Monday, October 10, 2005

The Great Pharmacy Search

Lets try to flesh out the mechanics of how to send chemotherapy drugs to Iraq.

I'm just a retired engineer, not a doctor or pharmacist or medical professional of any sort, so I had to do quite a bit of learning and searching to figure out how to do it. I asked a LOT of dumb questions a LOT of places. It took weeks and weeks. Eventually I got it figured out and did it. Here's a recap of what I learned.

Chemotherapy drugs are typically only administered in a hospital setting and not prescribed directly to patients. Even then, the typical physician never uses them, only specialist oncologists. They typically have a list of "side effects" warnings that rivals the warnings packaged with Colt handguns: "You risk INJURY OR DEATH by handling this weapon." If they are spilled, the instructions call for treating the event as a hazardous waste spill. They are nothing to play with, strictly very specialized poisons for waging war on cancer.

The typical pharmacy does not carry these drugs for the above reasons. Similarly, no physician in his right mind would normally write anyone a prescription for them to be filled at the local pharmacy.

With this in mind it will come as no surprise that I was able to obtain nothing but a few price quotes from the nice, but rather bemused, pharmacist at my local Wallmart.

I next tried asking for advice at the pharmacy of the Kaiser Permanente Hospital in South Sacramento, presenting them with a written statement of what I was trying to do. The pharmacy was unable to help, but they referred me to the hospital's patient assistance staff and I got a chance to talk the problem over with a rather knowledgeable and very helpful lady there. She advised me that retail pharmacies are normally licensed only to dispense drugs to specific individuals based on doctors' prescriptions, and that their licenses simply do not permit things like shipping crates full of stuff hospitals. What I needed, she informed me, was a wholesale pharmacy!

I therefore began searching for wholesale pharmacies on the internet. I found a pretty good list of pharmaceuticals wholesalers and distributors here: Link . I followed links from that site, looked over the various websites, and eventually came up with a list of 10 outfits that looked like they might sell what was needed and were located in the USA (mostly because outfits in the USA usually have toll-free 800 numbers but also because payment arrangements and legal recourse are MUCH easier with stateside companies).

I sent emails to the 10 candidate companies explaining what I needed, what I was trying to do, asking whether they shipped internationally, and requesting unit price quotes on a list of chemotherapy drugs. Most of my emails went un-answered, so I followed up with telephone calls. This took a couple weeks and the list got shorter and shorter as I crossed off outfits that didn't ship internationally, didn't carry chemotherapy drugs, etc, etc, etc. Finally it was down to a couple outfits in Florida and an outfit called Ameristat in Minneapolis. Eventually I concluded that Ameristat was the best choice. The outfits in Florida were less responsive and seemed to be bound by Florida regulations that complicated matters unnecessarily, while Ameristat was responsive and cooperative and had previous experience shipping chemotherapy drugs to the middle east.


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