"If I'm getting the drugs, I might as well support Israel" at the same time, said Kay, a resident of Wyndmoor. "Let them get the money."
The 74-year-old, who says that at first, she was "very leery" about filling her prescriptions from a pharmacy she'd never visited – much less seen – is one of a growing number of people who obtain prescription drugs from online international pharmacies, where prices could be as much as 50 percent less than buying them inside the United States.
As if that weren't incentive enough, in the past several years, the introduction of the Israel-based Web sites www.MagenDavidMeds.com and www.Isrameds.com has allowed American consumers to do their part in supporting the country's economy.
"I do it because of the low price, and because I want to give Israel business to help support it," said Reva Rosard, who's been buying from Isrameds since her gynecologist made her aware of the possibility two years ago. "Even if Canada's prices were a little bit less, I would still opt for Israel."
'Expecting a Return'
Drugs sold overseas are often cheaper than those sold in the United States because governments in other countries – Israel, Canada, Germany, Britain, Spain and Greece, to name just a few – regulate the prices.
Here, big pharmaceutical companies set prices based on a simple economic model: High demand allows for high profits.
"There's a major driver in this country, and it's called the stock market," said Mitchel Rothholz, vice president of professional practice at the Washington D.C.-based American Pharmacists Association. "There are investors who are expecting a return, and pharmaceutical companies want to show them a profit."
Take, for example, Lipitor, the popular pill that reduces cholesterol levels. According to www. pharmacychecker.com – a site that compares prices for such products – the cost per a 10-mg. pill at CVS is $2.52 for a 30-day supply; the cost at MagenDavidMeds is $1.36, a nearly 46 percent savings.
According to Nathan Jacobson, founder and chairman of MagenDavidMeds, the Lipitor he sells contains the exact same ingredients, and even originates from the same Pfizer factory in Ireland.
Though buying medications overseas seems to be gaining in popularity, technically, under the federal Food, Drug and Cosmetic Act, it's illegal for a consumer to bring a foreign drug product into this country – if it is available at a local pharmacy – unless it meets certain requirements. Food and Drug Administration policy allows for patients with serious or life-threatening diseases to import certain pills if they are not available here.
Though ordering from the online international pharmacies is unlawful, the seniors and the uninsured – the main users of the services at this point – are rarely, if ever, prosecuted.
The FDA says the agency doesn't have enough money or manpower to search packages coming into this country, though "once in a while," mail is detained and searched. The agency also does not go after individuals purchasing medications from abroad; though it would like to crack down on those international companies at fault, it must work with the corresponding FDA counterpart of a nation abroad – a difficult feat in and of itself.
In the works, explained Avi Fadida, marketing manager for Isrameds, is legislation that will allow Americans to legally have access to low-cost medications from Israel and other foreign countries. In April, the Senate Committee on Health, Education, Labor and Pensions held a hearing on the Pharmaceutical Market Access and Drug Safety Act of 2005, proposed by Sens. Byron Dorgan (D-N.D.) and Olympia Snowe (R-Maine).
The full Senate has yet to deliberate on the bill.
'Pharmacists Answer Questions'
Naysayers contend that prices in the United States remain exorbitant to cover research costs incurred by U.S. pharmaceutical companies that allow for cutting-edge medications to be developed, and thus used by the entire world. They also say that consumers could be exposing themselves to rogue pharmacies and unregulated medications when purchasing items overseas.
"There is more that you get from a pharmacy than a medication," said Rothholz, explaining why having contact with a local pharmacist has more value than purchasing from an unknown international one. "Pharmacists answer questions, and make sure you aren't having interactions with other medications you are on."
Still, Jacobson claims that Israel has a near fool-proof system of dispensing medications because of steps taken to protect against terrorism.
Because of the country's strict regulations, drugs purchased from Isrameds and MagenDavidMeds are packaged in tamper-proof, foil-wrapped blister packs, according to company representatives, and have a lot number and expiration date on both the box and the bottle. All drug information is written in English and Hebrew, and sometimes, even Russian and Arabic. The packaging, some say, is much safer than that provided in the United States.
"It's like the airlines," explained Jacobson. "What's the best airline in the world? El Al. Not because it wants to be, but because it has to be."
In addition to the packaging and the ability to support an economy nearly 6,000 miles away, customers of the two Israeli-based sites can be assured that medications are kosher.
"My medications arrived in eight days – and even had a lovely note with it," reported Kay. "It was in April, and it assured me that the medications were all kosher for Passover."