Some stock up on medications while others travel for medical procedures that are either too expensive or illegal in the United States.
In November 2016, I was itching to get to Barcelona. Literally itching.
I’ve had psoriasis since I was 10 years old and have been using mometasone to treat my symptoms for about a decade now.
In the United States, the medication is only available via a doctor’s prescription.
It’s also beholden to our country’s expensive drug market. Even with insurance — when I had it — my doctor would only prescribe a tiny tube that would last a few days. And those were $10 with my copay.
But in countries such as Spain, mometasone is available over-the-counter at any drugstore with a green cross on the outside.
As soon as we landed, I asked my wife if we could stop by as many pharmacies as possible so I could stock up on medication. It was supposed to be our honeymoon, but she understood.
As we went to those pharmacies in between sight-seeing trips, I brought along the packaging as my wife helped me convey my message in Spanish: “I want all of your mometasone.”
In a way, I was a medical tourist. I wasn’t there to get an expensive medical procedure, let alone a therapy that wasn’t approved by the U.S. Food and Drug Administration (FDA).
My medication was simply cheaper and easier to obtain in Spain, so I gathered enough for a three-month supply, the amount I would be allowed to bring back through customs.
If U.S. federal law allowed me to take more back, it would’ve been cheaper — especially during those years when I couldn’t afford health insurance — and easier than taking a yearly flight to Spain to stock up on my topical steroids.
It doesn’t help that this year alone, prices of mometasone cream have gone up 381 percent.
As costs of healthcare continue to rise in the United States, more people are opting to travel abroad to get procedures and medications.
California Healthline — not affiliated with this Healthline — recently reported on a case of a Wisconsin doctor and a Mississippi patient who traveled to Cancun, Mexico, to perform a knee replacement surgery at Galenia Hospital.
They found it cheaper to fly to the resort town and do the procedure there than do it within U.S. borders. The woman actually received a $5,000 check from her insurance provider for the trip.
The website reports it was part of the North American Specialty Hospital (NASH), which has organized treatment for dozens of American patients over the past few years at the Cancun hospital, which some self-insured employers in the United States prefer because of its cost-saving capabilities.
While some people travel due to cost considerations, others travel for treatments not approved in the United States.
Chris Scott, PhD, professor of medical ethics and health policy at Baylor College of Medicine in Texas, says medical tourism has been going on for decades.
While many people are attempting to find ways around the United States’ costly healthcare system, others travel for therapies not available at home.
Both scenarios, Scott says, are “worrisome” because overseas clinics can range from legit, validated healthcare centers to “illegal sketchy fraudsters.”
“There’s been an explosion of clinics,” he told Healthline. “With that, you get patients who will incur the risk they wouldn’t have in the U.S.”
On August 15, Mikaela Aschoff was in Cancun, but not for the normal reason college students typically end up there.
She went to a Celltex facility there to have an intravenous infusion of 200-million stem cells before flying back to Texas, where she’s in her second semester at LeTourneau University in Longview.
“It’s all still experimental,” Aschoff told Healthline following her annual procedure.
Her yearly sojourn started at her freshman homecoming dance. “Out of nowhere, I just passed out,” she said.
Aschoff was eventually diagnosed with dysautonomia, a spectrum of disorders that affects the autonomic nerve system. The ailment alters her heart rate, blood pressure, and other functions.
Aschoff felt her body deteriorating and experienced seizures, migraines, brain fog, and fibromyalgia. She was homebound and dependent on a wheelchair.
“It affected me head to toe,” she said.
After years of medications and therapies, Aschoff says she was ready to try anything.
“Stem cells were my last hope,” she said.
She met another person like her at a conference who had used Celltex’s stem cell treatments. She was less concerned that the stem cell therapy didn’t have FDA approval and more concerned about the $50,000 price tag.
Aschoff said she conducted thorough research on Celltex and the stem cell technology. She also talked with other people who used the treatment before pursuing the therapy.
Her mother started a GoFundMe account and soon the family had enough money for her treatments in Cancun.
“I was cautiously optimistic about what stem cells could do,” Aschoff said.
She underwent her first three series of infusions in January 2017. The day after her first round of treatments, she woke up without her usual pain and was able to read a book for four hours, something her migraines and brain fog typically prevented.
Months later, she felt she had more energy. In her first semester of college, she made the dean’s list.
“I’m waiting in excitement to see what’s improved tomorrow,” she said following her annual treatment.
While Aschoff’s stem cell treatments give her hope about a healthier future, the treatments remain experimental in the eyes of the FDA, which is why she has to leave the United States to receive them.
While Celltex remains based in Texas, it performs the stem cell treatments in Cancun following a 2012 warning letter from the FDA about its Sugarland facility.
The federal agency said Celltex couldn’t continue the treatments without approval following a clinical trial, which led Celltex to open its clinic in Mexico.
Following the 2012 letter, Celltex officials say, their U.S. operations became compliant with FDA guidelines and procedures. They added their stem cell therapies are approved by COFEPRIS, the Mexican equivalent of the FDA.
Last year, the FDA sought injunctions against two other U.S.-based stem cell companies.
A 2009 study conducted by researchers at Johns Hopkins University and other institutions examined online advertising and locations of stem cell clinics. They identified 37 stem cell clinics, mostly centered in Europe or Asia.
“Given the accelerating pace of globalization, it is time to consider international approaches toward enhancing oversight for the clinical translation of stem cell research,” the researchers concluded.
Scott, the medical ethics professor, said in 2017 there were more than 500 similar clinics. He says marketing campaigns by Celltex and other companies are unethical because they’re “advertising therapies where no evidence exists.”
While some people leave the U.S. healthcare system to pursue stem cell and other yet-to-be proven therapies, others do so out of necessity — whether for travel or cost considerations.
Lisa Dorenfest and her partner, Fabio Mucchi, have been sailing the world for years.
Since the two met, those travels have included numerous trips to hospitals and specialists for numerous medical problems, including cancer.
“We’ve sailed in the face of adversity and have been treated around the world,” Dorenfest told Healthline.
Dorenfest quit her job to go to yacht master’s school after her friend died of breast cancer. That’s when she found a breast lump of her own.
Mucchi was in the Bahamas when he suspected something was wrong with the lymph nodes on this throat. He saw a doctor in New York but traveled to Italy for an ultrasound that confirmed his cancer. As a dual citizen of the United States and Italy, he received free care while in Europe.
Over the years, Dorenfest and Mucchi have collectively undergone partial removal of a liver in New Zealand, a lumpectomy in the United Kingdom, chemotherapy in Australia, a double hernia in Malaysia, and plastic surgery in Brazil. That included coordinating care from specialists in Italy and Australia at the same time.
During their travels and treatments, Dorenfest and Mucchi said they’ve found procedures that cost one-quarter to three-quarters of what they’d pay in the United States, even though Dorenfest has found her “doctors for life” at Memorial Sloan Kettering Cancer Center in New York City.
“We do now somewhat choose our destination based on our medical care,” said Mucchi, who’s now 41 months into remission from his latest round of cancer.
And some of the places they’ve found good care include Malaysia, Thailand, Brazil, and Colombia. They note those countries are some of the cheapest places to get treated.
“The price is literally a fraction of what you would pay for in the States,” Mucchi said.
And while they continue to travel and keep an eye on their health, they say they always consider the quality of their lives over the quantity.
But, like so many others, they also consider the cost — no matter where they have to travel.