. Solve.com in Surrey, BC would keep me out of the donut hole and be far cheaper in the long run. I am very impressed–they tell you where it is made (New Zealand) and where it goes before it gets to your home. You do have to allow about 2-4 wks for the order to be placed and delivery. You can go to their website and check out prices for brand names and generics for all kinds of drugs.

  2. JimP
    Winchester, VA

    I checked for Avodart at PharmacyChecker.com. All but two of the 26 online pharmacies listed have a pharmacy located in some second- or third-tier country in addition to Canada. Even though many have “Canada” in their name and all have a pharmacy in Canada, you will probably be getting your discount prescription drugs from Turkey, Barbados, Mauritius or India. That certainly isn’t what I consider to be a reliable Canadian pharmacy!

  3. Lee

    Misinformation and scare tactics are often used to dissuade Americans from using online pharmacies. Thank you for being a voice of reason for consumers.

    Legitimate international pharmacies exist. And they’re an important alternative for Americans struggling to keep up with drug costs. Importation is not a long term solution or a cure-all but it’s a common sense and immediate short-term alternative for consumers who have no other options.

    Four million Americans import their needed medications from Canada and other countries each year (despite the fact that it’s not technically legal). Many have come to depend on this virtual lifeline to medication.

    RxRights.org aims to educate consumers on drug pricing issues and direct them to safe online pharmacies.

  4. Penelope

    Canadian supervision of their drug supply I understand is much better than the FDA. I think the FDA’s nose is out of joint, because another country does a better job of policing their drug supply than they do!

  5. Phil
    Pasco County Florida

    I order through Canada all the time. pharmstore.com Never an issue. Had my Pharmacist check the meds, she even agreed, the real thing!

  6. HankieT

    I get my 2 more costly drugs from canadadrugs.com. They are on your list, CIPA approved, fantastic customer service, fast shipping. My Advair copay in
    2016 was increasing to $250/month, from $150. Ahead of the new year, I got my 3 month supply for $256 total and they came from England in 1 week. My Nasonex will not be covered in 2016, but I got 3 for $152, instead of $94 each. These took 2 weeks from England. Shipping is free. These are name-brand, not generic!

    My specialist dr. is ok with this, but he makes me pick up the RX and submit it myself. He will not fax it or renew the RX by phone. My family dr. is Canadian and gets her own RXs from Canada.

  7. Lynne

    Check with the drug company. They may have a program which will help offset the cost of you using their medication. If this is done correctly, their $ toward your medicine will go toward your out-of-pocket.

  8. Diana
    Boone, NC

    Several years ago I ordered one of the medications I take from an on-line supposedly Canadian pharmacy. The drug was sent to me directly from India. While it looked like the drug I was taking, the odor of it was horrible. I threw the pills away and never ordered again.

  9. Dianne
    North Carolina

    I’m glad you are changing your position on Canadian pharmacies! I have ordered one of my meds from Canada for years — same manufacturer and same packaging as I can buy in the US for four times the price. Medicare won’t help pay but the saving is still substantial.

  10. Marcia

    My blood pressure medication is manufactured by a company in India, needed to change it, the company was investigated, and found out it diluted the chemo meds, and sent them to the US. Why are we buying meds from other countries, and why is the FDA allowing this.

  11. Gale
    Durham, NC

    I was directed by a pharmacist to the website http://www.cipa.com. This is an organization that certifies Canadian pharmacies, and lists the websites of legitimate pharmacies.

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