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A Survey of the Use of Foreign-Purchased Medications in a Border Community Emergency Department Patient Population

      Abstract

      Many reports suggest that the use of imported medications in the United States continues to grow, fueled mostly by the rising price of prescription drugs. This trend may be problematic for several reasons, including the potential for counterfeit or impure products, a lack of pharmacist support outside of the United States, and the ability to purchase agents without a prescription from some countries. We performed a survey of Emergency Department (ED) patients in a border community to observe the magnitude of imported medication use, and to begin to determine the rationale behind the practice. A survey was conducted of 1008 ED patient encounters of individuals reporting at triage to be on any prescription or over-the-counter medication. Participants were queried on their use of imported medications and implications of such use through a questionnaire. A total of 966 patient encounter surveys were included in the analysis. Of this number, 7% reported the use of medications purchased outside of the United States. Most of these were purchased in person and in Mexico. The most commonly cited reason for importing medications was decreased cost, and almost a quarter of those importing medications stated that their physician had recommended it. The most common medications imported were antibiotics, and nearly a third of all of those buying foreign medications had done so without a prescription. Our study suggests that many patients in our community purchase medications outside of the United States.

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      References

        • Smith C.
        • Cowan C.
        • Heffler S.
        • Catlin A.
        National spending in 2004: recent slowdown led by prescription drug spending.
        Health Aff (Millwood). 2006; 25: 186-196
      1. Kreling D.H. Mott D.A. Wiederholt J.B.O. Prescription drug trends: a chartbook: a final report. 2001 (Menlo Park, CA: Kaiser Family Foundation Report 3019)
        • Calvillo J.P.
        • Lal L.
        Pilot study of a survey of US residents purchasing medications in Mexico: demographics, reasons, and types of medications purchased.
        Clin Ther. 2003; 25: 561-577
        • Casner P.R.
        Antibiotics over the counter and across the border.
        Ann Intern Med. 1984; 100: 462-463
        • Casner P.R.
        • Guerra L.G.
        Purchasing prescription medication in Mexico without a prescription: the experience at the border.
        West J Med. 1992; 156: 512-516
        • Tabet S.R.
        • Wiese W.H.
        Medications obtained in Mexico by patients in southern New Mexico.
        South Med J. 1990; 83: 271-273
        • Guglielmo W.J.
        Where does drug importation stand now?.
        Med Econ. 2005; 82 (44,46): 42
      2. Retail drug monitor. tracking 13 key global pharma markets: 12 months to February 2006. IMS Health. Available at: www.imshealth.com.

        • Lugo A.M.
        Mexican border medications: potential toxicity.
        J Toxicol Clin Toxicol. 1999; 37: 121-125
        • Ault A.
        FDA hones in on counterfeit and imported drugs.
        Lancet. 2003; 362: 1208
        • Suwanvecho S.
        • Baker J.R.
        Accidental over-anticoagulation: substitution error by a foreign pharmacy.
        Ann Pharmacother. 2000; 34: 1132-1135
        • Haidar W.N.
        • Hoel R.W.
        • Takahashi P.Y.
        Intracerebral hemorrhage associated with use of an imported medication.
        Am J Geriatr Pharmacother. 2004; 2: 197-200
        • Davis D.P.
        • Poste J.C.
        • Kelly D.
        The UCSD Research Associate Program: a recipe for successfully integrating undergraduates with emergency medicine research.
        J Emerg Med. 2005; 28: 89-93
        • Saatsoglou P.
        Pharmaceutical reimportation: magnitude, trends, and consumers.
        Manag Care. 2004; 13: 7-9
      3. U.S. Food and Drug Administration. Purchasing medications outside the United States. Available at. http://www.fda.gov/ora/import/purchasing_medications.htm.