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 Health & Beauty | April 2005 
Senior Day-Trippers Seeking Fun, Cheap Prescriptions
 Susan Carroll - The Arizona Republic
| | Pauline Reidy, a retired nurse who lives in Peoria, asks about prescription drugs at the Purple Pharmacy during a shopping trip in Algodones, a Mexican border town south of Yuma. The town is popular with seniors trying to save money. (Photo: Christine Keith/Republic) |
The luxury bus idled in the dark strip-mall parking lot in Mesa, the starting point for a carefully planned "drug run" to Mexico. Before sunrise, the seats filled with women in sensible shoes and men in loose polo shirts. As the minutes ticked by, they grew increasingly impatient. "Come on!" someone hollered at the driver. "What are you waiting for?"
Billie Deeds, a 75-year-old Apache Junction retiree, shook an empty, white pill bottle.
"Hurry up. We gotta go," he said. "I gotta have my pills. I'm gonna die here."
Every two weeks, Scottsdale-based Especially 4-U Tours shuttles busloads of mostly senior citizens from the Valley to Algodones, Mexico, where they have a few hours to haggle in farmacias, sip margaritas or shop for souvenirs. Company owner Sandra Lozier calls the trips "drug runs," she said, because everyone heads straight into pharmacies clustered south of the U.S.-Mexican border.
Fueled by the steep price increases in the United States and promises of deep discounts in Mexico as well as Canada, a relatively small but growing number of Americans are turning to foreign pharmacies, despite repeated warnings by the U.S. Food and Drug Administration about safety and quality concerns.
The amount U.S. consumers spend on prescription drugs in the United States has quadrupled since 1990 to more than $160 billion a year, according to the U.S. surgeon general. The U.S. government does not keep estimates for the drug business in Mexico generated by American consumers, but an expert at the Center for Pharmacoeconomic Studies at the University of Texas at Austin put the figure at more than $800 million a year.
Angered that Americans pay the highest prescription drug prices in the world, some members of Congress have lobbied to legalize the importation of prescription drugs over the Internet from Canada, which has better regulation of its pharmaceutical industry than Mexico does. Four bills are pending in Congress but have met with major opposition from the pharmaceutical lobby and from the FDA.
In the Valley, the demand for cheaper, imported drugs has created cottage industries, such as Prescriptions Drugs Canada, a company with offices in Scottsdale, Mesa and Sun City that orders Canadian medication and ships to customers here. Tour bus companies based in Arizona take advantage of the proximity to Mexico to shuttle thousands of seniors each year to buy prescription drugs, charging about $30 to $40 for a daylong trip.
U.S. Surgeon General Richard Carmona has cautioned against buying drugs in Mexico, which does not have the same quality standards or a regulatory authority like the FDA. The department has issued repeated warning about drugs purchases over the Internet and south of the U.S.-Mexican border.
In July 2004, the agency put out an alert for a batch of the cholesterol-regulating drug Zocor sold in Mexico after tests found that certain packages did not contain any active ingredient.
"In Mexico, all bets are off," Carmona said. "The drugs can be repackaged or tainted. We have no way to know that they're safe or effective."
Dr. Marvin D. Shepherd, director of the Center for Pharmacoeconomic Studies, said researchers report that about 20 percent of medication bought in Mexico is substandard by U.S. standards or counterfeit.
"Some individuals have been hospitalized because of these medications," he said, adding that two deaths in California and one in New Mexico were attributed in recent years to fake Mexican prescription drugs.
Seniors, particularly those who rely on Social Security or fixed pensions, are confronted with a challenge: How to balance tight budgets but still afford prescription medication that can cost hundreds of dollars a month.
"My doctor said, 'You take your pills or you'll die," Deeds said as the bus carrying about 40 senior citizens cruised along Interstate 8 southwest of the Valley one recent Thursday.
Deeds relies on Plavix, the second-most-commonly prescribed medication for seniors in the United States, to reduce the risk of stroke. Manufactured by the pharmaceutical giant Pfizer, Plavix costs about $4.37 a pill in Arizona. In pharmacies in Algodones, a Mexican border town south of Yuma, a Mexican version of the drug sells for about $2.43 per pill.
"I've concluded I can save half or more in Mexico," Deeds said. "Some pills that are $3 (each in Arizona) are $1.25 down there."
Most seniors heading across the border to buy drugs said they think warnings by the FDA are overblown. Many said that they have bought drugs in Mexico for years and that they have had no complications from the medication.
"They say you have to worry about what you get down there, but as long as it works . . . " Don Fulton, 75, said with a shrug.
Others said they make sure to read the fine print on Mexican pill packages and look for recognizable brands.
"Let's just say I don't trust everything," said Margaret Parks, a 64-year-old retired civil engineer who inspects each package she buys.
Before the bus pulled into the border crossing just north of Algodones, the tour guide offered a bit of advice about what to say to U.S. Border and Customs Protection agents.
"No matter how much you buy, it's a three-month supply, and it's all for you," the tour guide said. "Otherwise, they will bring you back to the drugstore, and you will have to turn everything in and get your money back and you won't be able to bring anything through."
Technically, the importation of drugs not approved by the FDA, including foreign-made versions of U.S.-approved drugs, is illegal. But under FDA guidance, border officials allow the importation of small amounts of drugs, typically less than a three-month supply, as long as they aren't controlled substances in the United States.
Shepherd said that if Americans follow the rules outlined by the FDA, they run little risk of being stopped at the border or detained in Mexico. To buy controlled substances legally in Mexico, he said, Americans should take prescriptions written in the United States to Mexican doctors and get them to write a second prescription. Many pharmacies have a physician on staff who writes prescriptions for free.
Last May, Raymond Lindell, a Phoenix man who went to Nogales, Mexico, to pick up 270 tablets of Valium for his wife, was arrested by Mexican authorities for not having a valid prescription. He ended up in a Mexican prison for almost two months before charges were dismissed.
"If it's a controlled substance like Vicodin or Valium, or any psychotropic drug, you've got a substantial risk," Shepherd said. "The Mexican authorities can arrest you because you don't have a Mexican prescription, and on this side of the border you can get arrested because you don't have an American prescription."
As the seniors filed off the bus and crossed into Mexico, they were greeted by young men trying to hustle them into pharmacies.
"Fifty percent discount," one vendor called out. "I am not a liar!"
Hector Gutierrez, who manages a chain of eight Mexican pharmacies just south of the border, smiled broadly as the customers entered one of his drugstores, bustling with shoppers. Colorful signs outside the stores advertise hundreds of drugs, from Celebrex to Cipro.
Gutierrez said the drugs sold in the pharmacies are safe and high-quality, but he cautioned against buying controlled drugs like Valium, saying Mexican authorities sometimes check prescriptions.
He said the town relies heavily on U.S. customers, particularly senior citizens.
"We survive by the snowbirds," he said. "In the winter, there are so many tour buses down here, we don't even count them."
Pauline Reidy, a retired nurse who lives in Peoria, haggled inside the Algodones pharmacy.
"Do you have Plavix? How about Diazide?" she asked a young woman behind the counter. "Do you have Aricept? How much is Aricept? Lopresor?"
Reidy takes about 11 medications and has prescription drug coverage, but she has been coming to Mexico for years to avoid $50 co-payments on name brands.
"I'm on a fixed income," Reidy said. "If I get six months' worth of drugs here, I'm saving, six, seven hundred dollars a year - and that's with insurance."
"For people who don't have any insurance at all, this is dirt cheap. I mean, my God, it's about half the price."
Not all the seniors on the bus found exactly what they wanted on the trip. Many reported prices had increased since their last trip. Others couldn't find newer drugs or discovered that name brands still were more expensive in Mexico than their insurance co-payments back home.
But most filed onto the bus carrying bulging plastic sacks, comparing bargains. No one reported problems with U.S. border inspectors.
As the bus headed back into the Valley and came to its first stop at Sun City West, the tour guide called out over the microphone: "Don't forget your pills, gang!" |
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