Warren B. Seiler III, MD
John Di Saia, MD
Beatriz H. Porras, MD
Shervin Naderi, MD, FACS
Edward Zimmerman MD
Paula Di Marco Young, BS RN
Seth A. Yellin, MD FACS
Dr. Kevin D. Light
Stephen Weber MD PhD
Brian K. Sidella
Sabine Zenker, MD
Daniel Kaufman MD
Brian Howard MD FACS
Mickey A. Couvertier
Lila Bratani MD
Alex Denes MD FACP
33 CommentsCheap Restylane & Botox: Are you buying it from Canada?
I've received a number of inquiries about buying Restylane, Botox, Juvederm, and other injectables from Canada, Ireland or even Bulgaria.
Here's are two threads from the Physician to Physician discussion area:
Purchasing Restylane from Canada: Legal or not?
Buying Restylan Cheaper Oversees.
There does seem to be a great deal of pricing disparity. The Canadian suppliers and pharmacies who are selling Restylane and Botox are certainly undercutting the pricing that doctors are charged in the US.
(There are often pharmacies offering Botox and Restylane for 75% off advertising on this site.)
My own experience is that some of our physicians have and are currently buying all of these (Restylane, Botox, Juvederm, and whatever else they can find) from Canada or elsewhere. It brings up a number of questions for docs and problems for the companies. How can they exploit the market opportunity in the US which will generally accept higher prices while still selling into countries that won't?
Reader Comments (33)
I thought this was made illegal by congress. The companies that were importing meds for patients have all been closed around us.
Hmmmm.... I certainly know of some doctors who are importing Botox and Restylane both. There are often companies who are Canadian pharmacies who show up in the adword links on this site. I'm wondering if what the legality is here? Is it illegal to import it, or illegal to administer it?
Despite the fact that buying botox from canada might be illegal, is there any other reason we should not consider a cheaper deal for botox ?
Other than the fact you could lose your license. I have a friend that ordered "botox" from a company the was supposedly working on FDA approval etc. He ordered it and used it. He lost his license for 1 year and had tens of thousands in lawyers bills. There are also a few who have ended up in jail with permanent loss of their medical license. This is definitely not something I would push at this time.
Just to make something clear....when you purchase Botox from Canada you are purchasing Botox made by Allergan. Not another product or one that is trying to be approved for future use (that is just dumb!) The price of Botox (made by Allergan) is about $100 less per vial if purchaed from a wholeseller located in Canada. Same with Juvederm.
HS,
Hopefully you are purchasing the real botox. I think anything from Canada is OK but I would watch from some other countries. It still comes down to the question is it legal to bring these into the US?
I ordered some meds from a compounding company out of Canada (meds I can get in the US legally) and the box was labeled "for animal use only". I asked the company about it and they said it was so they could get it through customs. That sounded a little shady so I never ordered from them again.
Hello,
My rep is from here in US who sells botox for $475. The bottle has the rainbow hologram on the label. It says Allergan marketing authorization holder: Allergan Ltd.Marlow,Bucks,UK.
Further on the label it states- manufactured by Allergan Pharmaceuticals Ireland, westport,Co.Mayo, Ireland. Has anyone else used this?
We have used this for awhile with no problems. My question is if this illegal or improper? Must one buy the higher priced Botox from the Allergan rep in this country by law? Where does one find out this information? Obviously, the rep says its legal.
Thank you.
Greetings to All,
Everyday thousands of prescription medicine packages cross into the USA from Canada. These packages get inspected by US Customs and FDA, yet they continue on their course to their respective customers in various states across the USA. The US government knows its citizens are getting taken by "Big Pharma".
If individuals can import for personal use, why can't an MD??
Even if the product is manufactured in the same FDA approved facility.
Have a peaceful day.
And so.. the question remains.... is it illegal for an md to purchase/import Botox or fillers from Canada???
It seems we still don't have an answer for this concern.
Perhaps we should have a site that ACTUALLY gets an answer to some of these concerns instead of having US simply discuss.
Anyone, other than someone with an IDEA, that has FACTS and could shed some light would be greatly appreciated. I do share the resentment that Big Pharma has stolen the Intellectual Capital from Physicians and continue to exploit American citizens and physicians alike.
Cheap drugs from Canada,
My understanding is it is a grey area. It is not aproved by the FDA etc. Obviously the company does not want to loose profit. If you buy it up here and use it down there the company would do their best to stop you. Allergan.ca will not sell to you, you would have to buy from an internet site and that could be fraught with problems - where the drugs were sourced?
The FDA would only know if there was a problem and therin lies the problem. If there was an issue that however unlikely could be linked to using an FDA unaproved product there would be a queue of Lawyers waiting to rip you apart. Certainly the company would sell you to the wolves unless it suited them. Your malpractice insurer would take the oppotunity to drop you like a brick and probably give you a shove for good measure.
The difference between patients buying meds for themselves and us buying them for them or using on them is if they do it - it is their fault. If we do it it will always be our fault however irational. The law is an ass, most politicians are lawyers and big pharma provides a lot of sponsorship. What more do you need to know??
David
seems like lots of docs are looking for reliable source for botox...our clinic orders botox from a compounding pharmacy in Canada.
we haven't had any problems...botox is same quality as here...but i think they source it from Ireland and the UK. They can give you a discount on your first order i think (we did). also, they are other pharmacies too...make sure they are licensed though...and make sure they are a Canadian online pharmacy...easy to track in case of problems.
It is illegal to buy re-imported Botox. meaning if the Botox was inthe US left and then came back in.
Ok......there is so much misinformation in this blog I can't stand it anymore. Here are the FACTS on Botox you first need to understand. Botox as you know is manufactured by Allergan.......what you may not know is 100% of all Botox produced by Allergan is produced in Dublin Ireland. It does not matter whether you buy it in the U.S., in Europe, Asia or Iceland......it all comes from the exact same place. Secondly, understand the FDA approved this drug (NDC #00023-1145-01) as long as it is produced by Allergan and is packaged by Allergan.
Is it legal to buy Botox from Canada? Yes, as long as it is the EXACT same product and is produced by Allergan.
Given it is produced in the U.S., distributed usually by distributors in Europe to Canada, and then delivered to the U.S. it violates NO transportation laws because it never was in the U.S. to begin with (because it started in Ireland, went to Europe or Canada or both, and then to the U.S.).
Allergan U.S. reps will do a war path drum beat about Botox coming from Canada not having an NDC#; this is false, the reason is an NDC # is assigned to the drug, NOT THE DISTRIBUTION CHANNEL. I have had attorneys look at all this so don't believe the U.S. Allergan reps......is nice to see their party is about over big time with new FDA approved equivalents coming on the market as I write. Couldn't happen to a bunch of nicer thieves......the disparity in pricing is usurous.
And answer for Ashley Med Group question........No it is not legal as you describe it (Botox was in U.S., left the U.S. and came back in)...that would violate Transportation/Trade laws. But if it was never in the U.S. to begin with, and comes in (i.e. Botox bought from Canada) it is ok for all the reasons I mentioned in my previous blog.
Do you have something form the FDA that says it is legal to sell it and a Letter form the FDA that says it legal for DR's to buy it. If so please post. That is the Question
Tom, could you please provide the name and location of the law firm (and maybe even the name of the attorney) you had look into this for you? We are definitely interested in purchasing Botox from Canada and saving some $$$, but we would like to get a written legal opinion from an American law firm stating that doing so would not violate any laws. The attorney that looked into it for you would obviously already be well-versed in all of the issues surrounding this subject, so it would be great to talk to/hire him or her directly.
Thanks!
anyone got the legal firms name and number to give us for that legal opion
RA...can you give the number for your rep who sells it at 475...we are paying 525 through Allergan direct. Thanks
we are purchasing it from the direct Allergan number here in California for 525....any place here in the US for a lesser price?
Botox in Canada costs Canadian physicians and pharmacists about $350 per 100 u. Supposedly the reason is that the Canadian health authorities negotiate the price with Allergan and the price is kept low for those who use it through the Canadian Health service. This of course is for Botox therapeutic, but the same price applies for Cosmetic, which is not provided by Canadian health insurance. Allergan closely guards its Botox and makes any physician who obtains it from them sign a covenant not to sell or administer it outside of Canada. That doesn't mean everyone complies, but that is what the company tries to enforce.
You can however find it at the Canadian price through a source that is certified by Pharmacy Checker, a reputable organization that legitimizes Canadian pharmacies which sell to Americans. Google Botox and you will likely find it.
To each their own but I have heard that this is illegal. It's very tempting but I had an attorney look into it and was told that unless the Canadian company who you are buying it from has FDA approval, it's illegal.
I work for a Canadian company for about 5 years and we sale Botox allover the USA. So I do not think this could be
illegal.
Tuesday I will find out if my company is FDA approved maybe this is the difference as AMS is saying.
If you are looking for a better price please email me I can get a better price for anyone interested.
OK SO CAN I AND EVERY OTHER US COSMETIC DOC BUY BOTOX AND RESTYLANE FROM CANADA AND NOT GO TO JAIL? PLEASE JUST ANSWER YES OR NO????
@dm Please don't go all caps on us.
Here's your answer: No, unless you trip and jab the needle in an eyeball.
The simple truth here is that Allergan and others have a lot to lose if laser clinics and plastics start ordering their Botox wholesale from Canada. I'd never trust any Allergan or other rep to give me the truth on this. The comment about 'Allergan coming in and closing your practice' above is a taste of how ignorant some of these reps are. I would certainly never tell my Allergan rep where I was buying Botox no matter where it was.
If you're buying Botox from Cananda you're going to be saving a LOT of money, but as with anything medical, there's possible issues. As I see it the issue is not 'legal' and it's ridiculous to think that you're going to go to jail. The problem would arise if there was some issue with the treatment and you ended up in a malpractice suit. Your malpractice may not cover it and the prosecuting lawyer would certainly bring it up, painting you as a 'cost-cutting' doc that doesn't care about your patients.
I for one have ordered Botox from this site and been ecstatic about both the service and the cost. I will continue to to do so. That's not an indication of poor care on my part. (It's the same damn Botox!) It's just that I've weighed the costs and concerns and decided that for the treatment of my patients this fills the need better than any other solution I can find.
This site, Medical Spa MD, has been around for years. It has a thriving, active community. There are many discussions and connections on it that I've participated in and, above all, it passes the 'sniff test'. If we were discussing importing Botox from Turkey or somewhere else I would feel very differently.
The ability to go onto the MedicalSpaRX.com site and participate in a 'Group Buy' makes even more sense and is now our default method of ordering.
I can see everyone's point. But for my patients and my clinics, it's the best choice for us.
Oh, and here's the link to Medical Spa RX: Botox. Please put a bunch of orders in under the Group Buy so I can get my Botox sooner.
yes I will join in on that when my supplies deplete... probably late january.
for now, I need RESTYLANE! so if anyone else is in my position, please go to seattlemedical.net, my rep: Vince, told me that they can do a group option for their Q-MED products until DEC 31. They will ship when there are enough orders
e-mail them through the site, tell them that this is prat of A.DiGiulio's (Michigan) group
Does anyone work with the group QP Medical? They have great prices and have been very good to work with. They say they are liscensed and even faxed a copy of the liscense. But does this make it so? Does anyone have any documentation stating we are not doing anything illegal when purchasing from the UK or Canada. The Allergan rep has been concerned regarding our decline in sales. Can they get us in trouble? Any help is appreciated. Thanks
The big deal is that these products are not FDA approved to be used in the USA. They may be the same product, but the fact that they are not FDA approved should be cause for thought.
I represent a UK pharmacy that sells cosmetic injectables and dermal fillers. We are registered with the US FDA and I could provide US FDA registration if requested. We are one of the ONLY foreign pharmacies with US FDA registration.
Botox is $325 for 100 unit vial and we purchase directly from the manufacturers' respective distributors in the UK. All products have proper serial numbers. If you are interested in seeing a full price list, please contact Julie 646.450.0888.
I represent a UK pharmacy that sells cosmetic injectables and dermal fillers. We are registered with the US FDA and I could provide US FDA registration if requested. We are one of the ONLY foreign pharmacies with US FDA registration.
Botox is $325 for 100 unit vial and we purchase directly from the manufacturers' respective distributors in the UK. All products have proper serial numbers. If you are interested in seeing a full price list, please contact Julie 646.450.0888 or email CosmeticsRX@gmail.com
There seems to be a lot of confusion here about what is legal and how do I avoid losing my license and avoid lawsuits. Why don't you buy through normal channels and sleep better at night?
How much does this equate per visit with FOREIGN STUFF?
DOES US CUSTOMS consider this to be SMUGGLING? You use it for humans and it is labeled for VETERINARY USE.
I have no idea what it means for a pharmacy in another country to be REGISTERED with FDA. DO YOU? Registered for what? To do WHAT? THAT DOES NOT SOUND RIGHT TO ME. They are not manufacturing the stuff so why do they have to be registered as Pharmacies? if they were manufacturers that is a different story.
Your biggest problem is ETHICS. You can lose your license for being "unethical" by AVOIDING ANY US LAWS. ONE LAWSUIT COSTS A LOT MORE THAN ALL THE VIALS YOU USED FOR A FEW YEARS PLUS THE IMPACT ON YOUR PRACTICE IN YOUR COMMUNITY as it will certainly get in your local papers.. DO YOU REALLY THINK IT"S WORTH IT? That is being SHORT SIGHTED. YOUR rep knows more about your purchases than you know and he is losing COMMISSIONS. IT'S ALL ABOUT MONEY NOT QUALITY AND YOU KNOW IT.
HAVE A FEW DOCS GET TOGETHER AND BUY IT DIRECTLY FROM ALLERGAN AS A LARGE ORDER. I'm SURE ALL YOUR BUDDIES WOULD LIKE TO SAVE A FEW BUCKS. TAKE TURNS MAKING THE PURCHASE. THE ONLY PROBLEM IS YOU WILL BE REVEALING HOW MUCH YOU USE TO YOUR COLLEAGUES.. IT MAY BE POSSIBLE TO HAVE IT DROP SHIPPED DIRECTLY TO EACH DOC WITH ONLY ONE PURCHASE ORDER SO EVERYBOY WILL BE HAPPY.
THE PROBLEM IS ALLERGAN AND OTHER COMPANIES. THEIR PRICING STRUCTURE STINKS. THERE IS NOTHING WRONG WITH USING A LEGIT PRODUCT AND MAKING A FEW BUCKS BUT THEY ARE TRYING TO SQUEEZE AS MUCH OUT OF YOU AS POSSIBLE AND THAT IS WHAT IS CAUSING THE PROBLEM.
HOW ABOUT SHOWING YOUR REP: INVOICES OF WHAT YOU BUY IN 6 MONTHS. and asking him for SAMPLES TO EQUAL THE DOLLAR VALUE OF THE DIIFFERENCE IN PRICE SO THAT YOU COULD BUY IT FROM HIM... THAT WILL KEEP EVERYBODY HAPPY. ESPECIALLY YOU. SQUEEZE HIM.
Charge PATIENTS a little more or FORGET IT. Patients have no idea as to how many CCs WILL BE USED. THEY ARE THERE AND THEY ARE COMMITTED TO THE PROCEDURE. What surprises me is how crazy these broads are alout a little wrinkle. Over the years they will spend as much as a FACE LIFT. Go to the bank and get a loan. It will be cheaper in the end.
Has anyone purchased from Julie at cosmeticsrx@gmail.com? Do have other good sources for botox? It can be found from most Canadian pharmacies for about $325 per 100 IU's, but I would prefer to buy from a distributor that is registered with the FDA.
All responses are appreciated!