They don't want their names used, as if they were engaging in some illegal or unsavory business.
But they are not. This retired Payson couple is simply getting the prescription drugs they must have, the only way they can.
The wife says she started looking for affordable medications about two-and-a-half years ago, when she retired and lost her insurance.
"I took 14 prescription drugs at that time, and about four of them cost $100 a month," she said. "We're on Social Security. There's no way we can pay that."
She still gets her heart medication through the pharmacy at the Payson Safeway supermarket. "But the ones that aren't life-dependent, those are the ones we purchase outside of the United States," she said.
This woman and her husband are not alone. Sharing their predicament are countless thousands of other seniors, low-income families and uninsured or underinsured individuals across the nation. Americans with breast cancer or depression or ulcers or high blood pressure or a host of other ailments that scare or threaten them.
Americans who are forced to turn to Mexico, Canada and other countries in order to get around a health system which too often gives them the choice between spending what money they have on food and rent or on the medications they need to function properly and to remain as pain-free as possible.
Americans pay more for prescription drugs than any other people in the world, and those expenditures make up the fastest-growing segment of the increasingly expensive U.S. health care system. By 2010, 16 percent of what Americans spend each year on personal health care will be spent on prescription drugs, according to a recent report by the U.S. Department of Health and Human Services.
In 1999, it was 9.4 percent.
The prices of the 50 most prescribed drugs for older Americans rose, on average, at almost triple the overall rate of inflation last year, according to a report by the liberal consumer advocacy group Families USA.
It was that sort of increase the retired Payson couple could not possibly keep up with.
"We're angry," the wife said. "When we were considering retiring and moving to Payson, the HMOs were just starting to talk about pulling out of the area. I talked to a health insurance agent, and her comment was, 'They can't just pull out of town and leave you with no insurance coverage.' Well, they did. And here we are."
One of the drugs both the husband and wife require is the ulcer medication Prilosec. As of June of this year, with her senior discount, thirty 20-milligram capsules could be obtained at the Payson Safeway store for $129.49. The same number of capsules sold for $96 in Mexico ("But they didn't work at all," the wife said), and $78.10 in Canada.
But then the couple found a brochure about a Lake Havasu City company, Prescriptions International, which distributes pharmaceuticals produced in India including a generic version of Prilosec. Price: Ninety capsules, a three-month supply, for $31.57.
If it weren't for these beyond-the-border alternatives, the wife said, "I probably wouldn't take some of these drugs, even though I'm supposed to. But that would threaten my future health, because I'm a diabetic, and diabetics are prone to a number of problems as they age. I would have to ignore that, and just take the ones that are keeping me alive now."
"A lot of people roll their eyes and look skyward when I tell them we get our prescriptions from India," the husband said. "But if they were faced with our drug bills, they'd do it, too. Heck, and we're not even a worst-case scenario."
According to Senior Circle Advisor Cory Houghton, a number of local retirees are turning to India, and it's proving to be a positive, money-saving alternative for them.
"After all, some of our best a scientists come from India," she said. "And because India doesn't acknowledge our patent laws, they are allowed to practice 'reverse engineering,' which means they can take a drug that's still under patent and produce a very similar drug."
Alternatives right here
Despite Houghten's enthusiasm for new ways for senior citizens to make their prescription-drug needs affordable, she doesn't push any one method on all those who come to her for help. Instead, Houghton tells them about three alternatives to the normal, too-pricey channels.
"The first thing you have to do is look at their income and what they are comfortable with," she said. "Are they comfortable ordering prescriptions by mail order, as you do through Canada and India? Are they comfortable sending a check, or giving their credit card number out and not knowing who's going to end up with it, or with getting a three-month prescription from their doctor every three months? Because that's how they all work. A lot of our seniors aren't willing to do that."
If discomfort on those counts is affirmative, Houghton might lead them to the many discount prescription drug programs offered by most major drug manufacturers.
"Glaxo and some other pharmaceutical companies have developed an 'orange card' that can save you more than 40 percent when you buy your prescriptions in the U.S. through reputable pharmacies," Houghton said. "This way, you don't have to worry about mailing the prescription order off or who's going to get your credit card."
Some companies even offer free medications, she said, where "Normally, you can get a one- to three-month supply, but I found one the other day that will give you free medication for a year."
No matter what path seniors choose to take toward lowering their prescription drug costs, Houghton said, the most important thing is to act and not wait for the government to come up with a solution.
"And right here on a local level, there's quite a bit we can do," Houghton said. "We can continue to support the programs at the Senior Center that offer free meals, so our seniors will never have to choose between eating and their medications. We can offer to help our seniors to get their medications, to find the best, user-friendly route for them.
"And I don't care whether they are 15 years old or 115 years old; we need to ask people in our community, 'What do you need?,' and then find ways to help them. We can't wait for the government to come up with a plan. What do you do in the meantime?"
Getting lower prescription prices
For information and assistance in obtaining lower-cost prescription drugs, Rim country residents of all ages can call Cory Houghton weekdays from 9 a.m. to noon at 468-1012, or visit her at 215 N. Beeline Highway. To contact Prescriptions International, call (928) 854-8179 or write to 2445 Angler Drive, Lake Havasu City, AZ 86404.