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So why exactly does the US get screwed on Surpass?

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  • So why exactly does the US get screwed on Surpass?

    A 100 gram tube in Ensenada, Mexico last week: $20, and that's over the counter; I had my dad buy me seven. I paid AED 31 for a 50 gram tube the week before in Dubai, which is about $8, so I bought seven there. Again over the counter. Called Voltaren in Dubai, Mexico, Canada and many other places, Voltarol where I buy it in the UK and Holland, all OTC. So what is the feeble excuse they come up with for it not being OTC here?
  • Original Poster

    And, yes, it is the same strength everywhere. Same color on the box, same font, etc. Except for the Arabic, of course.


    • #3
      Good question. I stocked up on Voltarol at Boots when I was in England a few weeks ago. However, I've been meaning to check the strength and haven't got round to it, because I noticed they had a prescription strength as well as an OTC version available. (I had elderly dad in tow who thinks it's a bit odd I do things like this so wasn't able to do as much investigating as I would have liked at the time.)

      I'm about to go rub some into my own neck. Who knew you could cause so much pain pulling a shirt on awkwardly?


      • Original Poster

        It is a godsend for the arthritis in my feet. I love this stuff. So does Oliver if he's ever got a bit of the puffy going on lol.


        • #5
          The short answer is that for Voltaren, it most likely hasn't even been approved long enough in the US to be considered for an Rx to OTC switch. According to the FDA website, Voltaren gel (diclofenac sodium 1% topical gel) for pain relief for osteoarthritis was approved in 2007.

          Switching a drug from Rx to OTC in the US is a pretty complicated regulatory process. We have a very different regulatory environment than other countries where drugs that treat actual conditions/diseases rather than just symptoms are readily available OTC.

          Some info on the process:


          The FDA weighs a drug's safety against its benefit to patients. The agency considers whether consumers will be able to understand and follow label directions, whether patients can diagnose the condition themselves--or at least recognize the symptoms they want to treat--and whether routine medical examinations or laboratory tests are required for continued safe use of a drug.

          This is a really good article discussing the pros and cons of switching a drug from Rx to OTC.


          I find this statement sad, and it backs up why FDA has the process they do--essentially they must protect us from ourselves:

          According to the National Council on Patient Information, some Americans have incomplete knowledge about OTC medicines and may take too much of a single product or mix drugs inappropriately. Despite widespread use, consumer polls show that only 34 percent of the public could correctly identify the active ingredient—or the therapeutic substance—in their brand of pain reliever.
          Last edited by Leather; Jan. 3, 2011, 01:52 AM.


          • #6
            I have my 2 tubes from Italy that I am nursing along ever so slowly, love this stuff, but not enough to get a doctors prescription and pay my copay for Yeah for friends traveling overseas!


            • #7
              Don't you have Tensolvet gel over there (highdose tooical heparin gel, has been around forever in Europe but I've never heard of anybody using it in N.A.)? Not that it is OTC but it works so much better than Diclofenac. Besides quite a lot of horses react allergic to diclofenac over here. It isn't approved for equine use in Europe and I don't know any colleagues who would routinely use it even if it was legal.
              It is funny how some drugs are so widely used over here and totally unknown in N.A. especially when so many other things are launched on your end first and only get here after ages (e.g. omeprazole/Gastroguard or Strangles vaccine...)
              Froh zu sein bedarf es wenig...


              • #8
                it's not just surpass

                prices of regular human meds vary country to country (i mean retail, not considering insurance). i can't think of an example off the top of my head but my dad repeatedly stuns us with price differences between here and poland. i know some of it is related to the negotiations between the governments and the pharma companies. given that time and time again we pay higher prices here, someone is certainly not looking out for our best interest...
                TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


                • #9
                  It's the same on all meds.

                  I remember paying something like $65 for 30 caps of Nitrofurantoin some time ago. I travelled home and forget the antibiotics, so had to get some there (Europe), and paid 2 Euros for a 50 capsule pack!

                  It's the way the systems runs in the US I guess. Why is health insurance in the US so much more expensive then in other countries, even when people take out private non-government schemes overseas. Same question, I'm assuming similar answer. Perhaps it goes to research, who knows.

                  But than on the other hand supplements in the US are way cheaper than in Europe.

                  Originally posted by Kareen
                  It is funny how some drugs are so widely used over here and totally unknown in N.A.
                  Yeah, I miss Sputolysin (a mucolytic), my horse did very well on that when needed; at times of RAO flare-ups, it would sort him straight out. Sputolysin has been used for years in Europe and OTC, impossible to get in the US not even on prescription, nor anything else remotely similar available
                  Last edited by Lieslot; Jan. 3, 2011, 07:24 AM. Reason: added


                  • #10
                    I think the potential for lawsuits, whether actual harm has been caused by a product or not, account for some of the price differences. Pharmaceutical companies and other health care product companies (in the U.S.) pay exorbitant liability premiums and that cost gets passed on to the consumers.

                    Virtually every aspect of healthcare in the U.S. is much more expensive due to these premiums as well. Our health care crises will never be resolved until the insurance companies modus operandi is reformed.

                    Flame suit donned.


                    • #11
                      LOL, sure Addison, if you want to greatly simplify a very complex issue and try to ascribe 100% of the cost issue to what might be 10% of the problem according to SMRT people on all sides of the issue. Absolutely it could be that simple.
                      Your crazy is showing. You might want to tuck that back in.


                      • #12
                        Seriously DMK?

                        Not quite what I said or suggested.

                        The "100%" and "simple " bit is yours.


                        • #13
                          Originally posted by Addison View Post
                          Virtually every aspect of healthcare in the U.S. is much more expensive due to these premiums as well.
                          well OK, not 100%, just virtually every aspect. My apologies.

                          Seriously, malpractice suits are a small part of costs. Behavior modification as a result of malpractice is another component to be sure. But they are in no way even a substantial chunk of the cost variables that set us apart from other nations, nor are they a significant part of our medical inflation, just a part of it. If you could magically make the malpractice insurance problem disappear, and project yourself 5 years in the future, it's doubtful costs would have shifted much. LOL not to mention that doesn't have too much to do with the "insurance companies modus operandi" unless you mean malpractice carriers (which doesn't make too much sense in context).
                          Your crazy is showing. You might want to tuck that back in.


                          • #14
                            Because the politicians are in the pockets of big pharma and the healthcare industry. And until we change our funding of political campaigns and the power wielded by lobbyists, nothing will change.


                            • #15
                              Again, I never said 100% or virtually all health care costs may be attributed to insurance problems.

                              Those are your words, not mine.

                              The OP asked why certain drugs were much cheaper in Europe and I gave a suggestion.

                              The sand box is all yours.


                              • #16
                                Originally posted by Addison View Post
                                Again, I never said 100% or virtually all health care costs may be attributed to insurance problems.

                                Those are your words, not mine.
                                LOL, well those aren't my words either, so we can just leave it at that.
                                Your crazy is showing. You might want to tuck that back in.


                                • #17
                                  I agree prices for pharmaceuticals are an absolute joke. For instance why is Equimaxx sold for as little as $8.99 US (OTC, retail!) by Pfizer (if I am not mistaken) per doser while it cost me €16.60 (net!) from Virbac to buy as a veterinarian overhere??? Mind you I wouldn't be allowed to import the stuff for less from anywhere outside Germany, not even the Netherlands because I am a vet.
                                  Absolutely ridiculous... Sorry for hijacking I could just go ballistic over this BS we're exposed to sometimes
                                  Froh zu sein bedarf es wenig...


                                  • Original Poster

                                    Originally posted by mypaintwattie View Post
                                    I have my 2 tubes from Italy that I am nursing along ever so slowly, love this stuff, but not enough to get a doctors prescription and pay my copay for Yeah for friends traveling overseas!
                                    Much to be said for friends with a big stash too. Convenient when your horse is in the stall next to mine LOL.


                                    • #19
                                      And to think I got ticked because the Voltaren went from $8.95ish for 100g to $7.90 for 50g in one jump. Double the cost because I guess it's popular. Before discovering this, my vet charged me $120 for 100g of Surpass. I thank the fine people of COTH for enlightening me about Voltaren.

                                      No idea why certain things are priced the way they are. I know I got so ticked when I found out my buddy in PA is paying $40 for the same size Banamine that I'm being charged $110-$120 for. Wormers... we won't even go there. Pneumabort? You guys pay about a quarter of what we do. And on it goes.

                                      No idea why there is such a difference with so many things. I guess it comes down to who has their hand in who's pocket.
                                      Sometimes I just think funny things - Dudley Moore in Arthur
                                      Come join us at - TheMuckBucket


                                      • #20
                                        Just found (through a bing search) an on-line Canadian pharmacy that has the OTC Voltaren for $11.95/100ml.
                                        What you allow is what will continue.