I hear it is much cheaper to mail-order infertility drugs from other countries. How would I find a foreign pharmacy that ships Fertinex to patients in the United States?

-- Patsy

You can often find bargain prices for drugs when ordering from out of the country. But there are risks. First, it is not exactly legal to order medicines from abroad, and your shipment may be confiscated by customs if it is inspected as it enters this country. Second, your drugs may not arrive in time, which means you will have to postpone treatment.

Another problem is that you will often have to buy a larger number of ampules than you may actually need. Your doctor cannot know in advance exactly how many ampules of drug you will require. Normally, if the stimulation takes longer than planned, you would order an extra day or two. However, you can't call a European pharmacy and say "I need two more Follistim for tomorrow." Rather, you would need to order a larger number of ampules ahead of time.

Most reproductive endocrinologists have found that recombinant FSH products -- Gonal-F and Follistim -- provide a more stable, uniform response than Fertinex does, and they have switched to these formulations. While these newer products are a bit more expensive, early studies have suggested that you may use fewer ampules overall, thereby reducing the cost when compared to Fertinex. Unfortunately, the cost savings achieved when purchasing the newer recombinant FSH medications overseas is much less.

While many of my patients have ordered drugs in this way, some have lost their money or have had to postpone treatment when the drugs did not arrive within the specified time. I think a better approach is to write your representatives in Congress and tell them to get back to work on important issues such as addressing why we in the United States pay so much more than our European counterparts pay for the same medications.