My Experience Buying Inhalers Internationally

Written by Sue M., RN | Posted May 01, 2023 | Updated May 02, 2023

After over 30 years as a pediatric nurse, I decided to retire 18 months ago. Given my long career, I thought I knew my way around insurance and how to manage prescription costs. It was only when I began getting my health care and medications through Medicare that I realized I knew very little.

Mine is a single-person household and I have had to be frugal since my divorce many years ago. Living in a rural area means jobs are few and don’t pay as much as in urban areas. In the spring of 2021, I was admitted to the hospital with a sudden eosinophilia asthma attack while mowing my lawn, and I decided to retire when my employer called everyone back to the office while COVID-19 was still very active in our area. With lung disease, working in a college environment, in close contact with multiple employees, was just too much risk.

Upon retiring, I picked the most comprehensive Part D insurance, along with standard Medicare and a supplemental policy, checking to make sure my two inhalers, Spiriva Respimat and Symbicort, were in the formulary. I was also taking other generic medications for asthma and other conditions. With employer insurance, the inhalers were affordable with an option to purchase a three-month supply with the same co-pay as a one-month supply. It never occurred to me that this would be different with Medicare. A lot of things didn’t occur to me, but I was soon to discover I couldn’t afford my medications using a Medicare plan.

My monthly cost for insurance was around $81 and my inhalers alone were over $175. By month five, I was in the donut hole with inhaler costs increasing by nearly $100 each. I began calculating the annual cost of Part D and my two inhalers and I was absolutely shocked to find it was over $3000! I was already purchasing generic meds out of pocket to avoid going into the donut hole at month four: the out-of-pocket at a mail-order pharmacy cost less than getting them through my Part D plan. With my new, much lower income, I knew I had to do something different or I wouldn’t be able to pay for either my medications or my basic daily needs. I heard about ordering from Canada through co-workers and friends who had relatives that ordered their medications from out-of-country pharmacies.

Before renewing for my second year of Medicare, I did some serious research. I realized how Part D worked and how medication costs were calculated for all policies, and knew I had to do something different. I researched Canadian pharmacies and found a “safe list” of vetted pharmacies on and compared the costs of those listed. I was also fortunate enough to qualify for free medication through the drug manufacturer of one of my inhalers, but still couldn’t afford the cost of the Spiriva inhaler, my generic medications, and the expensive Part D plan.

During the renewal period, I chose the least expensive plan that would cover my generic medications for less than I was paying out of pocket, without a deductible. It had a large deductible for anything other than basic generics and didn’t cover any of my inhalers. But it was only about $60 per year, and generic drugs averaged $2.00 each per month. I found that I could purchase a 90-day supply of the Spiriva inhaler at about half the cost of my expensive Part D plan plus the cost of the inhaler. The new plan, including my generics and purchasing Spiriva Respimat from Canada, saves me over $1500 per year!

I was leery at first, so I ordered my first 3-month supply of inhalers before the renewal policy period was in effect. The ordering process was so easy and my doctor had no problem sending the prescription to the Canadian pharmacy. My order arrived in about 8 days and, though the packaging was slightly smaller, the product was exactly the same as those I had purchased in the U.S. I immediately started using the new supply from Canada and found no difference in how the medication worked. I was thrilled! I now order regularly from the Canadian pharmacy and have no concerns or regrets about making this change. I would strongly recommend looking into this option for anyone paying high out-of-pocket costs!

The cost of medications for seniors in the United States is criminal. I regularly participate in activities that advocate for lower drug prices and have written my representatives, begging them to take action. Too many seniors can’t pay for their much-needed drugs and don’t have the ability to search the internet or otherwise discover ways to save money. I would love to help others find answers to this problem and will continue to do what I can to share this knowledge.

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