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In the changing landscape of U.S. health care, new alternatives have given consumers greater choice in how they buy their prescription medications. The traditional corner drug store now competes with a global market that includes online suppliers and now, a third, hybrid layer.

A local Stroudsburg company, Canada Drugs & U.S. Discount Drugs, advertises savings of 30 to 80 percent by shopping your prescription among a number of U.S. and overseas suppliers. Besides Canada, they deal with pharmacies from Australia, New Zealand, India and Fuji.

You call or stop by Canada Drugs' offices with your prescription. Using the Internet with proprietary software developed by their parent company, they generate a price quote based on prices at offshore pharmacies. More than one country may be quoted, giving the patient more choices.

If you place an order, your prescription is faxed to the pharmacy in the country you've selected, and your medication arrives in the mail within two weeks.

We compared prices from Canada Drugs & U.S. Discount Drugs with two other sources; CVS Pharmacy on Route 611 in Stroud Township, and Drugstore.com, an online drugstore. We chose four common drugs, three of which are expensive medications often used by senior citizens. We then compared prices based on a 90-day supply. The drugs were Vytorin and Lipitor, both for cholesterol management; Diovan, a blood pressure medication; and Viagra, for treating erectile dysfunction.

Our study showed that in fact the prescriptions quoted by Canada Drugs were between 48 to 67 percent less expensive than the average cost from the two U.S. pharmacy sources. In each case, the lowest price supplied by Canada Drugs were from India. However, in most cases, the company also gave us lower prices from Canada or New Zealand.

Chris Cappoza from Marshalls Creek has been a customer of Canada Drugs since it opened. He pays $11 for a one-month supply of Clonazepam, an anti-seizure and anxiety medication that used to cost him more than $70 according to Cappoza. Although the pharmacy he chose is in India, the medication comes from the United States, since controlled substances cannot be shipped across the border, Cappoza said.

According to Canada Drugs owner Debbie Morton, the countries she sends prescriptions to are chosen because they have regulatory agencies equivalent to the U.S. Federal Drug Administration. Since Mexico lacks that, her company will not fill prescriptions there.

Morton said the prescriptions she places are filled by licensed pharmacists. And according to her, individuals, as of October 2006, are permitted to import 90 days of medication for their own personal use.

When Morton herself received a prescription she sourced from a Canadian pharmacy, the label on the bottle showed it came from Sanofi Pasteur in Swiftwater.

There are some drawbacks. Controlled substances cannot be imported — including pain and tranquilizing medications and narcotics. And they won't accept your prescription insurance. So you will have to pay up front, submit your receipt on your own and wait for reimbursement.

According to Jim Kitchen, interim director of pharmacy at Pocono Medical Center and a pharmacist, there are several reasons why you might want to think twice about price shopping your medications.

Besides not having a way to verify the practices of overseas regulating bodies, there is the issue of delivery. Although the FDA regulates drugs in the United States, each state licenses the pharmacies and pharmacists, according to Kitchen. That provides oversight as to how prescriptions are prepared and dispensed.

Kitchen thinks price shopping is a good thing, although he cautions against it. He feels patients should find one pharmacy for all their medications. The advantage to that is the pharmacy will have all their medical records and be able to monitor the patient's entire history and drug interactions.

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