Anonymous - 8-13-2004 at 01:38 AM
http://www.thedesertsun.com/news/stories2004/local/200408110...
By Natalie Singer
August 11th, 2004
Editor's note: This is a reprint of a 2002 story.
LOS ALGODONES, MEXICO - As the hot morning sun shines across the dusty, winding streets, the Americans arrive.
They pull up in Mercedes and old clunkers and tour buses, paying a few dollars to park on the U.S. side of this tiny border town near Yuma.
Then they file into Mexico on foot, marching with their bright white sneakers and silver hair down the wide sidewalks toward their common destination:
Mexican drugstores.
Driven by prices as much as 90 percent cheaper than at home, thousands of U.S. residents - most of them seniors - travel to Mexico every day to buy
prescription drugs.
In the Coachella Valley, those on the quest usually journey just a few hours to Los Algodones, a town of 12,000 that boasts about 20 pharmacies.
Even in the sweltering heat of summer on a recent weekday morning, Americans filed in and out of the pharmacies in Los Algodones searching for a deal.
Outside the shops - some modern and sterile, others housed in faded buildings off the main thoroughfare salesmen hawked their wares.
"You need medicine? Come to the purple pharmacy," called out Javier Arturo Maya from the doorway of the well-known, plum-colored Grupo Liqui?s.
"It?s your Mexican Wal-Mart."
The store?s manager says business is good.
"I can?t even count how many Americans come each day," said Edgardo Martinez, manager at Grupo Liqui?s, which advertises "the best prices on quality
generic and name brand medications" on the Internet. The company owns three pharmacies, a liquor store and a restaurant in Los Algodones.
Don and Ruth Smith of Thermal listened as sales associates in the purple pharmacy called out their discounted prices.
The retired couple had traveled to the town to price the medications they need but cannot afford at home.
"We?d be doing fine financially except for this medicine thing," said Ruth Smith.
She takes medicine for high blood pressure and cholesterol, which cost her $285 a month at home, she said.
When her husband had chemotherapy for colon cancer, Smith skipped some of her own medication so they could afford his.
She knows it?s not safe.
"I want to be alive to take care of my husband," she said.
Purely economics
Although many say the trip is pleasant - a chance to eat some authentic Mexican food and pick up handmade knickknacks - those who travel to places
like Algodones are driven purely by economics.
A survey of seniors in eight states released in July by the Kaiser Family Foundation and the Commonwealth Fund found that nearly a quarter of seniors
reported skipping doses of medicine or not filling prescriptions because of cost.
The survey looked at 10,927 Medicare beneficiaries age 65 or older. It also found that 18 percent of seniors in California did not have prescription
drug coverage, and 38 of the state?s low-income seniors had no drug coverage.
Among seniors who lacked drug coverage, 30 percent nationwide skipped doses and 31 percent did not fill a prescription because of cost.
"Medicare beneficiaries are already spending over one-fifth of their incomes on health care," said Karen Davis, president of The Commonwealth Fund.
"For the sickest among them, the specter of wiping out retirement savings on rising prescription drug costs is truly frightening."
Seniors really feel the financial pinch.
"It?s very frustrating for those of us on a fixed income," said Jane Devon, a 63-year-old Sky Valley resident who needs an assortment of medications
to treat her fibromyalgia, osteoarthritis and high blood pressure.
Though Devon has private insurance, it doesn?t cover the brand name drugs she needs.
She finally found her answer in Los Algodones.
The medicine that cost her $334 in the United States costs $120 in Mexico. She heard about the town through friends.
"It?s worth the gas to go there," she said.
"There?s nothing but drugstores and doctors, and everyone you see has gray hair."
Robert Evans, owner of Celebrity Tours, knows the strain that drug prices put on Coachella Valley seniors. He takes a busload of them to Algodones
twice a month.
"I started last year with one trip a month, but now I do it twice because of the demand," he said.
Long frustrated by the high cost of prescription drugs in the United States, many seniors are now also angry with lawmakers, who failed during the
recent Congressional session to add a prescription drug benefit to Medicare.
"It?s entirely politics," said Henry McCarty, local resident and special projects coordinator for the local chapter of AARPcq: the acronym is now the
legal name of the organization. "The president promised it, the members of Congress promised it, but they cannot seem to work something out."
Meanwhile, McCarty said, seniors are having to make hard choices they shouldn?t have to make.
"Some people work all their lives and now have to choose between their rent or mortgage payment, food and medication."
Costs climbing
Meanwhile, the cost of medication is on the rise.
The average price for a prescription drug rose 10 percent from $49.84 to $54.27 between 2000 and 2001, according to a study by the National Institute
for Health Care Management.
Among the 50 best-selling drugs, average price in 2001 was $71.56.
Between 1981 and 1999, drug prices rose 306 percent while the Consumer Price Index rose just 99 percent during the same period, according to the
Bureau of Labor Statistics.
Seniors bear the brunt of those rising costs.
While the average consumer purchases 10 prescriptions per year, those over age 65 purchase 28.5, according to the Henry J. Kaiser Foundation
Prescription Drug Trends 2000 chartbook.
According to the Congressional Budget Office, the average senior is expected to use over $2,000 worth of prescription drugs this year, and almost one
in 10 seniors is expected to use more than $5,000.
Compounding the problem is the fact that many are prescribed new, brand-name drugs when they could easily be treated with far cheaper generics, said
Coachella Valley pharmacist Greg Collins.
"In generic drugs, the ingredients are the same," Collins said. "New medicines come out all the time, and the drug company reps will push the
advantages to doctors and consumers. But pharmacologically, it doesn?t necessarily mean it?s a better drug."
Although pharmacists often make more money by filling generic prescriptions than brand-name ones (the profit margin is wider), Collins said he asks
his clients? doctors to prescribe generics out of concern for seniors. "People really can?t afford these meds. Forty dollars (of savings) can go a
long way," he said.
The customers
So who crosses the border for prescription drugs?
An August 2000 survey looked into the number of prescription drugs being brought into the United States by pedestrians at eight ports of entry along
the 2,000-mile border with Mexico. It was conducted by the U.S. Food and Drug Administration and other agencies including U.S. Customs, DEA and USDA.
The most common importer was an older white male with a prescription from the United States bringing back primarily antibiotics or pain relievers for
his own use.
During the four hours on a Saturday last month at border ports in California, Arizona and Texas, 63 percent of those interviewed had prescriptions.
A second survey in April 2001 at seven ports coincided with the "snowbird" season. During four hours, 586 people brought in a total of 1,120 drugs.
Most seniors say they have no problems crossing back into the United States with their medications.
They say the process of buying in Mexico is so easy that they haven?t been asked for their prescriptions or even to show their purchases to customs
officials.
"The border guard just passed us through," Cathedral City resident David Dowd said. "There?s no problem. I think they can tell if someone doesn?t look
right."
A U.S. resident can now personally import up to 50 dosage units of a U.S.-approved medication without a prescription, according to guidelines on the
U.S. Customs Service Web site. The medicine must be declared, and many shoppers report being allowed to bring back a three-month supply with a
prescription.
"Cholesterol, diabetes, hormones for menopause, medicine for stomach ulcers," said Pharmacia Juarez manager Sara Juarez, ticking off the most common
purchases made by her numerous American customers. "They don?t get nervous (about buying the medication here)," she said through a translator. "They
see it?s the same medicine made by the same company."
Indeed, many drugs sold in towns like Los Algodones are packaged in boxes identical to those from American pharmaceutical companies found in any U.S.
drugstore.
Others, however, have their own Mexican versions.
One of the bottles Dowd brings back from trips to Algodones reads "Gecor." The medicine, he says, is the Mexican version of Zocor - a lipid-lowering
agent Dowd buys south of the border for about 81 cents a pill. That?s compared to more than $3 per pill he said he?s paid at home.
Dowd said he checks with his doctor about the safety of the pills before he takes them. Buying in the United States is not a logical option for the
82-year-old, who?s had two heart failures and a kidney failure and once spent as much as $800 a month on medicine in the U.S.
The FDA and U.S. Customs Service have issued brief, vague warnings about the safety of drugs bought in Mexico. But many local residents who have
purchased the medications say they aren?t afraid.
U.S. costs
And although the savings are worth the trip, many say, the fact that they are forced into Mexico by skyrocketing U.S. prices is not fair.
"It?s vulgar," said Bill Goodwin. Last month the Palm Springs resident priced 30 pills of antibiotics at a valley pharmacy and was told he?d have to
pay $186.
Instead, Goodwin, 76, who has private insurance, went to Mexicali and got it for $38.
"We have the option, but what if you live in Idaho? This is what I paid taxes for 50 years for? It?s just unfair."
Carl Hilgenfeldt, 76, of Thousand Palms was driven to Mexico by his asthma. A breathing puffer cost him anywhere from $25 to $33 in the United States.
In Tijuana and Algodones, he can get three for about the same price.
"So I quit buying them here," he said. "I?m pretty much a USA enthusiast and try to buy almost everything I can that?s made here. But this is
ridiculous."
"Why doesn?t the government do anything about the high cost?" wondered Julian Reyes, a 40-year-old Indio resident. Reyes said the diabetes medicine he
needs to stay alive costs him about $3 a pill in the valley. He got the same medicine for 15 cents a pill in Mexico.
"People have to pay for rent, food, all these other costs. And then the price of medicine in the U.S. is incredible."
And until something changes, many say they?ll keep going to destinations like Los Algodones, where the price is right and the roads are lined with
pharmacies beckoning them to come inside.