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Modern telecommunications and shipping networks have simplified buying almost anything over the web from overseas, yet it remains illegal to import medicines without explicit authorization from the Food and Drug Administration. While the US government does not generally enforce this prohibition for cases involving limited personal use, the restriction remains, and the practice is widely discouraged. Under the banner of patient safety, industry-backed lobby groups have advocated for and caused search engines such as Google and Bing to discourage people from buying overseas. Further, payment organizations such as Mastercard, PayPal, and Visa and delivery companies such as FedEx and the US Postal Service are being pushed by government bodies to make purchasing and delivery from foreign sites more difficult. This problem has worsened because of recent responses to the opioid epidemic that are fueled in part by the pharmaceutical industry, the same group that benefits from the current restrictive system. However, a growing body of evidence, including empirical evidence in this report, demonstrates that foreign pharmacies credentialed by independent groups sell safe medicines. Furthermore, as high drug prices increasingly come to dominate conversations on health reform, politicians on both the left and right are beginning to see the benefits of limited personal importation. This report argues that rather than advancing patient safety, the main reason importation is illegal is economic. By arguing that the same logic justifying global price discrimination for pharmaceutical products applies within countries and among them, I show that it is both equitable and efficient for underinsured (usually low-income) Americans to pay less than they currently do and, further, that personal importation achieves this aim without overhauling America's existing drug framework or compromising patient safety., Unlike much of the industrialized world, drug companies maintain significant control over drug prices in the US market. While convoluted distribution systems and governmental programs complicate the system--where prices are [...]

We surveyed 487 smokers in the UK and U.S. on attitudes towards, and uses of, non-combustible tobacco products. We found that a higher percentage of sampled smokers had tried them in the UK, relative to the U.S., especially among those who claimed they had tried to quit smoking previously. This difference in attitude and uptake is consistent with messaging differences in the U.S. versus the UK. While public health pronouncements by UK authorities typically state that non-combustible products are 'far safer' than cigarettes, U.S. authorities have been far more muted in their support for new non-combustible tobacco products. Consistent with prior literature, we find that take-up rates of alternative smoking products amongst younger smokers are higher than the average. Keywords: Vaping, e-cigarettes, attitude, US, UK, 1. Introduction In the United States electronic-cigarettes, or e-cigarettes, have started to spread, particularly among young adults and teenagers. As per the Centers for Disease Control and Prevention (CDC), in [...]

Malaria mortality rates have more than halved in the past 15 years due to major disease-control efforts. However, gains have slowed in the past few years, with a few large and badly governed nations showing little progress and malaria still killing hundreds of thousands of children every year. Some might argue that we should suspend efforts now that additional success is becoming more difficult to achieve, but sustaining the fight is important to keep the failures of the past from reemerging. Key challenges include insecticide and drug resistance, substandard drugs, procurement and distribution problems, product theft, and systemic corruption. If major donors including the President's Malaria Initiative (PMI) and the Global Fund do not address these challenges head-on, then they might lose political support. President Donald Trump wants to cut PMI's budget, but funding should be sustained and gradually increased as long as PMI and Global Fund show they are willing to overcome problems., When President George W. Bush announced the President's Malaria Initiative (PMI) in 2005, nearly a million people (the majority children) were dying from malaria every year (WHO 2010; UNICEF and [...]

Key Points * To warn consumers of the dangers of importing medicine, the search engine Bing has placed pop-up warnings against foreign websites selling medicines. Unfortunately, the sites targeted are [...]

Policies to restrict the use of prescription opioids, such as oxycodone, accelerated an already lively illicit opioid market. Fentanyl, a powerful opioid, treats real patients, but it and its new analogues have found their way into illicit markets. The tiny amounts required to provide a 'high' to users and the resulting value are ideal for illicit traders, as hiding products, especially in transit, is useful to avoid discovery. As a result, there has been an explosion in the use of fentanyls in the past few years. Original research of online sellers in China and surveying drugs users and dealers in the Philadelphia area leads to the inevitable conclusion that fentanyl use has exploded over the past two years, and with it has come a significant increase in fatal overdoses., Due to the devastating effects of opioid addiction in the US, resulting in more than 42,000 deaths in 2016 (CDC 2018), one of the Trump administration's policy aims is to [...]

With the stated aim of increasing revenue and discouraging smoking, Pakistan raised tobacco duties over the past five years. The result empowered illicit actors, with a flourishing of illicit production and smuggling of cigarettes. Revenue rose initially, only to fall back as untaxed products proliferated. While organized crime and local production interests were the big winners, smoking rates have remained largely unchanged. Pakistan's authorities have tried to resolve the problem through better enforcement and lowering of duties for certain products, but overall the lesson learned is that rapid duty increases have significant negative effects that are difficult to reverse when illegal supply cannot be controlled., June 2018 Public health announcements, public area smoking bans, cigarette pack warnings, advertising and sponsorship restrictions, and enforcement of rules against selling to minors are all touted as ways to [...]

NOVEMBER 2017 Executive Summary Thirty years ago, most medicines consumed in rich nations were made there. Today most of the ingredients and nearly half the finished products come from India [...]

The possibility of reverting to the pre-antibiotic era is increasing. With dirty hospitals, poor prescribing practices by physicians, and poor patient adherence to correct antibiotic use, the threat was already [...]

Increasing access to medicines for diseases that primarily affect the poor, such as malaria and tuberculosis (TB), involves a complex interplay of private-and public-sector efforts--some of which are often ignored [...]

According to the US Food and Drug Administration (FDA), pharmaceutical companies in developing countries are increasingly falsifying data about the quality of their medicines. Moreover, a 2010 Pew survey shows [...]

Abstract Fake and substandard medicines are a significant problem in developing nations, and a growing problem in developed ones too. There have been assessments of basic medicine quality from many [...]

ABSTRACT The rules underlying the assessment of quality of generic drugs, and their bioequivalence to brand name products, have not changed significantly since the passage of the Hatch-Waxman Act in [...]