In her working years, Audrey Brooks ran a punch press, tracked employee benefits for a steel company and wired circuit boards on ancient IBM computers until her fingers were raw.
Now retired, the Ojai grandmother is applying a mind for detail to a new task: finding cheap prescription drugs on the Internet for fellow seniors. In the past six months, she has helped dozens of low-income people cut their drug bills by steering them to bargains in Canada, where socialized health care keeps prices low and the exchange rate favors Americans.
Dogged by an array of medical problems herself, including an advancing case of glaucoma that may soon leave her blind, the 69-year-old doesn't buy her own drugs online. She gets by on her Social Security check, and her HMO covers most of her medicines.
But she took on the volunteer work for a local nonprofit group anyway, because drug prices "are just terrible," she said, and she is tired of waiting for Congress to do something about it.
"Hon, I'd be in Washington right now yelling my head off if I was able," said Brooks, a rail-thin 5-footer with quick eyes. "The people I help are just trying to get by, like everyone else."
Brooks joins an army of seniors trying to cope with high drug prices by buying them outside the U.S. Older Americans make up 13% of the population but account for 42% of the country's spending on medicines.
Groups in border states charter buses for "drug runs" to Canadian and Mexican pharmacies. Elsewhere, they jam community rooms to learn about discounts at big-box stores, to sign up for steep discounts offered by some pharmaceutical companies and to apply for price breaks through state-run programs. Increasingly, though, seniors are saving money on medicine without even leaving home.
That is where Brooks comes in, especially for folks intimidated by computers or worried that they will be taken in by unscrupulous operators. She has worked around computers since the days when they hummed in 4-foot-high boxes, so rummaging in cyberspace comes naturally. And she consults only pharmacies she has verified as licensed by the Canadian government.
Brooks meets with new "clients" to review their prescriptions, carefully noting each drug by brand and dose, then begins her simple -- though legally fuzzy -- process. She searches pharmacy ads online, finds the best price and downloads an order form from the store's Web site.
She faxes the order and a copy of the doctor's prescription to the pharmacy (the original prescription must follow by mail). Payment can be made by credit card or check, she said.
After seeing how it's done, many seniors handle their own refill orders. But Brooks helps those who are uncomfortable with the process.
One recent day, Brooks helped a caller find a cheap source of Actonel, used to prevent brittle bones. Though the caller's private insurance supplemented her Medicare coverage, she was spending nearly $300 for a 30-day supply.
Seated at an aging Hewlett-Packard in a guest bedroom of her modest wood-paneled home, Brooks tapped in the name of one of several pharmacies she uses. It's easy to get ripped off, Brooks said. So she never orders from Mexico or other countries that are less regulated than Canada and where, federal officials say, fraud is more prevalent.
Clutching her mouse in a hand so thin that spidery blue veins show through, Brooks looked up the cost of a 90-day supply. The price quoted was $132.88. Even with a $12.50 shipping charge, the saving was $754 --a typical result, she said.
"Hon, I had one lady go from a $3,300 monthly bill to $466," she said, looking up from the keyboard through thick glasses.
Brooks sometimes finds herself in front of the computer at 10 p.m. to keep up with the 35 people she helps each week. But she paces herself, taking cigarette breaks or visiting two grandsons who live down the block.
The seniors who call tell her heartbreaking stories of choosing between paying for food and paying for medicine, she said. "Maybe I was put on this Earth to help other people," she said. "That's what's really important to me."
Terry, a Ventura woman in her 50s who for privacy reasons asked that only her first name be used, said Brooks helped cut her $5,000 annual prescription bill in half. Dependent on a wheelchair, she takes six medications for chronic arthritis, high blood pressure and other ailments. The most costly drug, Neurontin, helps control excruciating pain in her legs, hands and arms, and she takes it around the clock, she said.
Terry's doctor referred her to Brooks, who helped her find better prices. Now Terry re-orders every three months. "Audrey's saved me a lot of money," she said. "She's a true angel."
How many seniors use cyberspace for their medicines is unclear. Elizabeth Wennar, executive director of a Vermont consumer group called United Health Alliance, informally surveyed Canadian pharmacies a few months ago and stopped counting at 1.2 million U.S. buyers. Her group, consisting of doctors and consumer activists, launched a Web site three years ago to help people buy Canadian drugs.
Most of the seniors who come to Brooks fall into one category. They earn too much for the deepest discounts offered by drug companies and other sources, but they cannot afford the co-payments of insurance plans that supplement Medicare, which does not cover drugs. State-run Medi-Cal covers drugs only at poverty level.
Some people are skittish about foreign purchases because they are a legally gray area; a raft of regulations governs what can be imported, and Congress has been debating the issue. For now, though, seniors should have little fear of prosecution, said a Food and Drug Administration official, who requested anonymity because the subject is politically sensitive.
"Unless they are ordering controlled substances or are ordering a lot of drugs, they wouldn't see an FDA official on their case," he said.
But consumers have other reasons to be wary, Brooks said. U.S. buyers of foreign products have little recourse against counterfeiting and other fraud without U.S. laws to protect them.
"A lot of countries will mail you anything," whether harmless knockoffs or something downright dangerous, she said. Canada's regulation of pharmacies is similar to that in the U.S., she noted.
Brooks' one-woman assistance league was started by Help of Ojai, a nonprofit agency that provides services for seniors in the rural Ojai Valley. Her help is free, and she accepts only referrals from that group.
Project director Karen Kaminsky said she launched the program last summer after hearing her clients' stories about struggling to pay for prescriptions.
She knew Brooks' attention to detail from shopping trips sponsored by Help. At one local nursery, she recalled, Brooks insisted on getting two packages of spring bulbs for the price of one, even though the ad containing that offer was in error.
"She nailed them," Kaminsky said. "I knew she'd be perfect for the job. She's sharp as a tack and a tough girl."
Tough, indeed: She rode a BMW 650 motorcycle until her 40s, when she separated four ribs and injured her back in an accident. "Every time I see one I want to ride," she said. "But no more for this old lady."
Divorced for decades, Brooks raised three children on her own, including a boy she took into her home as a teenager. That son is now an executive with Aetna health insurance in Georgia. Brooks hasn't told him about the work she does.
Brooks, who was raised in Michigan and then lived for many years in Oregon, moved to Ojai three years ago to be closer to her daughter. She had a stroke nine years ago and takes pills to control her still-erratic blood pressure. She relies on another medicine to manage a twitchy ulcer.
Doctors say they can't stop the glaucoma that is stealing her vision. She figures she will soon need a magnified computer screen. She is already taking Braille classes and is training another woman to take over the prescription service.
When it comes, blindness won't be a problem -- just another challenge, Brooks said. And with any luck, she has a few more of those ahead.
"One thing I haven't done is the law. Maybe I'll go get a law degree and go after the drug companies," she said with a chuckle. "Sugar, that would be something."