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    Prescription for Trouble?

    Despite being illegal, more Americans combat high prescription drug costs by buying abroad.

    Concerns About Safety

    "Our specific concern is that we don't know what consumers are getting, like we do when products are purchased from state-licensed pharmacies in the U.S.," says Thomas McGinnis, PharmD, FDA director of pharmacy affairs. "If you're going to order medications from outside the U.S., you may get the same thing as what's at your local pharmacy, but you may not. It's a 'buyer beware' situation. We're concerned about the safety of these drugs."

    Still, McGinnis admits there isn't a single documented case of an American killed by prescription drugs bought from licensed Canadian pharmacies, a finding echoed by Health Canada, which regulates the country's prescription industry.

    "Unless you walk into the store, you really don't know if it's really a licensed pharmacy," McGinnis tells WebMD, adding that such information would be hard to track. "We've had consumers complain to us that they thought they were ordering from a Canadian web site -- it had a maple leaf -- and the package was postmarked that it came from India, and the product inside was manufactured in India. We really worry about drugs from India."

    The majority of drugs sold in state-licensed American pharmacies are manufactured in Puerto Rico, with backup facilities in the U.S. and elsewhere, says McGinnis. "The FDA goes to these manufacturing facilities, no matter where it is in world, and inspects it to make sure there's the right active ingredients and right equipment to make the product. We monitor the shipment and storage, we monitor the product from warehouse to pharmacy. We're comfortable with products sold in the U.S."

    City Finds a Way

    Michael Albano, the mayor of Springfield, Mass., says he feels the same way about the insulin he buys for his diabetic son and the other drugs purchased for his 2,200 current and retired municipal employees. His city is the nation's first to initiate a program for municipal employees to buy prescription drugs from Canada. They fax or mail prescriptions and the products are sent to their homes. Boston recently announced it would begin a similar city-run program in coming months, and politicians in other states, including most recently Illinois, are considering the same.

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