A Doctor's Experience Buying dapagliflozin (Farxiga) From An International Mail Order Pharmacy

Written by Lucia Mueller | Posted November 01, 2023

Dr. Berge Markarian, a retired Floridian OBGYN, is sick of high drug prices in the United States. His solution? PharmacyChecker-accredited international online pharmacies and GoodRx coupons. 

One of his prescribed medications, called dapagliflozin, is used globally for the treatment of type 2 diabetes. In the United States, dapagliflozin is marketed under the brand name Farxiga and does not appear to have generic availability until October 2025. It's been known as an expensive maintenance drug for years. In fact, Farxiga's cost is so out of hand that it has made the short list of drugs on which Medicare will be negotiating prices this coming year, with relief set for 2026. 

Things look a bit different abroad: First of all, dapagliflozin is marketed in other countries, including Japan and the UK, under the name Forxiga. A slight spelling difference, but one that could cause concern should an American choose to order from a UK pharmacy without appreciating the international branding choices. Additionally, unlike in the U.S., the generic is approved and available elsewhere: the European Medicines Agency granted marketing authorization for the generic Dapagliflozin Viatris (dapagliflozin) as therapeutically equivalent to Forxiga (dapagliflozin) in March 2023, and Health Canada approved generic alternatives in May 2023. Finally, we have perhaps the most glaring contrast: price. 

PharmacyChecker recently asked Dr. Markarian a few questions about his prescription drug savings choices, particularly his experience ordering prescription drugs internationally. 

PharmacyChecker: Where do you live and what do you do for work?

Markarian: I am a 96-year-old retired MD, living in Florida.

When did you realize your medication costs were so high?

I’ve never had to decide between bills or medication,  but I realized about 4 years ago that my medication costs were very high. 

Which medication do you order from abroad?

I’ve been buying my dapagliflozin 10mg (90 tablets) for $35.00 online from a PharmacyChecker-accredited international online pharmacy for a year now. I am very satisfied with the prompt delivery – and the drug has improved my symptoms. 

How much did you ultimately save?

I paid $35.00 as opposed to $1,600.00.

PharmacyChecker compared costs for Farxiga in the U.S. and its marketed brand counterpart, Forxiga, and the generic dapagliflozin across online pharmacies located in other countries that ship internationally.

Farxiga (dapagliflozin) International Cost Comparison

10mg, 90 tablets

Average Price of brand Farxiga at US Pharmacies  $1,964.97
Generic dapagliflozin in the US Currently not available.
Medicare Spending in 2021 $1,637.10
Walmart with GoodRX Coupon  $1,639.00
An Independent US Pharmacy with a US coupon on PharmacyChecker.com $1,635.28
A Canadian Mail Order Pharmacy Accredited through the PharmacyChecker Verification Program $334.40
A British Online Pharmacy Accredited through PharmacyChecker Verification Program $238.92
An Indian Online Pharmacy Accredited through the PharmacyChecker Verification Program $61.20
Generic dapagliflozin from a Canadian Online Pharmacy Accredited through the PharmacyChecker Verification Program $99.95
Generic dapagliflozin from an Indian Online Pharmacy Accredited through the PharmacyChecker Verification Program $37.99

Prices collected Oct 2023

What other methods have you used to save on your prescription bill? 

GoodRx. I also buy my dofetilide (180 capsules) for $30 from an online pharmacy located in Kentucky.

How did you feel about ordering medication internationally?

I read online about PharmacyChecker’s verification program. I felt good about ordering internationally. 

How long did it take to receive your medication(s)?

My medication arrived within two weeks. The accredited pharmacy I use is very responsive and customer-oriented. 

From which country was your medication dispensed?

They came from India.

How was the medication(s) packaged?

They were packaged well.

Do you recommend ordering internationally?

I recommend ordering internationally. I’m very grateful to find out about PharmacyChecker and I recommend it to friends frequently. 

Berge Markarian, MD, graduated from the University of Istanbul, Faculty of Medicine in 1952. He served in the Turkish Allied Army during the Korean War. He had his own private practice as a doctor of obstetrics and gynecology in Hialeah, Florida from 1960 to 1990 and served on the Board of Directors of Palmetto General Hospital in Hialeah, Florida from 1977 to 2004. He is an advocate for lower drug prices in the United States.

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All medications should be available internationally. I hope this happens very soon. Big Pharma is as evil as any other criminal entities. No different than the drug cartels. They are a cartel.
How can a patient get an American Doctor to write manual prescriptions to send to overseas pharmacies to buy reasonably priced drugs?
If a medication requires a prescription in the country in which you reside, you must present a valid prescription from a prescriber in that country to your chosen accredited online pharmacy. The PharmacyChecker Verification Program enforces prescription requirements to ensure consumers’ safety when shopping for affordable medication online.

If you live in the United States, you should speaker with your doctor about your plans to use an overseas pharmacy and what that requires. You or your doctor will send your prescription to your chosen pharmacy based on the pharmacy's instructions (typically via fax or email). We require pharmacy websites, verified and monitored by PharmacyChecker, to ensure that patients have access to a pharmacist for consultation and require that they clearly publish an active telephone number and valid mailing address on their website. Most verified pharmacy websites have a “Contact Us” page, which also typically includes their business hours. Some pharmacies also have a “Live Chat” option allowing you to ask questions while on the pharmacy’s website.
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