Can Web Fill Pharmacy’s Role?
Many Americans now regularly use the Internet to find bargains on air travel, consumer loans and children’s toys, but how useful is the Web in finding less expensive prescription drugs that are vital to your health? And what are the pitfalls in using the Internet instead of your local pharmacist?
It’s not surprising that consumers would turn to the Internet to look for deals on prescription drugs. Americans spent a record $154 billion filling their prescriptions last year, up 17% from 2000. The average price of a prescription at a retail pharmacy was $49.84 last year, up more than $4.50 from 2000. Why are prices increasing so quickly? Well, drug companies are increasing their prices, and doctors are prescribing more drugs. Also, many patients are switching to new and often more expensive medications that promise more effectiveness with fewer side effects.
A survey by AARP found that 76% of Americans older than 45 take a prescription drug on a regular basis.
Recognizing the growing demand, many leading pharmacy chains, including Rite-Aid and CVS, now operate online pharmacies. One company, MedcoHealth Solutions, claims to be the first online pharmacy to have reached $1 billion in sales. Besides the large pharmacy chains, there are a host of smaller firms doing business in the United States and Canada. Anyone with an e-mail address is probably swamped with electronic solicitations for discounts on Viagra or a host of herbal remedies to treat baldness, weight loss and assorted other disorders.
Hoping to rein in the Wild West atmosphere of the Internet, state officials have stepped in to help consumers by attempting to regulate online pharmacies. The National Assn. of Boards of Pharmacy, whose members are officials of 50 state agencies that regulate pharmacies, has created a procedure to investigate and certify online pharmacies. Approved sites are given a seal of approval identifying them as Verified Internet Pharmacy Practice Sites, or VIPPS. So far, 13 online pharmacies have received approval, including CVS.com, Eckerds.com, Drugstore.com, RxRequest.com and Medcohealth.com. (For a complete list, go to the pharmacy board’s Web site, at www.nabp.net, scroll down to the section on “Internet pharmacy” and click on “Find a VIPPS-certified pharmacy.”)
Consumers should be wary of Web sites that offer to send drugs but only require a health questionnaire with an order. Any legitimate online pharmacy will insist on getting a copy of the doctor’s prescription. And a legitimate site will have a toll-free number where consumers can call a pharmacist with questions.
Online pharmacies in Canada are making a strong pitch to price-conscious Americans, though technically it’s illegal for U.S. residents to make such purchases. They promise bigger discounts than their cyber rivals in the United States. There’s some truth to those pitches, as Canadian drug prices can be significantly lower than U.S. prices. Canadian drug prices are regulated by the government; U.S. prices are not. Also a favorable exchange rate makes Canadian drugs cheaper for Americans. One Canadian government study found that Canadian prices for brand-name drugs on average were 62% of U.S. prices.
But Canada’s lower prices also create a dilemma for U.S. shoppers. Though it is also illegal to actually travel to Canada to buy drugs, thousands of Americans do it every month, crossing from northern border states such as Vermont and Michigan. Many Americans are unaware that it’s illegal to buy drugs from Canada over the Internet and so they continue to search for deals. So how good are the bargains to be had?
I checked prices at Canadameds.com, which fills prescriptions at a licensed pharmacy in Winnipeg. It offered a month’s supply of Celebrex, an arthritis drug, at $28.59 U.S.; Claritin, an allergy drug, at $33.44; and Lipitor, a cholesterol drug, at $53.29. I compared these prices to a number of U.S. Web sites in a random and informal survey: The Canadian price for a month’s supply of Celebrex was $13.86 cheaper than the lowest U.S. price that I found. The savings on Claritin was $38.75 a month. The Canadameds.com price for Lipitor, $53.29, was virtually the same as the cheapest U.S. price.
Even when consumers are confident they are dealing with legitimate Web sites, careful shopping is required. With hundred of drugs available, there are great variations in price. Don’t assume that the Internet will offer the cheapest prices; check prices at your local pharmacies, which may have senior discounts, promotional discounts or lower prices on some drugs.
California consumers who are enrolled in Medicare (people older than 65 and those who receive Social Security disability payments) have another yardstick against which to measure Web prices. A state law allows those people to buy drugs at the same discount the state pays when it buys drugs for Medi-Cal, the health program for the poor. If you are eligible, you can request the discount at the drugstore. Some pharmacists and store managers may be unfamiliar with the state discount program. (The list of the most popular drugs is available through the California Department of Health Services, at www.dhs.ca.gov.)
I checked Internet prices for Celebrex (100-milligram tablet), Claritin (10 milligrams) and Lipitor (10 milligrams), using a 30-day supply of each drug as my yardstick. Celebrex was selling for $42.45 at Drugstore.com, $43.47 at YouRxPlan.com, $46.84 at Eckerds.com, $47.45 at Walgreens.com and $47.79 at CVS.com. California’s discount price was $50.91.
Claritin cost $72.19 at YouRxPlan.com, $75.87 at Eckerds.com, $78.60 at Drugstore.com, $88.99 at CVS.com and $90.99 at Walgreens.com. The state discount price was $93.47. Lipitor cost $53.89 at YouRxPlan.com, $59.86 at Drugstore.com, $60 at Eckerds.com, $64.99 at CVS.com and $65.99 at Walgreens.com. California paid $69.91 for the product.
When surfing the Internet, consumers should also be cautious about those e-mail messages from dubious operations that offer Viagra with “no physical exam necessary” or diet pills that promise you will “lose 8 to 12 pounds in two days--safely!” A Food and Drug Administration investigation indicated there are as many as 400 sites offering prescription drugs to consumers, roughly half of those in the United States and half abroad. Many of them pose a potential danger to consumers, William K. Hubbard, an FDA senior associate commissioner, told a Senate Aging committee in July. These sites may sell drugs that have expired, contaminated products or incorrect doses, he cautioned.
And some of the sites may be pure rip-offs that don’t deliver any drugs but run up unauthorized charges on customers’ credit cards.
Consumers can get a good deal from online pharmacies, but must first make sure the vendor is legitimate. They should look for a board of pharmacy seal of approval and for a site that asks for a copy of a prescription. And they should compare Internet prices to other discounts that may be available at brick-and-mortar pharmacies.
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Bob Rosenblatt can be reached at bobblatt@aol.com. Dollars and Sense runs the fourth Monday of the month.
