Cheaper drugs that you buy outside the US and that are just as good as what you buy for too much money in the USA?

I was going to do a blog on this and let you know how I saved money on drugs and how you can do the same thing. For several years now I have gotten my prescription drugs via a Canadian pharmacy. They honored prescriptions from US doctors. The drugs they provided were generics that were manufactured in countries where I know the standards to be excellent such as the UK. I worked for a British pharmaceutical company and I am well aware of the standards in the UK. The price I paid was decent and a fraction of what I was going to have to pay in the US.

Why am I speaking about the past? Because there's bad news. My Canadian pharmacy will stop shipping to the US next month.  They are no longer allowed. Not because they don't want to but because there appears to have been a legal issue. I don't know if that was something against them in particular. I am of course very suspicious that this is a more sweeping move very much in favor of the US pharmaceutical industry. For the moment I have my supplies, I'll have to shop around and see what I need to do. Now that I have Medicare and part D (Drugs) it may not be too bad.

I have seen and heard the stories about the prices people have paid for their drugs and the huge difference it makes to purchase them outside the USA. We spend the winter in a retirement community in Arizona and hear the stories about the difference in price. Drug companies want to offer treatments to improve the lives of patients. At least, that is what they say. Drugs that are not affordable do not improve the life of patients. One of the difficulties the pharmaceutical companies have is that patients do not renew their prescriptions once they have taken a drug for a month. They can't afford it. There is rent, groceries, what not. And people want to travel, go to the theater, play golf. You can spend your money only once. The pharmaceutical slogan rings rather hollow when improvement of life is so unaffordable. Without a drug plan you will pay the highest price because you don't have the drug plan's volume purchase that can knock the price down. And drug consumption increases as we get older and need treatment for high blood pressure and high cholesterol. Pharmaceutical companies will invent some new drug that is marginally better than the previous one. Statistically better doesn't mean that it makes a difference biologically. On the contrary. The newer drug is so much more expensive that it isn't taken continuously. It looks good in drug trials because then the drug is paid for. I've spent a decade in that world, I know what I am talking about.

The debate over health care is far from over. In my opinion health care should be free for all. Drugs should be affordable. Medicare should cover all Americans and the VA could probably be abolished in that model which could easily better the health care of veterans, those people who we thank for their service by making it often really hard for them to get proper care for their wounds of war. I practiced medicine in Canada. It is not a system where people die on wait lists. That is lobbying talk. That is money changing pockets. People in Canada who come to the USA to get certain procedures are not sitting waiting for years as some politicians would have you and me believe. They just are willing to pay more. They stay in more expensive hotels too probably when they are traveling. Canadian health outcomes are the same as the USA and when it comes to pre and perinatal care they are better. Universal health care systems worldwide give top quality medical care. The UK is rated best in many analyses.

And so there is really no use in telling you how you can obtain your medications cheaper when ordering it via a Canadian pharmacy and having it shipped to your address because it seems that it won't be possible any more. To me that is utterly unfair and is once again an illustration that the pharmaceutical industry loves to tout how they take care of patients but what they really do is taking care of their investors and their executives. They take care of themselves and their own.

Pharmaceutical companies develop drugs and that often involves very minor changes in molecules especially when we talk about pills such as cholesterol or blood pressure lowering medications. Any minor change can yield a new patent and with that new and more money. In the USA, unless we are talking about anti-cancer drugs or other life saving therapies,  the companies usually need to show that their drugs work better than placebo, the sugar pill. In other countries especially in Europe they need to show that they are better than what is currently best practice. A much higher bar. And guess what. They are not easily that much better. As I have said earlier, statistically better does not mean that it makes a difference in biology, especially when you are already taking a bunch of other drugs for other conditions. Drug interactions are insufficiently studied. It is hardly possible to do that because the number of combinations with other drugs is huge and simply prohibitive to make such studies relevant or even affordable. So the effect a drug has according to its label is mostly what it does in people who don't take little else if anything. But the hype over a new drug is gigantic. People are having parties and are dancing because they are so happy with the new drug. And they are still dancing while the adverse effects are being listed. You're watching happiness while death is being mentioned in the side effects list. Body language that talks louder than the "big words" of the bad stuff. You're not going to be dancing when you're handing your credit card to the cashier. And you're not necessarily going to feel better when you're on your new blood pressure drug. Because it may not make a bit of difference from what you used to take other than that it is a whole lot more expensive.

In closing I'd be amiss if I didn't mention what happens with anti-cancer drugs and therapies for life threatening conditions. In those circumstances the existing therapy must be continued. Patients would do very poorly if they suddenly didn't get their life saving drugs because of a drug test and so, rest assured, obviously in those kind of circumstances the new medication is not compared with placebo. I am planning a future blog to discuss how pharmaceutical companies do the clinical trials that they need to do to get approval for their drugs.