Crossing Borders To Save On Insulin
Insulin prices have been a source of unanswered stress for those with diabetes in the United States for at least the last decade, and while the government is beginning investigations into pricing practices in response to protests and rising outrage, many Americans aren’t content to wait and hope that their life-saving medication will someday be affordable.
While some create GoFundMe pages or hope that Biohackers in California will create an open source insulin, many Americans, about 19 million of them, have found another solution: buy medications from outside U.S. borders.
Going out of country for drugs seems extreme, but so is the cost savings. Reddit users have found and shared ways to save on insulin from both Mexican and Canadian pharmacies. And it’s not just individuals shopping across borders. PEHP Health & Benefits, a nonprofit that provides health benefits to public employees in Utah, offers an option for patients to fill certain medications in Mexico.
If approved, PEHP will coordinate the member’s travel, cover roundtrip airfare for two from Salt Lake City to San Diego, and pay for transportation to and from a designated hospital in Tijuana, Mexico. Members who participate can also receive a $500 reimbursement for each trip up to four times a year.
“We have an obligation to those we serve to find low cost options for quality healthcare services,” says PEHP managing director Chet Loftis, “Pharmacy Tourism is just one such option.” The program is part of Utah’s new “Right to Shop” legislation, designed to reward people for using high-quality, low-cost healthcare options.
Michelle Fenner, whose son has type 1 diabetes, decided to add an excursion to Tijuana when she was going to Los Angeles for a marathon. She had to update her passport, but getting her son’s three-month supply of insulin for about $600, when it normally costs $3,700, made it well worth it.
U.S. Citizens not close to a border sometimes choose to order prescriptions from Canada by mail, despite the FDA’s disapproval of such practices. While it seems that, so far, U.S. citizens are getting away with Canadian drug orders, the practice is still illegal despite being common.
The FDA’s guidelines state, “In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use because these products purchased from other countries often have not been approved by FDA for use and sale in the U.S.” They go on to explain that the agency can’t guarantee the safety of these products.
There are some cases in which importation might be allowed, such as in the case of drugs that have no known significant risk or where the consumer affirms in writing the product is for personal use, but these are situations in which importation might be allowed, and insulin is not specifically mentioned. The guidelines could stand some clarification. (Visit the FDA’s website for full guidelines.)
The World Health Organization warns would-be pharmacy tourists that in developing countries, about one in 10 medical products is either substandard or falsified. But for many seeking affordable insulin, the significant cost savings is enough to keep them crossing borders.
However someone feels about insulin tourism, or medical tourism in general, it’s clear that a system that drives otherwise upstanding citizens to ignore the rules to get life-sustaining medications is not ideal. However much an American citizen might enjoy the huge savings they can get from a Canadian or Mexican pharmacy, they would almost certainly prefer to get that same savings, or even close to the same, at a pharmacy down the street.