U.S. seniors flooding Canada with orders for low-cost drugs

By Nancy McVicar
Health Writer
South Florida Sun-Sentinal

Posted December 16 2002

CanadaPharmacy.com, based in the small town of Surrey, British Columbia, started business 11 months ago with three employees mailing about 10 prescription drug orders a day to American seniors looking for better prices than they can get at their local pharmacy.

Today, the company has 50 employees filling orders for 50,000 regular customers all over the United States, said Mark Catroppa, vice president of marketing, but he thinks they are reaching just a tiny fraction of their potential customer base -- 40 million Americans on Medicare.

Despite the official position of the U.S. Food and Drug Administration that it is illegal to import Canadian drugs, thousands of Americans are doing it and the Canadian companies are developing ways to expand their market here.

"We get orders from every state in the U.S. every day, but we find the majority are from Florida, which is number one; Arizona, number two; and New York, number three," he said.

"The growth has been fairly exponential, and we expect that to continue," Catroppa said, "but right now, [Canadian mail-order pharmacies] are just a tiny fraction of 1 percent of the American market."

Drugs are shipped only after the company receives the prescription and gets health information about the patient.

"We have a medical profile that needs to be filled out. Usually, it's done over the phone. We ask questions. A pharmacist on our end looks at it, then if everything is OK, it will be sent to our Canadian doctor because it can only be filled if it's OK'd by a Canadian doctor," Catroppa said. "We don't charge for that."

CanadaPharmacy.com and other Canadian mail-order pharmacies are recruiting "affiliates" -- insurance agents and other people in this country who can help spread the word about the savings available by buying in Canada.

Canadian pharmacies offer many of the drugs most frequently prescribed to seniors at substantially reduced prices because its 33 million citizens are covered by government health insurance and the government negotiates with multinational pharmaceutical manufacturers to get the best prices.

With very few exceptions, American seniors on Medicare have no drug benefits and no one to negotiate lower rates on their behalf, so they pay the highest prices. For those who rely on multiple medications to survive, the cost can be daunting.

Bob Terner's 86-year-old mother takes nine prescription medicines, eight of them from a Canadian mail-order pharmacy, Mediplan Prescription Plus.

"She used to pay about $900 a month for her nine medications. Her Social Security check is $1,014 a month. Now we pay a little less than $900 every three months," Terner said.

A price list for Mediplan shows savings from 35 percent to 74 percent on selected drugs.

For example, 90 Celebrex 200-milligram tablets, prescribed for arthritis pain, cost about $244 in the U.S., compared with $112 in Canada, and 90 Zocor 20-milligram tablets, a drug to control cholesterol, cost about $388 here and $176 in Canada.

Despite the hefty savings available through Canadian pharmacies, some senior advocacy groups do not recommend that their members buy that way, including The Seniors Coalition, a four-million-member organization that lobbies on behalf of senior issues.

"Our biggest issue is a prescription drug benefit," said Chris Butler, a spokesman for the organization, "but we don't recommend [ordering from Canada]. That's just a real symptom of a real problem, and it's hard to tell people not to do something that saves them money. We just don't think it's a good idea to have people importing drugs on a massive basis with no oversight."

Instead, the coalition signed an agreement last week with an American drug wholesaler, Quality Pharmaceutical Services, based in Rhode Island, which offers discounts to seniors.

Seniors can get free discount cards to order their drugs by mail at about a 30 percent discount on brand names and about a 50 percent discount on generics, according to Jack Laub of Boca Raton, one of the owners of the company.

Several pharmaceutical companies also offer discount cards to help seniors afford their drugs, including one called Together RX, which covers 150 drugs manufactured by seven different companies.

Terner, 57, of Pompano Beach, said he has no worries such as those voiced by Assistant Attorney General Edwin Bayo, who is counsel to the Florida Board of Pharmacy. Bayo said he is concerned that there is no oversight of such shipments and no guarantee the drugs are safe.

Bayo made his comments after several storefront businesses opened in Florida to solicit business for the Canadian pharmacies. He said it was his opinion that if they accept prescriptions from customers without having a licensed pharmacist on site and send them to Canada, they are acting as unlicensed pharmacies.

Unlike storefront operations, marketing "affiliates" in South Florida say they are only making people aware of the companies, providing information on how to order and leaving it to individual customers to process their own prescriptions.

Terner said when his mother's first mail-order shipment of the drugs arrived from Mediplan, he took them to her doctor's office, where a nurse looked them over.

"She said, `Everything is fine. Everything has a bar code, a lot number, an expiration date.' All the drugs were correct, all the companies are right, everything came in a sealed package from the manufacturer," he said.

Paul Maresca, owner of Life Investors Insurance Agency of Boca Raton, said his company is the U.S. marketing company for Mediplan's Prescription Plus Pharmacy, has no storefronts and does not handle prescriptions. But he is seeking other people to help spread the Mediplan name and phone number.

"Our job is to find the means to get the word out to the people. We do this mainly through advertising," he said. "We find the avenues -- the newspapers that most seniors read, and we do health fairs. We get paid for marketing based on the gross sales of what the business does as a result of our [efforts]."

He said he gets letters from seniors thanking him for explaining how to order their drugs from Canada.

"Usually they tell us about how much they're saving," he said. "We've heard stories that a husband and wife are saving as much as $1,000 a month between them."

Nancy McVicar can be reached at nmcvicar@sun-sentinel.com or 954-356-4593.


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