One doctor wasn't sure what his legal status would be if it were known that he did use imported medications in his office.
The U.S. Food and Drug Administration (FDA) opposes Americans going to foreign suppliers for their prescriptions, citing safety concerns and the quality of imported products. Federal regulations restrict what can be imported, even for personal use.
State and local governments have had contradictory responses to the regulations and warnings. Some - such as Minnesota, Illinois and Michigan - have looked at ways to help their citizens obtain drugs from across the border, while other states, such as South Dakota, are contemplating prosecutions and civil actions against companies facilitating the importation of medications for local citizens.
The responses vary greatly. For some dermatologists, having their patients get prescriptions from out of the country is quite common, while other dermatologists say it hasn't even come up as an issue in their practice.
While some dermatologists share the FDA's concerns about the safety of imported pharmaceuticals, others say that for the most part, they believe the concerns are unfounded.
Alice C. Cardullo, M.D., from Wayne, N.J., is almost surprised that none of her patients have expressed any interest in obtaining their drugs from foreign sources.
"I know they are aware of the idea because I hear the ads on the radio all the time," she says. "They compare prices on drugs from Canada, so I'm aware of the issue, but I have yet to have a patient say anything to me about doing that.
The fact that her patients show no interest is fine for this practitioner of 23 years, because she would not favor that course of action.
"I have the same concerns I have when patients or pharmacists ask me to prescribe a generic drug rather than a brand name. I know brands; I'm regularly visited by various pharmaceutical representatives. Now, granted, they are soliciting for a particular product, but it has been shown on more than one occasion that the generic is not always quite as efficacious as the brand name. If we have those concerns here in our own country - on drugs that are regulated by the FDA - that's all the more reason to be concerned about drugs from elsewhere."
Just not comfortable
An assistant clinical professor at Columbia Presbyterian Hospital, Dr. Cardullo says there just isn't enough information about foreign drugs to allow her to be comfortable with them.
"I don't know the type of regulations they have, where these drugs are coming from. I don't know that the strength would be the same; I don't know that the ingredients would be equivalent," she explains.