Drug dealers

"The only difference between a pharmaceutical manufacturer's representative and a drug dealer is a tie." Back in the bad old days, when a rep could openly fly a bunch of docs to Myrtle Beach for the weekend so they could play a little golf, courtesy of BigPharma, I used to say this to their faces- and they would laugh. They'd still show up in twenty minutes when my grandma's doctor prescribed some new antibiotic that cost $120, and hand it to me with a smile. All that has fallen a little out of favor these days; seems there were suspicions that it was affecting what doctors prescribed to their patients. Heaven forbid. You should have seen all the blue-and-orange clocks, paperweights, notepads, and pens with "Vioxx" on them in the trash the day it got pulled. The TV ads are the best, though. I saw a cartoon a while back where a woman was saying to her doctor, "I want that drug where everyone's in the park having a good time."

If there's a more lucrative business on this green planet, though, I have no idea what it could be. The drug companies get to pose as society's great benefactors while robbing you blind, and the doctors are largely complicit. I used to do evening medication shifts at a nursing home. . . I'd leave my regular case-management job at 4:30, grab a box of supermarket sushi, and change into my scrubs while driving across town. Ride the elevator to the third floor, psyching myself up, and when the door would open, I'd scream, "Are you ready to rock and roll?!" I had twenty patients I hardly knew, and four hours to get these horrendous witch's brews of drugs into them. Twelve minutes a patient, they all look alike, and none of them look like the photos in the med ID book (a tuft of white hair, a pair of glasses, a sweater). Nearly all of them were in their 90's. They were all on Lipitor. Lipitor is an anticholesterol drug. I couldn't believe it. Quit taking that shit! High cholesterol didn't kill you! Have a steak! The tariff on a month's Lipitor- which, BTW, isn't available in a generic? Oh, about $110 a month. So here I am, crushing it up in applesauce, ice cream, whatever, with all the other high-priced (and inappropriate) junk they were on, and shoveling it into their uncomprehending mouths. Most expensive dessert you'll ever eat, and from the reaction, it was pretty nasty.

Of course, as a nurse, I've got to play by the rules. Or did, until I got prescribed some expensive drugs that my insurance company wouldn't pay for. Now, if you look in the back of the book you got from your health insurance company, there's a long list of things they don't cover. One whole category is anything having to do with that messy sex change stuff (now though, they'll pay for both my mammograms and prostate screenings; I guess all is forgiven). So, I was going to be paying out-of-pocket for my Estradiol and Aldactone. Estradiol is, of course, a "synthetic" estrogen, derived from soybeans, and it's pretty cheap. Aldactone is an antihypertensive and a diuretic, and an androgen blocker. That is to say, it blocks both the synthesis and the binding of testosterone. It's pretty necessary, although it's been linked to tumors, and, of course, you've got to get up in the night to pee pretty often. You only take it for as long as you need to. It's also fairly expensive. I was taking 100mg twice a day; depending on where you buy it, 100 tabs of the generic, spironolactone, will run you around $90. The brand-name stuff? As much as $250, even eight years ago when I was on it. Forget that.

One of the informational websites for transgender people had a section on pharmacies "offshore" where you could get your medications cheap. I checked a couple out, and went with one in New Zealand. I'd always wanted to go there, and this might be as close as I ever got! There was a warning on the website where I got their address to not tell them what you wanted the drugs for- as if that combination of drugs is ever used for anything else. I placed my order, and within ten days, it was delivered. One-hundred 100mg tabs of genuine Searle Aldactone, made in England, shipped to New Zealand in its Euro-style blister packs, packed up by the lovely people at Seven Oaks Pharmacy in Auckland, through customs in L.A. marked "supplements" ("Comin' into Los Angeles, bringin' in a couple of ki's. . ."), and delivered to my door in New England for a total cost of $25. Twenty-five dollars. One-tenth what they cost down the block at my local CVS. Plus, of course, I had some great New Zealand stamps to give my nephew.

Remember all the outcry against "black market" Internet pharmacies? All the warnings by the FDA about how dangerous they were? Dangerous to who? You? Like you can't read a set of instructions, or be trusted with your own safety? Oh, that's right, your pharmacist can give you all the warnings and look what you're on and check for interactions and your allergies. Right. It's just a piece of software, people. It's too late anyway; nearly all those offshore pharmacies have been shut down, replaced by scam artists who will gladly take your credit card number. I loved it when the drug companies cut a deal with the gummint to give them a discount as long as nobody was allowed to negotiate a better deal. Ya might want to pick up a tube of K-Y when you're down at the pharmacy, it's such a royal screwing.

Oh, and the warnings about not letting the pharmacy know what I wanted the drugs for? When I changed my name [to a girl's name], I sent them a terse, one-line email notifying them that the name on my credit card had changed. I got back a one-word message: "CONGRATULATIONS".
Lovely people, those Kiwis.