Hacker News Reader

>This is detailing a report from the FDA about packages they inspected. However, I wonder if there's no overlap with packages inspected by the DEA and/or CBP.

>Anyways, the article states "The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022". This was out of 53,000 packages inspected. However, the CBP reports finding 239 mail parcels with fentanyl at just JFK airport alone in 2018[0]. It's unclear how many packages the DEA has seized but it also sounds like a lot more than 33.

It has these CBP numbers in the article:

>the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities. But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.

If so, it sounds like there's even less reason for the FDA to be involved if the DEA is already catching the truly illicit stuff. The issue the article takes is that the FDA keeps asking for more and more money to inspect packages for opioids/fentanyl, but is using that money to mostly destroy legitimate medicine. If they had to say what they were actually doing with the money, they might not get it.

FDA seizing drugs that aren't in the NIDA-5 (cocaine/opiates/amphetamines/etc) will get a lot more contentious when the TikTok generation figures out how to skirt domestic shortages of tirzepatide and semaglutide by getting it from non-FDA approved facilities overseas.

However, asthma/cancer/ED/heart medications are probably for now more what the critical voting blocks care about.

I don't think that the overseas pharmacies have locked on to tirzepatide and such as of yet.

I'm seeing them very available in "bulk" out of China. Not much "pseudo-branded" out of India/elsewhere yet. Specifically looking at:

- Semaglutide: $10/month

- Tirzepatide: $60/month

- Liraglutide: $87/month

For unbranded/unlabeled Chinese "bulk" material, but packaged into consumer-ready vials, 2mg-10mg per vial. BYO QA/QC though, as with all non-FDA drugs. That's the huge catch, and it sucks for consumers. Testing just for active ingredient is >$100 and takes about a month. Testing for proper buffering agents, harmful contaminants, microbial contamination, etc is essentially unavailable at all.

If you have a valid rx is it still illegal for you to order the overseas drugs?

Default answer for Americans: “Yes it is still illegal, technically it’s smuggling, assuming it’s not a controlled substance.”

Nuanced answer: There is a loophole where Americans can get medicine from overseas if it is the exact same drug/brand/dose as their prescription AND the imported drug was produced under FDA supervision and is labeled for sale in the USA. This used to be a situation where you could get big discounts for the same brand name drug but now they have different brand names for different price markets and they don’t distribute the FDA drugs to India/Turkey/etc or do so at the same wholesale price; so this loophole doesn’t help much. You might find 10-20% discount off domestic retail price but not 80-90%.

Not a lawyer, but AFAIK if one has a valid rx for e.g. adderall, it's still illegal to make it (or even to buy it from a friend who got it via their own valid rx). I'd expect the situation to be similar.

Yes, otherwise everyone with a prescription that costs more than a few dollars a month would be ordering from these services and US pharmacies & drug-makers would go out of business (or be forced to cut prices dramatically)

[EDIT] As pointed out by another poster, unless the drugs are valid for import to the US and such and it's all done above-board—obviously, the US doesn't manufacture all its own drugs. But those aren't the cheap options.

I'm curious, where are you seeing these? I'm hardly an expert in finding this sort of thing.

That would be super inappropriate for this discussion forum.

The article mentions CBP's inspections as well.

> FDA spokesperson Devin Koontz said the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities.

> But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.

People getting small-fry otherwise legitimate Rx drugs aren't bribing the right people to let it through. And why would they, the stakes are much smaller.

People getting ordinary Rx packages seized are being struck by lightning. There's absolutely no need to bribe a customs official (major crime!) to import some unscheduled pharma (not even a crime). The vast, vast majority of imported pharmaceuticals aren't seized.

Criminals importing scheduled substances aren't bribing US customs either.