It’s only your life in their hands

I get one of my medications from another country. After years of trying every possible combination of drugs to ease my stomach symptoms and increase my appetite, my gastroenterologist told me about one of the most effective medications for my condition. However, it was/is banned in the United States. 

Desperate and willing to incur the “deathly” side effects of a banned drug, I spent hours searching for a reputable pharmacy that ships internationally. Finally, I landed on one thanks to my primary care doctor. He said that a number of his patients have to get their medications overseas because of cost and irrational prohibition by the Food and Drug Administration.

For instance, the drug I take – Domperidone – is a highly accepted and used medication in most other countries. It is considered so safe, that it is often taken by breastfeeding mothers. According to my perpetually-dubious-of-government-regulatory-agencies doctor, the drug was banned in the states for two reasons. One, there was a small study indicating that the medication could cause sudden cardiac changes. Once that study was unable to be duplicated, the pharmaceutical companies found that the prescription was so inexpensive to create and distribute, that they couldn’t make a significant profit off of it in the over-tapped American medicine market. 

Whatever the reason for its exclusion, this one medication helps me and I cannot easily acquire it. First, I have to find a doctor who is willing to prescribe a, technically, illegal medication. Next, I have to get that prescription to a quality pharmacy. Then, I have to navigate the medication through the out of country prescription verification process (including sending your identity documents to the pharmacy). Finally, I have to wait. Often for weeks. Wait for the verification. Wait for the payment. Wait for the shipping. Wait for the delivery.

Of course, insurance doesn’t cover this type of pill. The cost and shipping are out of pocket. The United States has also implemented new laws that limit the quantity of pills that can be shipped. I am only allowed a three-month supply. That means, two months into each batch, I have to start the whole process over again.

I am very fortunate to have a good gastroenterologist and flexible primary care doctor. They are willing to stick their necks out, so that I can get the meds that I need to survive. The pharmacy I use is very reliable and has a physical location, if worse comes to worse and I need to travel to pick up my pills. Their fees are reasonable. They also track every shipment.

Unfortunately, I have to rely on the much-maligned American postal service for distribution. With recent political games, those of us, the millions of us, who use the post office as a source for life-sustaining drugs, are feeling very vulnerable. As insurance companies push more and more telemedicine and online only pharmacies, we are suffering. 

Some insurance companies will only fill medications through the mail. There are people who can’t leave their home or who do not have physical access to a pharmacy. Their health is directly tied to having an efficient post office. Beyond the ongoing direct to consumer fiasco, pharmacies also use the postal service to refill their stocks. Most medications are made in countries far from where they are sold and used. Those pills depend on a fragile system: access to ingredients, healthy employees, immaculate factory conditions, frequent international flights, quick ground transportation, and accurate dispersal locations. 

Trusting an underfunded institution with your critical medications is terrible. We already handle the uncertainties and complications of doctors, pharmacies, treatments, and insurance companies. Why not throw the mail in to the mix? We don’t need another obstacle or roadblock to achieving good health. It’s a mess out there and we are in the fallout zone. 

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