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May 12. 2012 11:18PM
Veronica Farrington, center, of Sugar Hill with her children, from left, Edward, Roger and Lee Farrington and Jennifer Jhaveri. The photo was taken on her 80th birthday. Mrs. Farrington has been buying her anti-cancer medication online from foreign pharmacies because they are so much cheaper. But the FDA prohibits bringing unregulated medications into the country and the drug maker says it violates its patents on the drug. (COURTESY)
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Those struggling to pay for prescriptions have options
Cancer pill's cost sends her to India
Veronica Farrington, center, of Sugar Hill with her children, from left, Edward, Roger and Lee Farrington and Jennifer Jhaveri. The photo was taken on her 80th birthday. Mrs. Farrington has been buying her anti-cancer medication online from foreign pharmacies because they are so much cheaper. But the FDA prohibits bringing unregulated medications into the country and the drug maker says it violates its patents on the drug. (COURTESY)
Those struggling to pay for prescriptions have options
Veronica Farrington doesn't look like someone who's been bringing illicit foreign drugs into the country.
But after her doctors prescribed a promising but expensive anti-cancer drug, the Sugar Hill woman ordered a generic version of the medication online from India, at a fraction of the cost she was paying here.
And she apparently ran afoul of federal laws that prohibit importation of any unregulated medications.
One recent shipment was intercepted at a New York postal center and sent back to India, leaving her out $2,000 — and without her medication.
That left her “in a real fix,” said Farrington, who turns 87 this month.
Her story illustrates the difficult choices some cancer patients make to obtain life-saving drugs.
And it points out the conflict between the rights of drug companies to recoup their investment in developing such medications and the needs of patients struggling to afford them.
Farrington worked as a real estate broker in Boston until she was 75, retiring to New Hampshire in 2000. She has a comfortable income from Social Security and investments.
Three years ago, Farrington was diagnosed with non-Hodgkin's lymphoma and began chemotherapy. But after she had a bad reaction to the drugs, her doctor prescribed a monthly regimen of Revlimid instead.
The drug is working, Farrington said: “When I had my last body scan, they were amazed to find not only had it slowed the growth (of cancer cells), but the lymph nodes on my liver had shrunk a bit.”
The regimen calls for Farrington to take one pill a day for 21 days, then stop for a week before starting the cycle again. It costs $7,000 for 30 pills.
Even patients with Medicare Part D coverage can face thousands of dollars in annual premium and medication costs.
But Farrington doesn't have a Medicare drug plan. She says she has “never been a pill popper,” and Revlimid is the only medication she takes.
So with her children's help, she found a Canadian pharmacy that sent her the medication for $500 a month. But after that company stopped carrying the drug, the Farringtons turned to the Internet and found a supplier in India that sold a similar drug for $250 for 30 pills.
The first shipment came just fine, and Farrington was convinced it was the very same medication she was buying in this country. So she ordered a year's supply for $2,000 — and that's what got intercepted and returned. Just last week, however, a smaller shipment did get through.
Taking risks
Brian Gill is vice president of corporate communications for Celgene, which makes Revlimid. He noted its active ingredient is protected by multiple patents that are “respected around the world, except for a couple countries.” One of those exceptions is India, he acknowledged.
Only after the Revlimid patents run out in 2027, Gill said, can other companies make generic versions.
“That is the process here in the United States,” he said. “The innovator discovers, assumes all the risks, and commercializes up to a point where the patents run out and then that innovation, that asset, that property is turned over to society for pennies on the dollars. That's how it works.”
Gill stressed that patients do not know what they're getting when they order from a foreign pharmacy. “You're using a drug which we don't know what's in there and it's not being used under a risk-management procedure,” he said.
Many pharmaceutical companies, including Celgene, have programs to help patients pay for expensive drugs.
Sally Edson is the state health insurance coordinator for southern Grafton county. A Part D plan to cover Revlimid, she said, would cost someone in the Littleton area from $7,515 to $9,662 a year, including premiums and drug costs.
Once you reach a certain level of drug expenses in a given year (it was $6,448 in 2011), a Part D plan covers 95 percent of your drug costs for the rest of the year, she noted.
Farrington did meet with a counselor at a Littleton senior center last October to see about enrolling in a Part D plan. But at the time, she was getting her medication from Canada for $500 a month, so she opted not to enroll.
Now she can't sign up for a Part D plan until open enrollment begins again in October, and those benefits won't start until January. “I think that's what I'll have to do if I'm still around,” she said.
Lee Farrington, her daughter, said she has seen the difference the medication has made for her mother. “She's pretty much as healthy as she was three years ago before she became sick with this,” she said.
“She's bounced way back on this medication, so that's the part that makes it so difficult.”
Not unique
Farrington's story is not unique, Edson said. “It happens all the time,” she said. “More and more people come to us, and we spend hours sometimes with people trying to help them.”
She noted that seniors do have to pay a penalty if they didn't sign up for a Part D plan when they first became eligible for Medicare.
Edson noted that low-income individuals are eligible for extra help, and don't fall under the “doughnut hole.”
“But the people who are in real big trouble,” she said, are those who have to take so-called “Cadillac medications,” drugs that are either just coming on the market or are considered experimental.
“The Part D plans won't go near those, and they don't have to,” she said.
Shelbe Benson-Fuller, public affairs officer for U.S. Customs and Border Protection, said the federal Food, Drug and Cosmetic Act prohibits the importation of any prescription drug not FDA-approved for sale in the United States. It also bans the re-importation of an FDA-approved prescription drug by anyone other than the original manufacturer.
The CBP can refuse a package intercepted at a mail facility in the U.S. on behalf of the FDA, she said.
But authorities do not arrest people like Farrington for trying to buy drugs from a foreign company, Benson-Fuller said. “She definitely doesn't have to worry about that,” she said.
Bill sponsored
Two years ago, Rep. Andrew Renzullo, R-Hudson, sponsored a bill to let New Hampshire pharmacies and individuals buy prescription drugs from Canada. The measure died in committee.
Renzullo said Americans pay for the high costs of research and development of medications through higher drug costs, while other countries sell the same drugs far cheaper.
“If the world shared in the cost of developing the drug, I think it would come down for everyone,” he said. But until then, he said, “The answer could very well be that the federal government step out of the way.”
“If people are willing to trust the system of another country to get their drugs, then let them do it.”
But after her doctors prescribed a promising but expensive anti-cancer drug, the Sugar Hill woman ordered a generic version of the medication online from India, at a fraction of the cost she was paying here.
And she apparently ran afoul of federal laws that prohibit importation of any unregulated medications.
One recent shipment was intercepted at a New York postal center and sent back to India, leaving her out $2,000 — and without her medication.
That left her “in a real fix,” said Farrington, who turns 87 this month.
Her story illustrates the difficult choices some cancer patients make to obtain life-saving drugs.
And it points out the conflict between the rights of drug companies to recoup their investment in developing such medications and the needs of patients struggling to afford them.
Farrington worked as a real estate broker in Boston until she was 75, retiring to New Hampshire in 2000. She has a comfortable income from Social Security and investments.
Three years ago, Farrington was diagnosed with non-Hodgkin's lymphoma and began chemotherapy. But after she had a bad reaction to the drugs, her doctor prescribed a monthly regimen of Revlimid instead.
The drug is working, Farrington said: “When I had my last body scan, they were amazed to find not only had it slowed the growth (of cancer cells), but the lymph nodes on my liver had shrunk a bit.”
The regimen calls for Farrington to take one pill a day for 21 days, then stop for a week before starting the cycle again. It costs $7,000 for 30 pills.
Even patients with Medicare Part D coverage can face thousands of dollars in annual premium and medication costs.
But Farrington doesn't have a Medicare drug plan. She says she has “never been a pill popper,” and Revlimid is the only medication she takes.
So with her children's help, she found a Canadian pharmacy that sent her the medication for $500 a month. But after that company stopped carrying the drug, the Farringtons turned to the Internet and found a supplier in India that sold a similar drug for $250 for 30 pills.
The first shipment came just fine, and Farrington was convinced it was the very same medication she was buying in this country. So she ordered a year's supply for $2,000 — and that's what got intercepted and returned. Just last week, however, a smaller shipment did get through.
Taking risks
Brian Gill is vice president of corporate communications for Celgene, which makes Revlimid. He noted its active ingredient is protected by multiple patents that are “respected around the world, except for a couple countries.” One of those exceptions is India, he acknowledged.
Only after the Revlimid patents run out in 2027, Gill said, can other companies make generic versions.
“That is the process here in the United States,” he said. “The innovator discovers, assumes all the risks, and commercializes up to a point where the patents run out and then that innovation, that asset, that property is turned over to society for pennies on the dollars. That's how it works.”
Gill stressed that patients do not know what they're getting when they order from a foreign pharmacy. “You're using a drug which we don't know what's in there and it's not being used under a risk-management procedure,” he said.
Many pharmaceutical companies, including Celgene, have programs to help patients pay for expensive drugs.
Sally Edson is the state health insurance coordinator for southern Grafton county. A Part D plan to cover Revlimid, she said, would cost someone in the Littleton area from $7,515 to $9,662 a year, including premiums and drug costs.
Once you reach a certain level of drug expenses in a given year (it was $6,448 in 2011), a Part D plan covers 95 percent of your drug costs for the rest of the year, she noted.
Farrington did meet with a counselor at a Littleton senior center last October to see about enrolling in a Part D plan. But at the time, she was getting her medication from Canada for $500 a month, so she opted not to enroll.
Now she can't sign up for a Part D plan until open enrollment begins again in October, and those benefits won't start until January. “I think that's what I'll have to do if I'm still around,” she said.
Lee Farrington, her daughter, said she has seen the difference the medication has made for her mother. “She's pretty much as healthy as she was three years ago before she became sick with this,” she said.
“She's bounced way back on this medication, so that's the part that makes it so difficult.”
Not unique
Farrington's story is not unique, Edson said. “It happens all the time,” she said. “More and more people come to us, and we spend hours sometimes with people trying to help them.”
She noted that seniors do have to pay a penalty if they didn't sign up for a Part D plan when they first became eligible for Medicare.
Edson noted that low-income individuals are eligible for extra help, and don't fall under the “doughnut hole.”
“But the people who are in real big trouble,” she said, are those who have to take so-called “Cadillac medications,” drugs that are either just coming on the market or are considered experimental.
“The Part D plans won't go near those, and they don't have to,” she said.
Shelbe Benson-Fuller, public affairs officer for U.S. Customs and Border Protection, said the federal Food, Drug and Cosmetic Act prohibits the importation of any prescription drug not FDA-approved for sale in the United States. It also bans the re-importation of an FDA-approved prescription drug by anyone other than the original manufacturer.
The CBP can refuse a package intercepted at a mail facility in the U.S. on behalf of the FDA, she said.
But authorities do not arrest people like Farrington for trying to buy drugs from a foreign company, Benson-Fuller said. “She definitely doesn't have to worry about that,” she said.
Bill sponsored
Two years ago, Rep. Andrew Renzullo, R-Hudson, sponsored a bill to let New Hampshire pharmacies and individuals buy prescription drugs from Canada. The measure died in committee.
Renzullo said Americans pay for the high costs of research and development of medications through higher drug costs, while other countries sell the same drugs far cheaper.
“If the world shared in the cost of developing the drug, I think it would come down for everyone,” he said. But until then, he said, “The answer could very well be that the federal government step out of the way.”
“If people are willing to trust the system of another country to get their drugs, then let them do it.”
