Drug Companies Cut Canadian Supply
By: Source: AARP Bulletin Today Date Posted: 2004-03-30 11:26:00-05:00
Older Americans who rely on Canadian pharmacies to obtain prescription drugs at prices they can afford have reacted in anger and alarm to the news that Pfizer has choked off their pipeline.
Four other drugmakers have tried to limit supplies to Canadian pharmacies that sell by mail order to Americans, but Pfizer is the first to make a total boycott succeed.
"We've been flooded by frantic calls from patients," says Dave Mackay, executive director of the Canadian International Pharmacy Association, which represents 38 such pharmacies. He estimates their reserve stocks of Pfizer products will run out by the end of this month.
Americans who have to switch from Canadian to U.S. prices will take a hit to their pocketbooks. A 90-day supply of Lipitor, the cholesterol-lowering drug that is Pfizer's top seller, costs up to $145 less in Canada than in this country.
Many customers ask if they can switch, instead, to different brands. This isn't ideal, Mackay says, "but it would be much worse to go without if they can't otherwise afford their therapy." In some cases, he adds, "there are very good alternatives, but a patient's doctor must be the one to advise on this."
Almost all the Pfizer drugs most prescribed to older Americans have alternatives. For example, among the anti-cholesterol drugs known as statins, Zocor (made by Merck) is one brand alternative to Lipitor, and there are also generics such as pravastatin.
CONSIDERING ALTERNATIVES
The effectiveness of different drugs often depends on the severity of the disease. "If blood fats are very high, the super-statins like Lipitor and Zocor are much more potent," says David Guay, a professor of pharmacy at the University of Minnesota. "If these fats are not excessive, any statin can be used to reduce bad cholesterols to target levels."
For a drug like Prilosec—made by AstraZeneca, another company limiting supplies from Canada, to treat gastric conditions—"it doesn't matter how severe the disease is," Guay says. "All the alternatives work equally well."
Every drug's potency is different from another's, so doses between alternatives can vary, and some must be taken more frequently.
Many patients could reduce the cost of their drugs just by talking honestly about price with their doctors, says Paul Doering, a professor of pharmacy at the University of Florida. "Often there are less expensive alternatives that may even obviate the need to do business with our neighbors to the north."
Anyone thinking of switching brands should, besides consulting with their doctor, also ask about generics. These versions of many brand-name drugs are often much less expensive. In Canada, though, they don't always cost less than they do here. Canadian generic fluoxetine for depression, for example, can cost twice as much as the American generic.
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