Is it safe to buy cheap prescription drugs abroad?

Stocking up on cheap prescription drugs abroad without consulting a doctor can be dangerous, finds Joanne Christie

The 50-something man in front of me at the pharmacy in Goa turns around and grins. 'Sorry for the hold up love,' he says in a distinctly British accent. 'He's gone out the back as he didn't have enough Viagra under the counter.'

It must be apparent that I'm taken aback by his admission, so he continues to explain: 'Everyone does it. You can get a whole year's supply here and it costs nothing compared to what it costs in the UK – and you don't even have to see a doctor.'

After he's done, I tell the pharmacist I have a cold and want something like a day and night tablet. He gives me two lots of pills and assures me they'll work. I'm not too sure what I'm getting, but it only costs about 50p, so I pay.

I don't recognise the drug names, so I Google them. One is a decongestant; the other turns out to be Valium. On the back of the packet it says: 'Schedule H drug. Warning: to be sold by retail on the prescription of a registered medical practitioner only.'

After a blissful sleep, albeit with a slightly groggy wake-up, I decide to get a few more, for such future eventualities as long-distance plane trips. Having suffered insomnia on and off throughout my life, I know how hard it is to get doctors in Britain to prescribe you anything of the sort. I visit maybe five pharmacies around India, and have no problems getting what I ask for.

Along with India, many other countries such as Egypt, Turkey and Mexico have a reputation for a rather relaxed attitude to prescription drugs. But while bypassing the doctor and saving money might seem like a good idea, there are risks involved.

Heidi Wright, head of quality improvement at the Royal Pharmaceutical Society, says that there is a danger that people do not knowing what they are getting. 'Here, medicines are very well regulated, but when you go abroad you may buy drugs in countries that aren't so stringent,' she explains. 'Counterfeiting statistics are quite high in some countries; there's a real risk of ending up with something that isn't what it says on the bottle.'

Although Wright says that in most cases counterfeit drugs are simply ineffective, they can also contain dangerous ingredients, or be the wrong strength.

Harry Shapiro, director of communications and information at Drugscope, a charity that works to reduce drug-related risks in Britain, says people may also be putting themselves at risk of addiction, particularly if they are stocking up on painkillers.

'Drugs like Vicodin have been identified as drugs that have a high addiction potential,' he says. 'Most codeine-based products are now prescription-only simply because of this addiction potential, but when people are buying these drugs abroad, or over the internet, there are no checks and balances.'

Benzodiazepines, like the diazepam (Valium) I purchased, are also known to be addictive, though not to the same degree as codeine-based products. Your medical history and other medications you are taking are also not taken into consideration.

Like the man I met in India, many men buy Viagra overseas because it is cheaper and easier to get hold of. When Boots started an over-the-counter trial of the medicine in Manchester in 2007, patients still had to book a consultation with a pharmacist and paid £50 for four tablets. In India, that would get you hundreds of pills.

Taking Viagra without consulting a doctor or pharmacist can be dangerous, says Naomi Craft, a general practitioner and medical columnist. 'Cardiac patients in particular should always discuss the use of Viagra to avoid possible side effects. There are particular drugs called nitrates which are commonly given to people with heart conditions that you shouldn't take Viagra with,' she says. She says people who have had a stroke recently, low blood pressure, or an angulated erect penis should also not take Viagra.

You only have to look at the some of the more recent celebrity addiction cases to realise that it isn't only illicit drugs that cause problems. The International Narcotics Control Board's annual report, released in March 2007, claims the abuse and trafficking of prescription drugs is set to exceed illicit drug abuse. And in July, a group of MPs and peers called the All Party Parliamentary Group on Drug Misuse launched an inquiry into the scale of prescription drug abuses in Britain.

Much of the official concern about prescription drugs is directed at internet pharmacies and people selling drugs illegally, and you're unlikely to find yourself in trouble for bringing prescription drugs into Britain. It's not illegal to bring them home, as long as they are for personal use. Even anabolic steroids can be imported for personal use, according to customs officials.

The Medicines and Healthcare products Regulatory Agency (MHRA) however, will take action if they suspect that people plan to supply medications to others. 'If you are coming back from a country and bringing in huge quantities of medications, then common sense will dictate that you aren't going to get through those medications yourself, therefore you must be planning to sell them on,' says a MHRA spokesperson. 'The illegality comes in with the illegal sale and supply.'

Other countries have different rules, though, so if you're travelling via other destinations, it's wise to assess the situation before you go. For example, in Greece, codeine is banned, so even over-the-counter medications could land you in hot water.

However tempting it may be, stocking up on pills in countries where regulation is minimal is risky. If your doctor at home won't prescribe the drug you want, there's probably a good reason and going against their advice could be detrimental to your health. And while foreign drugs may be cheap, they could also be worthless, or even dangerous.

Source: https://www.theguardian.com/money/2007/dec/20/expat-finance-health1

Jeff Meckling

Greenfield, MA July 31, 2016

As a prescriber I have some relevant experience. First many insurances will NOT cover ANY amount of the drugs available in the US for ED. My patients, generally, are not "ashamed" about their ED - in fact their partners often accompany them to their appointments. They're simply frustrated (in more than one way) by the lack of coverage and the unaffordable cost, often buying one pill at a time at $25 a pop. And many insurances will NOT cover sildenafil 20mg unless the patient actually has an established diagnosis of pulmonary hypertension.

I believe Medicare should have the right to negotiate drug prices. And I think Congress should pass legislation that would make it illegal for companies such as Pfizer to continue the "pay for delay" tactics that keep the cost of drugs like Viagra artificially and obscenely bloated (and the FTC didn't seem interested or able to exercise what little power they wield).

In the end it is big pharm that is most responsible for the variety of unnecessary suffering that ED brings to individuals and their relationships across the US. And it shouldn't be surprising that the response to that suffering is to look elsewhere for the remedy that after fifteen years should be readily accessible and affordable to the majority of my patients.

M Shaffer

Washington July 28, 2016

While online " Viagra" may or may not be legitimate, generic sildenafil 20mg tablets are available and approved for pulmonary hypertension. These same pills may be used as an ED medication with correct dose adjustment. However many pharmacies refuse to dispense these pills for ED and instead direct patients to purchase Viagra.

Curtis

Bellevue, Washington July 26, 2016

I am currently working in France. My local pharmacy charges me 40 Euro ($43; full price to someone who isn't part of the French healthcare system) for my Symbicort inhaler (for COPD), which costs $360 in the US. The inhaler is made by AstraZeneca in France and as far as I can tell is identical to the ones I get in the US, except that the writing is in French. I checked with the pharmacist about sildenafil citrate (brandname Sildenafil Mylan, made in Ireland): 100 mg tablets are about $5.32, vs the $50 in the US as reported in this article. I haven't tried them, but my guess is that they are 100% as good as brand name Viagra.

The difference in US and French prices is purely what the market will bear. Americans have been brainwashed about the supposed evils of socialized medicine, so they don't fight back. The extra profits in the US are split between big pharma and their lapdogs in Congress.

Rhett

Houston July 26, 2016

The active ingredient of Viagra (sildenafil) IS AVAILABLE AS A GENERIC RX IN THE US LEGALLY. Viagra was originally approved under the brand name of Revatio for pulmonary hypertension and, since 2013, I believe, has been available as a legitimate, legal, US-sold generic drug in the 20 mg (as opposed to the 100 mg) strength. One can just ask your doctor to consider prescribing sildenafil 20 mg 1-5 tablets as needed. Self-pay cost around here is about $25 for 30 tablets of the 20 mg generic sildenafil strength (equivalent to 6 doses of 5 pills apiece) vs. self-pay cost of about $300 for 6 tablets of the 100 mg Viagra brand strength. (See http://www.goodrx.com/blog/its-here-finally-a-viagra-you-can-afford/)

There is no need to go out of the country or fall for an online scam to fill a prescription for sildenafil.

OSS Architect

California July 27, 2016

It may not be that easy. A "three letter pharmacy" here fills the prescription (in California, at least) through their "Specialty Pharmacy". To get ### to fill the prescription, it has to go through a special medial review; requiring more paperwork from your doctor, stating that you have diagnosed pulmonary hypertension.

After your Doctor falsifies your medical condition, the "Specialty Pharmacy' that fills the Rx is 50 miles away, and you have to physically pickup your Rx.
This really smacks of Pharma pressuring pharmacies to block any alternatives to paying $$'s for their trade name drugs.

Menno Aartsen

Seattle, WA July 27, 2016

Generic Sildenafil Citrate 20mg, manufactured by Torrent Pharmaceuticals Ltd., (based in India, with a subsidiary in Michigan) is indeed available by prescription in the United States, listed under National Drug Code (NDC) 13668-185-90 and others. Approved for the treatment of pulmonary arterial hypertension, my insurance lists it as 90 tablets for a total cost of $82.34. The problem you may experience is that your insurance will immediately list you as a patient with a pulmonary condition....

louis10

Hollywood, Fl July 26, 2016

I have been purchasing generic Cialis from Canadian Drug Pharmacy(CDP), on online pharmacy since 2013 and have never had a problem. CDP is certified by both the Canadian International Pharmacy Association and PharmacyChecker.com. The average cost of each pill including shipping is $4.50.
A current prescription together with a complete medical history is always required.
The Cialis manufacturer, Cipla Ltd of India, is a world wide highly respected producer of generic drugs.

HighStrungLoner

Portland ME July 26, 2016

I have bought low cost Viagra through the well-regarded All Day Pharmacy in India. Many folks with chronic illnesses like COPD use them regularly to purchase medications that are too expensive in the US. I'm sure there are others who are just as trustworthy.

NYHUGUENOT

Charlotte, NC July 26, 2016

There are at least two products containing the chemical in Cialis. They are also generic. They are not advertised for erectile dysfunction but are used to shrink the prostate. A swollen prostate effects urination. They are lot cheaper without the glamorous trade name and have the same effect. Insurance would more likely pay for them since they are being prescribed for a prostate problem. Some doctors are prescribing a daily 5% Cialis tablet for prostate maintenance.
I've been buying Cialis though reputable Canadian pharmacies for a few years and there has never been an issue or problem with it. It's produced under license in Turkey is packaged four tablets to a box. Average cost has been about $10 a pill for a 20 Mg pill which can be cut in half or whatever which also saves money. The pharmacy I use also has the generics for much less and I believe are produced in India.

HighStrungLoner

Portland ME July 26, 2016

My Urologist recently prescribed low-dose Cialis for exactly that. I've been going through pre-authorization hell for two weeks.

Melinda

Just off Main Street July 26, 2016

"Any pharmacy that’s offering generic Viagra is probably using counterfeit product that’s not approved,” said Carmen Catizone, the executive director of the National Association of Boards of Pharmacy."

More LIES, brought to you by big Pharma in the U.S.

A generic equivalent of Viagra from Canada, if ordered from a reputable source, is the same exact drug at 1/10 the cost.

When will the Anerican people finally stand up to the outrageous greed of the pharmaceutical corporations and say : enough!? No more drug commercials. No more price fixing of generics. We want the same prices Canadians pay.

Tod Cooperman, M.D.

New York July 26, 2016

Looking on PharmacyChecker.com, which was recommended by Mr. Bate, instead of paying $50 per pill in the U.S., the brand name product from Pfizer is available for less than $10 per pill. The price varies depending on the country from which it is dispensed and the online pharmacy used. Generic versions tend to be around $2 or $3 per pill.

SB

San Francisco July 26, 2016

The good generic variety is perfectly fine if you can get it. It is NOT a complex or expensive drug to manufacture, the list price consists mostly of profit.

If you can get it from a properly vetted Canadian pharmacy, do so. Pfizer is rich enough.

WEH

YONKERS ny July 26, 2016

The triumph of class and greed.

Gabriel Levitt

Brooklyn, NY July 26, 2016

I am the president of one of the verification companies mentioned in this article, PharmacyChecker, and very much appreciate the discussion. It should be noted that millions of Americans who are buying mediation internationally are filling prescriptions for blood pressure, asthma and diabetes because they can’t afford it here: see http://www.nytimes.com/2014/03/25/opinion/scare-tactics-over-foreign-dru....

The risks of buying medications online, including Viagra, are serious but this article would leave a consumer believing it’s very difficult to get lawfully-manufactured, genuine generic sildenafil citrate online – and that’s factually incorrect. Consumers can and do buy real generic Viagra when they stick to verified online pharmacies and don’t use rogue or spam sites that sell medication, fake and real, without a prescription.

richard

Arizona July 26, 2016

Generic Viagra (sildenafil citrate) is available in Canada from Canadian pharmacies online. I have been using it for over a year with great results and no side effects. The cost is very reasonable compared to Viagra.

A Goldstein

Portland July 25, 2016

Viagra is one of the three "PDE5-inhibitors." Cialis is available ex-U.S. because the patents have expired in other countries so generics can be made sold.

One of the uses of these drugs are for men who have had radical prostatectomies and are placed on say, tadalafil for a year or more to help restore sexual function. Many medical centers actually encourage their patients to buy generics via Canadian pharmacies that are fully licensed and which procure generic drugs like tadalafil. The generic manufacturers are well-vetted by Canadian Rx drug regulations. The generics are about one tenth the cost.

U.S. citizens requiring expensive drugs should be able to get recommendations from their health care providers for ex-U.S. drugs unless they are manipulated by the U.S. drug industry.

OSS Architect

California July 27, 2016

Indeed, the majority of patients undergoing radical prostatectomy, suffer impotence as a result. Several clinical trials have shown that men given a regular (daily) dose of a PDE-5 never develop post surgical impotence. It's a small dose; not enough to support an erection, but enough to keep the "plumbing" (capilaries) from atrophying.

To the dismay of Urologists and their hapless patients one thing stands in the way of successful recovery from this surgery: Big Pharma charges too much for these drugs and insurance companies have decided that 5-6 pills/month is "enough".

It's one size fits all medicine practiced by bean counters in Insurance companies practicing Medicine without a license. If you withhold effective, known, treatment that's called medical malpractice.

The PDE-5 class of drugs were originally developed to treat some severe cardiac/pulmonary problems. As a side effect they did "you know what". What were once rarely prescribed, inexpensive drugs, became a cash cow.

thomas bishop

LA July 25, 2016

“They are so ashamed because of the stigma, which is completely stupid,” said Dr. Paduch...

see also, birth control. sex, shame, innuendo, gossip, old wives' (and husbands') tales and even legal ramifications have gone together for millennia, sometimes even among doctors.

seemingly 99% of the adult population does it, but seemingly only about 1% like to talk about it directly, on the record.

Source: http://well.blogs.nytimes.com/2016/07/25/is-generic-viagra-legitimate/