How expatriates buy pharmaceuticals

Yes, Donald Trump is our president, but, no, I am not leaving.

I will stay here and cast my vote, support good candidates, and continue to share my opinion that the USA is better than Trump.

Trump is eroding both the Constitution and many of the political norms that have made this a workable democracy. Trump will end. So will Trump-ism, if there remain people in the U.S. who keep memories alive. I am a "revanchist," seeking not lost territory, but a restoration of lost values. It may be fruitless, but here I am.

The media read by Democrats and never-Trump Republicans arepublishing stories about people choosing to get out. Ones like these:

The New Republic

 

Slate

The bits of international travel I have done, and guest posts by Erich Almasy, have taught me that the USA may be comfortable in its familiarity, but it isn't the only nice place to live. That is especially true if one has the resources of a comfortably middle-class American. We aren't stuck here. 

College classmates Erich and his wife Cynthia Blanton worked for many years in Canada, then chose to retire in Mexico at San Miguel de Allende. Erich shares his experience buying the pharmaceuticals that are a frequent aspect of life as a 75-year-old. 

Erich Almasy and Cynthia Blanton

Guest Post by Erich Almasy

Where I Get My Drugs

No, not those drugs, although eventually México will make marijuana and magic mushrooms legal per a past ruling from its Supreme Court. No, I’m talking about prescription drugs, especially those brand-name patented ones that only go up in price. If, like me, you need medications for depression/anxiety (more than ever), cholesterol, blood pressure, gout (thanks, Dad), restless leg syndrome, or any other ailment you learned about through TV ads, then I have both good and bad news. If you are not already using it, please look at Mark Cuban Online Drugs. He’s my bet for our next President but in the meantime he has created a simple-to-use online delivery system that sells over 1,000 prescription drugs at wholesale prices plus 15 percent. If you want, you can also get medications somewhat cheaper from Canada. Or, even make a trip to Tijuana, and without a prescription, that makes them still more affordable.

Package, as it arrived in good condition

If you want to take the risk for a lot of reward, you might consider India, where the ingredients and precursors for nearly every drug you take are made. Recent news from Pfizer is that they will be bringing their drug manufacturing back to the United States, a country that currently only makes 14 percent of the drugs it consumes. This might take awhile and in the meantime, I will buy my anti-anxiety drug that Pfizer has under a tight patent and brand stranglehold from India. Or rather, I won’t, because for the cost for one month in the United States, two months in Canada, and three months in México I now have a two-year supply. I bought and used these drugs in all three countries, and I bought and tested the product from India, and it works great. Buying your medications from Mark Cuban or elsewhere may protect you, since Florida is not requiring pharmacy benefit managers to send them all prescription information. They’re after abortion pills, but where will it stop? 1984 anyone?

Buying from India isn't easy, and under Trump it may get harder. But saving myself thousands of dollars a year while on a fixed income is more than a blessing. If you wish to pursue this, prepare yourself for a lot of research and a lot of pushback. The internet will become your best friend as you learn about the scientific names, dosages, side effects, patent protection, generic names, and alternative manufacturers of your drugs. Luckily the next steps are easier because India has a giant clearinghouse similar to China’s Alibaba. It’s called IndiaMart, and it can serve as a middleman to help you find a distributor or manufacturer who will serve your specific needs. You’ll need to sort through many responses, research the proposed vendors, learn how to do wire transfers with your bank, and order samples to confirm their efficacy. But it is worth it, and for many brand names like Lisinopril™ or Statins, it’s pretty straightforward.

Then, the bad news - getting your drugs (excuse me, medications) into the United States. Best way is to have them shipped to a friend in Canada and sent as a personal package to you. Technically illegal (meaning like the cookies you brought back from Paris they could be confiscated) but it’s not like you’re buying opioids (at least I hope not). If you send directly to the United States, Customs and Border Protection (CPB) is looking for fentanyl and other narcotics packages coming from China and India. They will also say it is illegal to bring medications from outside the United States unless you are a visitor and need your prescription filled (Note: readers with foreign passports could claim under them). Their rationale is that the FDA can't ensure that drugs from other countries are safe and effective, and that drugs that are unapproved, adulterated, or misbranded are prohibited from being introduced into interstate commerce. Something called Section 804 of the FD&C (Food, Drug, and Cosmetic) Act has made importing some drugs from Canada legal because they significantly reduce the cost of these drugs to the American consumer, without imposing additional risk to public health and safety. Of course, all of this is to protect Big Pharma and it’s probably moot since we may not have an FDA after next week.

Here’s an example. For 30 years I have taken Allopurinol daily to lower my uric acid and prevent outbreaks of gout. Recently, a new drug called Febuxostat (Uloric/Turazive) has fewer side effects. Prices for one month of 30 x 80 mg tablets

United States Retail Pharmacy - $301.20

México Retail Pharmacy - $62.28

Canada Online Pharmacy - $27.60

Mark Cuban (Generic) - $9.94 (it's hard for me to get a prescription from a U.S. doctor without additional cost so I don’t use this method)

JB Pharma (India ) - $1.20

CPB will likely hold up your package at JFK Airport in New York, whether through Indiapost, DHL, or FedEx. CPB will contact you (see below) and may try to tell you that what you’re doing is illegal. However, it is all a “gray” area because there are dozens of exceptions, including if you cannot get the drug elsewhere. I’m fortunate because I have my supplier insert a letter addressed to CPB telling them that the medications are not for consumption in the United States and are headed to a courier in Laredo, Texas who will bring them to me in México. I also include a prescription from my local doctor. This works better than shipping direct to México, where our COFEPRIS (Federal Commission for the Protection against Sanitary Risks) is even more difficult to deal with than CPB (and in Spanish). 

The Letter You Will Receive From CPB:

Thank you for contacting the U.S. Customs and Border Protection (CBP) Information Center.

1. The U.S. Food and Drug Administration (FDA) does not allow mail imports of prescription medications or foreign over-the-counter prescription medications for use in the United States. However, there is an exception for travelers temporarily visiting the United States who might need their prescription medication mailed to them.

You will need to have your doctor write a letter in English, or have an official English translation attached, that explains:

• You are their patient with your name on the letter;
• Name of medication prescribed to you and why you need the medication (diagnosis);
• You are on temporary travel to the United States for a visit, study, etc., providing the dates of your visit; and
• Reason for mailing the medication to you, such as you forgot it at home, lost it, ran out, etc.

CBP recommends that the doctor address the letter to “Dear CBP officer” on the doctor’s professional letterhead. Please attach the letter to the outside of the package inside a clear packing slip. The packing slip should have “FOR CBP OFFICER” written on it. This will alert an examining CBP officer to open the packing slip.

Please understand, your medication is subject to inspection by the FDA, and the FDA may order CBP to hold the package. If this happens, it can take time before the FDA decides if your medication is admissible to the United States.

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