Importing meds: Are physicians as concerned as the government? Is cosmetic specialty an exception?

Karen Nash

But it isn't just life-saving medicines that are less expensive. Other medical materials, such as Botox (Allergan), Restylane (Q-Med Laboratories) and collagen may be obtained at lower prices than commonly paid in the United States.

The U.S. Food and Drug Administration (FDA) opposes Americans going to foreign medical suppliers, citing safety concerns and the quality of imported products. Federal regulations restrict what can be imported, even for personal use.

State and local governments around the country have had contradictory responses to the regulations and warnings. Some — such as Minnesota, Illinois and Michigan — have looked at ways to help their citizens obtain drugs from across the border, while other states, such as South Dakota, are contemplating prosecutions and civil actions against companies facilitating the importation of medications for local citizens.

On Track asked cosmetic surgeons around the United States what they tell their patients about getting drugs and other medical products from other countries; whether the surgeons share the federal government's view about safety issues with the foreign source medications and whether they think states should help facilitate or prosecute companies that help patients obtain medications from outside sources.

Some of the cosmetic surgeons think that the unique nature of their specialty insulates them from the debate, while other doctors say the issue has definitely come up in their practices. Some surgeons question the safety and reliability of imported pharmaceuticals; others think that, for the most part, the concerns are unfounded.

Quick stop

Robert G. Graper, M.D., Charlotte, N.C., says the issue may come up with his patients, but he doesn't let it get very far.

He says that the cost savings — either for the patient or the practice — isn't the issue.

"I am so risk-averse. All you have to do is have a problem and the patient says, 'oh, by the way, you used something that wasn't bought in this country, and I'm going to talk to my attorney' — and you're just dead."

Personal curiosity

In Mineola, N.Y., Elizabeth Emami, M.D., wonders if all of the hoopla over Canadian drugs on the part of patients is justified.

She decided to check the market out.

"To be honest, I bought it to just to see — because the prices are so different. We actually can't do anything in terms of a large volume; I just thought I'd compare it as if I were buying it personally."

What she found was that the medicine wasn't much cheaper in the long run and, for all of the hassle to get a prescription, it just wasn't worthwhile.

In Bay Harbor, Fla., Lee A. Gibstein, M.D., practices in an area that sees a large number of Canadian "snowbirds," so they, of course, get their medications "back home."

For the most part, it wouldn't bother him if his winter patients wanted to use the same source for their treatments down south as they used when up north.

"If they needed a treatment here, and the product was something we have in this country already — like hyaluronic acid products — I would feel comfortable using their product.

"If it's something we don't use here, I wouldn't feel comfortable."