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The Goodman Institute Health Blog

Drugs Ordered from Pharmacies Abroad are Illegal (but Mostly Not Opioids)

Posted on March 9, 2023 by Devon Herrick

Hardly a day goes by but what there’s a news article about opioid overdose deaths. Most deaths are tracked back to Fentanyl. According to police almost all prescription opioid drugs purchased on the street contain Fentanyl. China is thought to be the largest producer of Fentanyl and its precursors. To mitigate the risk of dangerous drugs entering the United States, the U.S. Food and Drug Administration (FDA) receives funding to inspect prescription drugs arriving in the mail from abroad. According to NBC News:

For years, the Food and Drug Administration has defended its efforts to intercept prescription drugs coming from abroad by mail as necessary to keep out dangerous opioids, including fentanyl.

“Additional staffing coupled with improved analytical technology and data analytics techniques will allow us to not only examine more packages but will also increase our targeting abilities to ensure we are examining packages with a high probability of containing violative products,” said Dan Solis, assistant commissioner for import operations at the FDA.

Here is where it gets complicated. Many drugs are manufactured domestically and exported to other countries. Many drugs are manufactured abroad and sold in the United States. However, it is generally illegal for American consumers to purchase drugs abroad and have them shipped to the United States. This is even the case even for drugs intended for personal use. The reason personal drug importation is illegal is that imported counterfeit drugs could inadvertently enter the U.S. drug supply chain and risk the health of Americans. There is also the risk of consumers harming themselves with poor quality drugs made in substandard factories. These are both legitimate concerns.

Prescription drugs sold abroad are often cheaper than drugs bought locally. Thus, some Americans are tempted to turn to foreign pharmacies to save money. Another problem with drug importation for personal use (aside from the risks mentioned above) is that logistically, the entire country cannot order prescriptions from pharmacies abroad. Some politicians defend personal importation despite the practice being illegal, while some companies even try to facilitate it.

“The FDA continues to ask for more and more taxpayer money to stop fentanyl and opioids at international mail facilities, but it appears to be using that money to refuse and destroy an increasing number of regular international prescription drug orders,” said Gabe Levitt, president of PharmacyChecker.com, which accredits foreign online pharmacies that sell medicines to customers in the U.S. and worldwide. “The argument that importing drugs is going to inflame the opioid crisis doesn’t make any sense.”

Proponents of allowing individuals to order drugs from foreign pharmacies (including some liberal politicians) argue that very few of the drugs intercepted at international mail facilities are opioids. The cite FDA data claiming nearly all prescriptions shipped in from abroad are for chronic health conditions faced by older Americans.

According to a detailed breakdown of drugs intercepted in 2020, the lion’s share of what was intercepted — and most often destroyed — was pharmaceuticals. The No. 1 item was cheap erectile dysfunction pills, like generic Viagra. But there were also prescribed medicines to treat asthma, diabetes, cancer, and HIV.

The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022 out of nearly 53,000 drug shipments its inspectors examined at international mail facilities. That’s about 0.06% of examined packages.

 FDA inspectors generally destroy illegal foreign mail-order prescriptions when found at international mail facilities. Whether you agree or disagree with the legality of drug importation for personal use, it gets much more untenable as more people try it.

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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