Crossing the border for cheap drugs

NICK EICHER, HOST: Coming up next on The World and Everything in It: healthcare tourism.

Prescription drug costs in this country have been rising for years. A Kaiser Family Foundation poll found that 1 in 4 adults say they don’t have the money to pay for them. But some people found a new strategy: buy prescriptions in another country.

MARY REICHARD, HOST: Prescription drugs in Mexico and Canada many times cost a fraction of what they cost in the United States. That saves consumers in the short term. But is cross-border shopping a legitimate solution long-term? WORLD Radio’s Sarah Schweinsberg has our story.

SARAH SCHWEINSBERG, REPORTER: Carlos Castillo and Alberto Brengas are the owners of Pharmacy D’Montse. The shop is just blocks from the U.S.-Mexico border in Tijuana. Castillo says the business relies on American customers.

CASTILLO: Some people came because they had no insurance. They came to get cheaper stuff like antibiotics, stuff like that.

Four years ago, Brengas say as many as 300 American customers crossed the border every week to buy cheaper drugs. Today, Tijuana’s more dangerous reputation has cut those numbers significantly.

BRENGAS: Now maybe 40 people, 50 people a week. But they spend $50 to $80 every time they come in.

The numbers might be down at this store, but overall they’re on the rise.

The U.S. government estimates nearly 1 million people from California alone cross into Mexico each year for healthcare, including prescription drugs. And a 2016 Kaiser Family Foundation poll found that 8 percent of respondents said they or someone in their household had imported medications at some point. That translates into about 19 million Americans.

In this Tijuana pharmacy, it’s easy to see why the practice is gaining popularity.

Owner Carlos Castillo places boxes of medications that are popular with U.S. customers on the glass countertop.

An antidepressant medication costs $6. A box of Viagra costs $2. In the U.S., that medication costs as much as $110 with insurance. There’s an acne-fighting skin cream called Retin-A. In America it costs around $60 with insurance.

CASTILLO: Retin A that one is like $20.

That’s a big savings, especially for people without insurance. For instance, here, a high blood pressure medication called Primazen costs $30. In the U.S., people with insurance hardly pay anything for blood pressure meds. But without insurance, it could cost as much as $200.

The savings are so significant some health plans are even encouraging patients to shop for medications in Mexico.

Norm Thurston is a Utah state representative. Last year he sponsored a bill called Right to Shop. It helped create a program to make it easier for more patients to access cheaper drugs.

THURSTON: We’ve got to do something to help alleviate the problem so that people can get the medications that are the best for them.

Under Thurston’s Pharmacy Tourism Program, public employees enrolled in the state’s health plan can take an all-expense-paid trip to Tijuana. They can go up to four times a year to buy 13 different prescription drugs.

THURSTON: They will fly you to San Diego. There’s a contractor that will pick you up at the airport and they’ll drive you across the border to an accredited hospital. You’ll meet with a licensed healthcare professional at the hospital. They’ll review your case and if they agree with your U.S. physician that this is the right prescription for you, they will dispense it right from the hospital pharmacy.  

The patient also gets another perk.

THURSTON: Once this is all done, the public employee’s health plan, will credit your health savings account with $500 pre-tax contribution.

Thurston says this is possible because by participating, the patient saves the health plan thousands of dollars. So far, only a handful of state employees have actually taken the trip, but that still translates into major savings.

THURSTON: Every time somebody does this, we’re looking at a savings of around 25 to $30,000 per year per person that does that. If we can get that number of closer to a hundred, that’s a massive savings to the plan.

But Adrienne Faerber, a lecturer at the Dartmouth Institute and expert on prescription drug pricing, says there are risks to buying medications abroad. In 2017, the World Health Organization estimated that 10 percent of drugs in developing countries were substandard or falsified.

FAERBER: The Food and Drug Administration makes sure that drugs that are in the pharmaceutical supply in the United States are safe and effective. So what these right to try laws would do is it introduces a level of uncertainty, as patients would be crossing borders.

Faerber says promoting medical tourism is also a problem from a policy perspective. She argues it wrongly relies on the health system in Canada and Mexico to supply Americans medications.

And while it may be a temporary fix for high prices, Faerber worries it could distract policymakers from finding long-term solutions.

FAERBER: We need to be coming up with policy solutions that will lower the price of drugs in the United States. How we do that? There’s a lot of really good proposals out there. And I think we need to be looking at those kind of policy proposals to fix the US healthcare system.

Reporting for WORLD Radio, I’m Sarah Schweinsberg.

(AP Photo/Elise Amendola) In this June 15, 2018 photo, pharmaceuticals are seen in North Andover, Mass. 

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