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It is well-known that Americans pay more for medication than the citizens of other nations. To avoid high prices, some enterprising Americans, perhaps as many as four million, buy from foreign web pharmacies, often at under half the price they would pay in the US.1
Until web sales took off, many Americans, particularly seniors in states bordering Canada, would travel over the border to buy their medication. A string of pharmacies in Western Canada sprung up to service this demand. Early in this century, demand switched from physically visiting Canada to online purchases from Canadian websites.
There are obvious risks to purchasing medication online due to the anonymity of the web, where rogue actors have established sites to sell bogus medicine and steal identities. Therefore, groups such as the Canadian International Pharmacy Association (CIPA) and PharmacyChecker.com were established to credential websites linked with real pharmacies selling proper medicine and assist patients looking for cheaper good-quality medication.
US pharmacies and all major pharmaceutical companies always disliked Americans purchasing foreign pharmaceuticals since the former directly lost business and the latter wanted to maintain consistently higher prices on medicines in the US. The argument advanced by the pharmaceutical companies is that higher pricing leads to more research and development. While there is truth to this stance, higher prices harm millions of poor or underinsured Americans, who may forgo or not take their medication as often as prescribed to save money.
With a nod to this reality, historically the Food and Drug Administration (FDA) has allowed individuals to import a 90-day supply of most prescription medicines, even though the law forbids such importation. While importation is prevented primarily to inhibit price arbitrage, it is often argued that importation aids safety.2
Recently, due to the alarming increase in fatal opioid overdoses fueled predominantly from foreign sources, legislative efforts and policy have increased the powers of various agencies, including the FDA, to intercept and destroy medicine imports. Clearly the target is illegally trafficked narcotics, especially opioids. Yet other medicines, such as personal imports of life-saving medicines, may be prevented in the process, as companies seek to limit any potential liability and packages are stopped without much reason.3
Fortunately this new opioid law—known as the SUPPORT for Patients and Communities Act—includes a measure protecting those importing drugs for “personal or household use,” putting into law, albeit not exhaustively, the sentiment that limited personal importation will be tolerated.4 However, reports persist of the FDA interdicting drugs intended for personal use.5 It is too early to tell how these recent policy measures are affecting drug imports systematically, but search engines and payment companies are clearly being pressured to limit people’s ability to import medicine.
Specifically related to Bing, informed sources tell me that Microsoft has been pressured by the FDA and legislators to prevent the sale of opioids over the internet. The message is clear that the government’s priority is preventing the sale of opioids rather than allowing access to medicines.
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