6 ms·

Seeing that US patients pay 20x for Lipitor as New Zealand is a pretty troubling stat. Even though it's clearly optimized for shock value, paying $124/unit can

by kunle 13y ago

Seeing that US patients pay 20x for Lipitor as New Zealand is a pretty troubling stat. Even though it's clearly optimized for shock value, paying $124/unit can mean a patient is choosing between solvency and health. Pretty sad.

hga 13y ago
Echoing the comment that w1ntermute's made after your's, Lipitor/atorvastatin wouldn't freaking exist as a drug without the system where it costs so much in the US during the period of patent protection. According to Wikipedia, it was first synthesized in 1985 and approved by the FDA in 1996; that period is well into the "you won't recover your drug development money without the US market" phase. But don't worry, if the usual suspects are successful, we'll all be paying peanuts for drugs in due course. Pity there will be no effective antibiotics against many resistant drug bacteria strains.... (The thing that really gets me is how many of these advocates for an end of medical innovation as an inevitable outcome of their nostrums will find their own lives cut short in due course due to it. Ideology trumps self-preservation.)
- samstave 13y ago
  Seems like we need a nationalized method for finding drugs, a DARPA for pharma that spends some of the trillions from defense weaponry on defense of national health.
  - hga 13y ago
    Making the process even more political is going to improve it???
    - tstactplsignore 13y ago
      Radical American conservative propaganda aside ("The government can't do anything right!"), actually, creating a nationalized pharma research and development program is an interesting idea definitely worth considering. The public sector has shown itself to be very capable of scientific innovation (see NASA, NIH, NOAA, the Internet, the Manhattan project), and even if several tens of billions were invested in the program, it would probably even become a net positive for the government if discoveries are licensed and sold at highly reasonable prices, both giving the program direct income and reducing national healthcare spending. And, of course, the agency would be able to focus on drugs which aren't the "Take 10 pills for the rest of your life while we bill you" kind. At the very least, there needs to be better regulation of big pharma practices and prices in the US. Unfortunately, due to the lobbying power of the industry, I doubt we'd see any real solution anytime soon.
      - twoodfin 13y ago
        Why regulate? If the pill doesn't do what you want for a price you find a reasonable, don't buy it.
- brazzy 13y ago
  You're parroting industry propaganda with no basis in fact whatsoever. I pity you for being so deeply invested in an ideology that trumps self-preservation.
  - bob13579 13y ago
    Are you implying that pharmaceutical companies would happily invest billions into a drug without patent protection?
    - brazzy 13y ago
      No, I'm implying that the insane price markups seen in the USA mainly fund insane profit margins and marketing budgets, not research. As for patent protection: something needs to change there as well, because too damn much of the research budget goes into drugs that are no improvement over existing ones, purely to take market share from a competitor or replace drugs whose patent protection is running out. source (look at the 10th and 11th paragraph): http://www.nybooks.com/articles/archives/2004/jul/15/the-truth-about-the-drug-companies/?pagination=false http://www.nybooks.com/articles/archives/2004/jul/15/the-tru...
- pessimizer 13y ago
  Lipitor is a single terrible drug from a pointless class of drugs that actually increase average mortality in people who take them. High cholesterol is associated with higher risk of heart attacks, but lowering cholesterol isn't associated with a lowering of heart attack risk. In addition, the side effects are vile and costs are high. The most depressing thing about the modern pharmaceutical industry is that its two biggest cash cows, statins and the modern new-school psychotropics, have very little evidence that they actually help anyone, and involve lobbying budgets the size of small nation's GDPs to keep the gravy train going.
  - hga 13y ago
    You could be right about statins, although I gather for some they appear to be a good idea. My doctors are pushing them on me, I'm firing the doctors sequentially hoping to get one who will listen (e.g. absolutely no cardiovascular disease in a long lived family) ... the major argument for their being first line treatment is that nothing less works in practice (e.g. "get more exercise). However that doesn't change the principle WRT to drug development today. What "modern new-school psychotropics" are you referring to? That's a field I know a fair amount about, and I don't see the problem you're citing at all (which is not to say some aren't over-prescribed, but I believe that is a different problem). I would probably be very ill or dead without one (low dose, off label Seroquel to treat anxiety which I have a family disposition towards; it's the difference between 4 and 7 hours of sleep a night, bright light treatment gets me the final extra hour I need). It and the other atypical anti-psychotics seem to be a lot better than the older "typical" ones, and those were miracle drugs, something witnessed by my mother when she was a nurse. Similarly, the current Prozac and beyond anti-depressants are maybe not quite as effective as the previous tricyclics but their side effect profiles are a whole lot better, e.g. making it more likely a patient will wait those out long enough for the therapeutic effect to begin, and I personally benefit from a laser specific SSRI (doesn't touch anything else), since "wrong" anti-depressants can make me manic.
    - robbiep 13y ago
      If you're taking seroquel that is probably a good reason to be on a statin given the current medical evidence as you have an increased risk of metabolic syndrome due to being on an antipsychotic.
twoodfin 13y ago
The uninsured patient, maybe. If you ran the math on the average marginal cost to the consumer for atorvastatin (Lipitor), I'd imagine it would be much, much lower. For one thing, the patent has expired and Lipitor now has substitutable generics available. Even before that, consumer co-pay for brand-name drugs is rarely more than $50 (usually much lower), and that gets whittled down further as you can convince your doctor to write a larger prescription. It's also tax deductible if you set up your HSA or FSA appropriately.
ams6110 13y ago
Lipitor is one of those drugs that is marketed to people who want to continue their diet of sugar and junk food and not have to worry about cholesterol. Lipitor itself has some really alarming side effects and it's definitely NOT something you want to be taking if you can deal with your cholesterol by making some simple behavioral changes.
- carbocation 13y ago
  Statins are quite safe and have decades of postmarketing data demonstrating this. This is not the class of drugs that deserves scary language. If you have a particular concern about statins, you should state it precisely.
  - ams6110 13y ago
    Liver damage, diabetes, memory loss, muscle problems.... http://www.mayoclinic.com/health/statin-side-effects/MY00205 http://www.mayoclinic.com/health/statin-side-effects/MY00205 Clearly the medical community has decided that the benefits outweigh the risks for most people, i.e. lower cholesterol. However while statins are shown to lower blood cholesterol, benefits in terms of reduced heart disease are not necessarily clear, especially in people with no other history of heart disease. A recent study found that "Statin use is associated with an increased prevalence and extent of coronary plaques" http://www.ncbi.nlm.nih.gov/pubmed/22981406 http://www.ncbi.nlm.nih.gov/pubmed/22981406 There is even disagreement that cholesterol levels alone are really predictive of heart disease: http://www.minnpost.com/second-opinion/2012/05/latest-thinking-controversial-statins-cholesterol-and-heart-disease-risk http://www.minnpost.com/second-opinion/2012/05/latest-thinki... No silver bullets....
    - carbocation 13y ago
      > However while statins are shown to lower blood cholesterol, benefits in terms of reduced heart disease are not necessarily clear, especially in people with no other history of heart disease. That's simply not a balanced summary of the literature. On balance, statins reduce both secondary events (heart attacks after your first one) and primary events (first-ever heart attacks). Even conservative groups such as Cochrane agree that, based on the scientific literature, statins are both efficacious and cost-effective for primary prevention [1]. Also, trying to throw away the cholesterol/heart-disease hypothesis is sort of like trying to throw away evolution. If you're right, that's Nobel worthy; but you're not right. > A recent study found that "Statin use is associated with an increased prevalence and extent of coronary plaques" That's not clear from the article you've cited, despite quoting a part of the abstract. You have left off an important qualifier that ends the sentence. Here is that full sentence, emphasis mine: "Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium." The abstract does not state that statin use is associated with an increased prevalence and extent of coronary plaques overall. (I don't have access to the rest of that article from my hotel room, so if the article itself does state so, please feel free to quote it in reply.) Also, this appears to be, effectively, a case/control study. The studies supporting statins are randomized, controlled trials -- the strongest form of evidence. Case/control studies suggest follow-ups, but are by no means equivalent to studies of highest-grade evidence. 1 = http://summaries.cochrane.org/CD004816/statins-for-the-primary-prevention-of-cardiovascular-disease http://summaries.cochrane.org/CD004816/statins-for-the-prima...
Alex3917 13y ago
Anyone who take lipitor is a moron in the first place: - It has zero to negative efficacy, at least for the for the vast majority of people taking it, and virtually no efficacy for the rest. - You can get generics that are equally 'effective' for virtually free. - It's vastly less effective than even the most minimal of lifestyle interventions. - If for some reason you really wanted to take those chemicals, you could just get them for free in your diet anyway. E.g. from red rice and I think certain other fungi.
- montecarl 13y ago
  s/moron/ignorant/
  - Alex3917 13y ago
    IMHO ignorant is what you are if you don't know about the risks and benefits of a certain drug, and a moron is what you are if you take that drug anyway. But I'll accept that I may be less charitable than most in this area. (Though then again if eating random stuff that could potentially kill you without knowing what it does doesn't make one dumb, then what exactly does?) Now granted none of us would be here if our ancestors weren't willing to eat random crap in the woods and risk dying, and there's certainly a need for us to do the same to benefit future generations, but if the work has already been done for you on a given substance then there's really no excuse not to do the research.
- thundara 13y ago
  So much wat. > - It has zero to negative efficacy, at least for the for the vast majority of people taking it, and virtually no efficacy for the rest. Citations? This is a pretty big claim for a FDA-approved drug that was the most profitable drug on the market as of 2011[1]. > - You can get generics that are equally 'effective' for virtually free. As of last year, yeah, this is a fairly recent development that if you don't follow pharma, you'd be unlikely to know. > - It's vastly less effective than even the most minimal of lifestyle interventions. Generally statins are prescribed in combination with recommendations of dietary restriction. > - If for some reason you really wanted to take those chemicals, you could just get them for free in your diet anyway. E.g. from red rice and I think certain other fungi. You're thinking of a different active ingredient, monacolin K, which is also sold in pill form (Lovastatin[2]) and found in red yeast rice and oyster mushrooms. A quick literature search found Lipitor to be more efficacious[3] (Double blinded, placebo controlled, n = 1049). Keep in mind that, as with all drugs, both are dose-dependent and have unpleasant side-effects when taken in combination with certain drugs, foods, and certain patient populations, such as pregnant women and those with liver disease. Hence why it's recommended to check with a doctor who is well versed in this matter, rather than self-prescribing at unknown dosages. [1] https://en.wikipedia.org/wiki/Pharmaceutical_drug#Leading_blockbuster_drugs https://en.wikipedia.org/wiki/Pharmaceutical_drug#Leading_bl... [2] https://en.wikipedia.org/wiki/Lovastatin https://en.wikipedia.org/wiki/Lovastatin [3] https://www.ncbi.nlm.nih.gov/pubmed/9185636 https://www.ncbi.nlm.nih.gov/pubmed/9185636
toomuchtodo 13y ago
I'm 30. I make ~$120K/year. My medical insurance for myself and my wife (28) is $650/month through United Healthcare (pretax). My company picks up the other portion. We are both in good health and have few issues. This is a $2500/year deductible plan per person (so not high deductible, which was only about $100/month cheaper, but had an extremely high deductible). So, now the background is done. My mother lives in Indiana. She is disabled, but has not been approved for disability yet. And I don't mean NPR's version of disabled, I mean she is physically incapable of working due to medical issues. She is on Medicaid (Hoosiercare I believe its called). Even with Hoosiercare (state subsidized insurance), I pay for between $500-800 month for her medications. These are co-pays, not the full amount. I have even considered inventorying her medication and ordering it in bulk from Canada. If I was not lucky enough to make the salary I make, be in good health, and have somewhat affordable health insurance, there is absolutely no way my mother would be able to afford her prescriptions. She requires these prescriptions to survive. I hate living in the US, and I was born here.
- robotresearcher 13y ago
  | I hate living in the US, and I was born here. Consider moving elsewhere. Canada is close by, culturally familiar and has your health deal comfortably beat. Seriously, if you don't like it but you are paying through the nose for it (and thus helping perpetuate it), why not take your talents and labour elsewhere?
  - halostatue 13y ago
    The downside is that to make it meaningful, he’d also have to move his mother, and with her medical condition(s), it seems very unlikely she’d be granted permanent residency on that basis. I immigrated to Canada 15 years ago; I’m pretty sure that I would not be eligible to immigrate today with how the Harper Government has gamed the immigration system. :|
  - pkulak 13y ago
    Moving to another country carries considerable costs for most people. However, at some point the difference in health care costs will probably be even larger. I'm a Canadian citizen and the only thing that lets me sleep comfortably while medical costs here skyrocket is the idea that I may be able to get my family into Canada in the future if I need to. That's still not guaranteed, however. Most countries don't just let you waltz in and start working.
bob13579 13y ago
Generic Lipitor is available at Walmart for $4.

by kunle 13y ago

hga 13y ago

Echoing the comment that w1ntermute's made after your's, Lipitor/atorvastatin wouldn't freaking exist as a drug without the system where it costs so much in the US during the period of patent protection. According to Wikipedia, it was first synthesized in 1985 and approved by the FDA in 1996; that period is well into the "you won't recover your drug development money without the US market" phase. But don't worry, if the usual suspects are successful, we'll all be paying peanuts for drugs in due course. Pity there will be no effective antibiotics against many resistant drug bacteria strains.... (The thing that really gets me is how many of these advocates for an end of medical innovation as an inevitable outcome of their nostrums will find their own lives cut short in due course due to it. Ideology trumps self-preservation.)

samstave 13y ago
Seems like we need a nationalized method for finding drugs, a DARPA for pharma that spends some of the trillions from defense weaponry on defense of national health.
- hga 13y ago
  Making the process even more political is going to improve it???
  - tstactplsignore 13y ago
    Radical American conservative propaganda aside ("The government can't do anything right!"), actually, creating a nationalized pharma research and development program is an interesting idea definitely worth considering. The public sector has shown itself to be very capable of scientific innovation (see NASA, NIH, NOAA, the Internet, the Manhattan project), and even if several tens of billions were invested in the program, it would probably even become a net positive for the government if discoveries are licensed and sold at highly reasonable prices, both giving the program direct income and reducing national healthcare spending. And, of course, the agency would be able to focus on drugs which aren't the "Take 10 pills for the rest of your life while we bill you" kind. At the very least, there needs to be better regulation of big pharma practices and prices in the US. Unfortunately, due to the lobbying power of the industry, I doubt we'd see any real solution anytime soon.
    - twoodfin 13y ago
      Why regulate? If the pill doesn't do what you want for a price you find a reasonable, don't buy it.
brazzy 13y ago
You're parroting industry propaganda with no basis in fact whatsoever. I pity you for being so deeply invested in an ideology that trumps self-preservation.
- bob13579 13y ago
  Are you implying that pharmaceutical companies would happily invest billions into a drug without patent protection?
  - brazzy 13y ago
    No, I'm implying that the insane price markups seen in the USA mainly fund insane profit margins and marketing budgets, not research. As for patent protection: something needs to change there as well, because too damn much of the research budget goes into drugs that are no improvement over existing ones, purely to take market share from a competitor or replace drugs whose patent protection is running out. source (look at the 10th and 11th paragraph): http://www.nybooks.com/articles/archives/2004/jul/15/the-truth-about-the-drug-companies/?pagination=false http://www.nybooks.com/articles/archives/2004/jul/15/the-tru...
pessimizer 13y ago
Lipitor is a single terrible drug from a pointless class of drugs that actually increase average mortality in people who take them. High cholesterol is associated with higher risk of heart attacks, but lowering cholesterol isn't associated with a lowering of heart attack risk. In addition, the side effects are vile and costs are high. The most depressing thing about the modern pharmaceutical industry is that its two biggest cash cows, statins and the modern new-school psychotropics, have very little evidence that they actually help anyone, and involve lobbying budgets the size of small nation's GDPs to keep the gravy train going.
- hga 13y ago
  You could be right about statins, although I gather for some they appear to be a good idea. My doctors are pushing them on me, I'm firing the doctors sequentially hoping to get one who will listen (e.g. absolutely no cardiovascular disease in a long lived family) ... the major argument for their being first line treatment is that nothing less works in practice (e.g. "get more exercise). However that doesn't change the principle WRT to drug development today. What "modern new-school psychotropics" are you referring to? That's a field I know a fair amount about, and I don't see the problem you're citing at all (which is not to say some aren't over-prescribed, but I believe that is a different problem). I would probably be very ill or dead without one (low dose, off label Seroquel to treat anxiety which I have a family disposition towards; it's the difference between 4 and 7 hours of sleep a night, bright light treatment gets me the final extra hour I need). It and the other atypical anti-psychotics seem to be a lot better than the older "typical" ones, and those were miracle drugs, something witnessed by my mother when she was a nurse. Similarly, the current Prozac and beyond anti-depressants are maybe not quite as effective as the previous tricyclics but their side effect profiles are a whole lot better, e.g. making it more likely a patient will wait those out long enough for the therapeutic effect to begin, and I personally benefit from a laser specific SSRI (doesn't touch anything else), since "wrong" anti-depressants can make me manic.
  - robbiep 13y ago
    If you're taking seroquel that is probably a good reason to be on a statin given the current medical evidence as you have an increased risk of metabolic syndrome due to being on an antipsychotic.

twoodfin 13y ago

The uninsured patient, maybe. If you ran the math on the average marginal cost to the consumer for atorvastatin (Lipitor), I'd imagine it would be much, much lower. For one thing, the patent has expired and Lipitor now has substitutable generics available. Even before that, consumer co-pay for brand-name drugs is rarely more than $50 (usually much lower), and that gets whittled down further as you can convince your doctor to write a larger prescription. It's also tax deductible if you set up your HSA or FSA appropriately.

ams6110 13y ago

Lipitor is one of those drugs that is marketed to people who want to continue their diet of sugar and junk food and not have to worry about cholesterol. Lipitor itself has some really alarming side effects and it's definitely NOT something you want to be taking if you can deal with your cholesterol by making some simple behavioral changes.

carbocation 13y ago
Statins are quite safe and have decades of postmarketing data demonstrating this. This is not the class of drugs that deserves scary language. If you have a particular concern about statins, you should state it precisely.
- ams6110 13y ago
  Liver damage, diabetes, memory loss, muscle problems.... http://www.mayoclinic.com/health/statin-side-effects/MY00205 http://www.mayoclinic.com/health/statin-side-effects/MY00205 Clearly the medical community has decided that the benefits outweigh the risks for most people, i.e. lower cholesterol. However while statins are shown to lower blood cholesterol, benefits in terms of reduced heart disease are not necessarily clear, especially in people with no other history of heart disease. A recent study found that "Statin use is associated with an increased prevalence and extent of coronary plaques" http://www.ncbi.nlm.nih.gov/pubmed/22981406 http://www.ncbi.nlm.nih.gov/pubmed/22981406 There is even disagreement that cholesterol levels alone are really predictive of heart disease: http://www.minnpost.com/second-opinion/2012/05/latest-thinking-controversial-statins-cholesterol-and-heart-disease-risk http://www.minnpost.com/second-opinion/2012/05/latest-thinki... No silver bullets....
  - carbocation 13y ago
    > However while statins are shown to lower blood cholesterol, benefits in terms of reduced heart disease are not necessarily clear, especially in people with no other history of heart disease. That's simply not a balanced summary of the literature. On balance, statins reduce both secondary events (heart attacks after your first one) and primary events (first-ever heart attacks). Even conservative groups such as Cochrane agree that, based on the scientific literature, statins are both efficacious and cost-effective for primary prevention [1]. Also, trying to throw away the cholesterol/heart-disease hypothesis is sort of like trying to throw away evolution. If you're right, that's Nobel worthy; but you're not right. > A recent study found that "Statin use is associated with an increased prevalence and extent of coronary plaques" That's not clear from the article you've cited, despite quoting a part of the abstract. You have left off an important qualifier that ends the sentence. Here is that full sentence, emphasis mine: "Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium." The abstract does not state that statin use is associated with an increased prevalence and extent of coronary plaques overall. (I don't have access to the rest of that article from my hotel room, so if the article itself does state so, please feel free to quote it in reply.) Also, this appears to be, effectively, a case/control study. The studies supporting statins are randomized, controlled trials -- the strongest form of evidence. Case/control studies suggest follow-ups, but are by no means equivalent to studies of highest-grade evidence. 1 = http://summaries.cochrane.org/CD004816/statins-for-the-primary-prevention-of-cardiovascular-disease http://summaries.cochrane.org/CD004816/statins-for-the-prima...

Alex3917 13y ago

Anyone who take lipitor is a moron in the first place: - It has zero to negative efficacy, at least for the for the vast majority of people taking it, and virtually no efficacy for the rest. - You can get generics that are equally 'effective' for virtually free. - It's vastly less effective than even the most minimal of lifestyle interventions. - If for some reason you really wanted to take those chemicals, you could just get them for free in your diet anyway. E.g. from red rice and I think certain other fungi.

montecarl 13y ago
s/moron/ignorant/
- Alex3917 13y ago
  IMHO ignorant is what you are if you don't know about the risks and benefits of a certain drug, and a moron is what you are if you take that drug anyway. But I'll accept that I may be less charitable than most in this area. (Though then again if eating random stuff that could potentially kill you without knowing what it does doesn't make one dumb, then what exactly does?) Now granted none of us would be here if our ancestors weren't willing to eat random crap in the woods and risk dying, and there's certainly a need for us to do the same to benefit future generations, but if the work has already been done for you on a given substance then there's really no excuse not to do the research.
thundara 13y ago
So much wat. > - It has zero to negative efficacy, at least for the for the vast majority of people taking it, and virtually no efficacy for the rest. Citations? This is a pretty big claim for a FDA-approved drug that was the most profitable drug on the market as of 2011[1]. > - You can get generics that are equally 'effective' for virtually free. As of last year, yeah, this is a fairly recent development that if you don't follow pharma, you'd be unlikely to know. > - It's vastly less effective than even the most minimal of lifestyle interventions. Generally statins are prescribed in combination with recommendations of dietary restriction. > - If for some reason you really wanted to take those chemicals, you could just get them for free in your diet anyway. E.g. from red rice and I think certain other fungi. You're thinking of a different active ingredient, monacolin K, which is also sold in pill form (Lovastatin[2]) and found in red yeast rice and oyster mushrooms. A quick literature search found Lipitor to be more efficacious[3] (Double blinded, placebo controlled, n = 1049). Keep in mind that, as with all drugs, both are dose-dependent and have unpleasant side-effects when taken in combination with certain drugs, foods, and certain patient populations, such as pregnant women and those with liver disease. Hence why it's recommended to check with a doctor who is well versed in this matter, rather than self-prescribing at unknown dosages. [1] https://en.wikipedia.org/wiki/Pharmaceutical_drug#Leading_blockbuster_drugs https://en.wikipedia.org/wiki/Pharmaceutical_drug#Leading_bl... [2] https://en.wikipedia.org/wiki/Lovastatin https://en.wikipedia.org/wiki/Lovastatin [3] https://www.ncbi.nlm.nih.gov/pubmed/9185636 https://www.ncbi.nlm.nih.gov/pubmed/9185636

toomuchtodo 13y ago

I'm 30. I make ~$120K/year. My medical insurance for myself and my wife (28) is $650/month through United Healthcare (pretax). My company picks up the other portion. We are both in good health and have few issues. This is a $2500/year deductible plan per person (so not high deductible, which was only about $100/month cheaper, but had an extremely high deductible). So, now the background is done. My mother lives in Indiana. She is disabled, but has not been approved for disability yet. And I don't mean NPR's version of disabled, I mean she is physically incapable of working due to medical issues. She is on Medicaid (Hoosiercare I believe its called). Even with Hoosiercare (state subsidized insurance), I pay for between $500-800 month for her medications. These are co-pays, not the full amount. I have even considered inventorying her medication and ordering it in bulk from Canada. If I was not lucky enough to make the salary I make, be in good health, and have somewhat affordable health insurance, there is absolutely no way my mother would be able to afford her prescriptions. She requires these prescriptions to survive. I hate living in the US, and I was born here.

robotresearcher 13y ago
| I hate living in the US, and I was born here. Consider moving elsewhere. Canada is close by, culturally familiar and has your health deal comfortably beat. Seriously, if you don't like it but you are paying through the nose for it (and thus helping perpetuate it), why not take your talents and labour elsewhere?
- halostatue 13y ago
  The downside is that to make it meaningful, he’d also have to move his mother, and with her medical condition(s), it seems very unlikely she’d be granted permanent residency on that basis. I immigrated to Canada 15 years ago; I’m pretty sure that I would not be eligible to immigrate today with how the Harper Government has gamed the immigration system. :|
- pkulak 13y ago
  Moving to another country carries considerable costs for most people. However, at some point the difference in health care costs will probably be even larger. I'm a Canadian citizen and the only thing that lets me sleep comfortably while medical costs here skyrocket is the idea that I may be able to get my family into Canada in the future if I need to. That's still not guaranteed, however. Most countries don't just let you waltz in and start working.

bob13579 13y ago

Generic Lipitor is available at Walmart for $4.