Americans who buy drugs in Canada in hopes of saving money could pay significantly more for certain medicines than if they had purchased generic versions at home, according to new research by the Food and Drug Administration.
Canadian price controls mean that brand-name drugs there can cost as little as half the U.S. price. Those potential savings are enticing increasingly more people to import drugs from Canada even though the practice is illegal and the FDA calls it unsafe.
Generic versions cost much less than their brand-name counterparts, however, and the U.S. generics market is considered the world’s most competitive. So FDA Commissioner Mark McClellan argues that for many people, buying more homegrown generics is a risk-free alternative to imports that could lower their drug costs.
“There are a lot of opportunities to save money while still making sure patients get the drugs they need,” he said in an interview this month with The Associated Press.
Price data analyzed
To back that contention, the FDA analyzed price data collected by the medical research company IMS Health. Included were seven drugs whose generic versions are top-selling treatments for chronic disease: the anti-depressant Prozac; blood pressure medicines Lopressor, Prinivil and Vasotec; Xanax for anxiety; Klonopin for seizures; and Glucophage for diabetes.
Comparing both brand-name and generic versions in Canada, the U.S. generics proved significantly cheaper for all but the diabetes drug, the study concluded.
The study measured average price per milligram, not what the patient pays per bottle, which can vary in dose and pill number.
Among the findings:
- Xanax had the highest disparity. The Canadian brand was roughly nine times the price, per milligram, of the U.S. generic. Next was Vasotec, five times the price of the U.S. generic.
- Canada’s generics ranged from fluoxetine, or generic Prozac, at 1.3 times the U.S. price to alprazolam, or generic Xanax, at four times the U.S. price. One generic, the version of Vasotec called enalapril, is not sold in Canada.
- Glucophage was the exception. The U.S. generic actually cost 39 percent more per milligram than Canada’s brand-name version.
The study used the price that pharmacies paid for each drug in 2002, the latest full year that prices from both countries were available from IMS Health.
“I think consumers think everything’s cheaper in Canada. It’s just not the case,” the FDA’s pharmacy affairs chief, Tom McGinnis, said in a recent interview.
He described a recent visit to a U.S. Customs facility in New York where inspectors were examining 10,000 packages of imported pharmaceuticals. McGinnis said he spotted a bottle of generic water pills for high blood pressure that cost a few cents a tablet in U.S. pharmacies.
Adding the shipping cost, whoever ordered that bottle from Canada spent about a third more than he would have at a local drugstore, McGinnis said.
Generics 'a great bargain'
Using generics is not an alternative for everyone because new drugs sell for several years before generic competition is allowed. Generics account for about half of U.S. prescriptions.
The FDA cannot say how big a role generics might play as an alternative to Canadian imports, either for individuals or for the two cities — Springfield, Mass., and Montgomery, Ala. — currently buying Canadian drugs for their employees. States from New Hampshire to Wisconsin are considering similar programs.
But other, larger studies also have concluded that U.S. generics tend to be the world’s cheapest.
“They’re a great bargain,” said University of Pennsylvania health financing specialist Patricia Danzon.
A Canadian study of 27 top-selling generics there concluded in 2001 that three-fourths of those drugs cost less in the United States, and Canadians could save millions by access to American versions.
The FDA also pointed to a Web site — PharmacyChecker.com — that provides consumers with real-time comparisons of drug prices listed in the United States and abroad.
For example, on Friday PharmacyChecker found the cheapest generic Prozac in this country, $13.19 for 100 20-mg pills. Abroad, the next best price was $49.78.