Across the border: purchasing drugs overseas can come with a price.

Tiffany Fletcher has high blood pressure and takes Diovan, a prescription drug, for her illness every day. The $35 monthly co-pay through her ex-husband's insurance is affordable. But what she couldn't afford was a bill for $1,422.75 from a local hospital for the treatment of her granddaughter, whom Fletcher has legal guardianship of. After the hospital trip, she went to a pharmacy and filled a prescription--for $175.

"I couldn't believe it! It's a disgrace that medical help and prescription drugs would be so expensive. The cost of the hospital visit could have been the down payment on a car for her," says Fletcher, who is self-employed as a home day care provider.

According to the National Association of Chain Drug Stores, retail prescription drug sales reached $182.7 billion in 2002, up more than 11% from $164.1 billion in 2001. As a result, cost conscious consumers may be inclined to purchase drugs from other countries. While drugs from overseas may be less expensive, pharmaceuticals bought from other countries may be unsafe.

"We have surveys that show Americans are importing drugs from places like Mexico, European countries. Thailand, South Korea, and the Philippines," says William Hubbard, associate commissioner for policy and planning for the Food and Drug Administration. "We think it is very unsafe. They can get drugs that are impotent or even super potent."

Prescription drug importation is illegal. However, the FDA has not prosecuted individual patients who have purchased foreign drugs, says Hubbard. Legislators like Rep. Denise Majette of Georgia's 4th District are working hard to make prescription drugs more affordable and importation from Canada legal. Along with many members of the Congressional Black Caucus, she cosponsored legislation H.R. 3707 to amend Title XVII of the Social Security Act to negotiate fair prices for Medicare prescription drugs. Likewise, she voted in favor of H.R. 2427, the Pharmaceutical Market Access Act of 2003, which would have allowed for the importation of prescription drugs from Canada. Both were excluded from the final prescription drug legislation.

"Unfortunately, the Administration is not doing anything to provide universal drug coverage. The prescription drug plan recently enacted is flawed," says Majette. "The CBC was united in its opposition to the prescription drug bill that recently passed Congress because it was written by the drug companies and HMOs; threatens the long-term viability of Medicare; prohibits the government from negotiating lower prices; and does not allow the importation of drugs from other countries, which would lower prices."

To save money on prescription drugs, ask your doctor about generic brands and samples, research discount online pharmacies (see sidebar), and seek out consumer organizations that provide member discounts, such as AARP. The Cost Containment Research Institute's book Free and Low Cost Prescription Drugs is another good resource. To older, log on to www.institutedc.org or send a check for $6 to Institute Fulfillment Center, P.O. Box 210, Dallas, PA 18612-0210.

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