A Medical/Customs Question

As some of the long-time folks here know, I was living in Quito earlier this year but had to return to the States for medical reasons. I haven't specified the reason up to now, but what it is is that I learned in May,while in Quito, that I have prostate cancer.

I've been being treated here and things are going well. The next phase of my treatment involves my going on a fairly new medication called Xtandi – a pill I will be taking daily for the foreseeable future.

As I've said repeatedly since I left, I intend to return to Ecuador (I loved it there!), but here's my problem:

This medication can only be obtained directly from the manufacturer (i.e., I can't go to the local Walgreens and get it) – they deliver it to my door. They will not send it to an address outside the US. On the other hand, they could deliver to my sister's house and she could send it via some method to be determined to me in Quito. But – will Ecuadorian customs let the pills in?

The question: Where do I go to find out? Ministry of Health? Customs? Somebody else?

Anybody know?

Of course once you re-arrive in Ecuador you will investigate the process of buying it directly there without having to import it by courier.

But since mailing/shipping pharmaceuticals is a very sticky problem all over the world, and since your future depends on this medication, I can only imagine that you would best question your Quito attorney about the particulars of shipping this drug into the country.

This attorney has been professional, knowledgeable, and a good ally to your case so far. I think you must consult him on this point. Perhaps some special permission is possible?

P.S. There is a wild card that probably won't be useful to you but -- the US embassy has diplomatic pouch privileges. The dip pouch is not inspected, controlled, or subject to any foreign government intervention.

Nearly always reserved for government business and gov employees only, one never knows what kind of conciliatory arrangement might be found if the right person at the embassy were approached with the issue. Could be worth a shot.

BobH wrote:

But – will Ecuadorian customs let the pills in?

The question: Where do I go to find out? Ministry of Health? Customs? Somebody else?


Bob,

As you know, the Ecuadorian bureaucracies are generally opaque.

They are also run by people who don't speak English as a first language.

They also can be slow to respond, and the response can be incomplete.

I would go, instead, to a reliable U.S.-based forwarding company that offers good customer service skills including English as a first language,  and reliable package-forwarding service.

Based on online referrals, I would contact U.S. Global Mail (usglobalmail.com), and ask them about this.  I'm sure such companies deal with this specific issue all the time.

I strongly advise that you NOT use Club Correos or its wily handmaiden, Econcargo of Miami, for such a sensitive matter.  You would regret it all your days.

Good luck with your treatment, Bob, and in getting back soon to Ecuador.

cccmedia in Quito (FORMER Club Correos customer, Nov. 2013-November 2014)

Hello Bob ... happy to hear you are feeling well and I wish you the very best. I would address the issue with the Ecuadorian Embassy in Washington, DC. Surely if you present proof of the matter they would have the authority to grant a waver. I may face a medicine issue of a less serious nature. Keep me posted please. Start at the top Bob.

Regards ... Tom   /   Don Chema

Thanks for the advice (and the good wishes). These are all excellent suggestions, and there's no reason I need to choose -- I'll try them all (and any others that folks might add), and hope that one or more might pan out.

Bob

BobH wrote:

Thanks for the advice (and the good wishes). These are all excellent suggestions, and there's no reason I need to choose -- I'll try them all (and any others that folks might add), and hope that one or more might pan out.

Bob


And we are hoping you get back to Quito sooner rather than later, meds ready to go.
In the meantime you can be glad once again you are no longer on Cebu, as 200,000 have already been evacuated as the central Philippines braces for another typhoon, downgraded from super but none the less dangerous as the next 24 hours will be crucial.  One of the selling points of Ecuador is that besides some very specific earthquake spots and volcanoes, there is not much to fear from mother nature.

Bob, I believe the drug xtandi is actually enzalutamide. Xtandi being the U.S. name. If that is the case, am pretty sure enzalutamide is being distributed in Latin America. There might be a good chance you can get it in Ecuador. Obviously be sure they are one and the same drug from your doctor, and that you can actually get it in Ecuador, but that could be an option.

Best of luck.

j600rr wrote:

Bob, I believe the drug xtandi is actually enzalutamide. Xtandi being the U.S. name. If that is the case, am pretty sure enzalutamide is being distributed in Latin America. There might be a good chance you can get it in Ecuador. Obviously be sure they are one and the same drug from your doctor, and that you can actually get it in Ecuador, but that could be an option.

Best of luck.


j600: Yes -- Xtandi is the brand name, enzalutamide is the generic. The problem is that the meds are outrageously expensive ($9k/month) and in the US I have Medicare Part D, plus and an arrangement through my Doc with the manufacturer to get discounts. In Ecuador, while the cost is likely lower, I'm not sure what else I might have going for me.

Still, I appreciate the info -- I'll follow up with my Doc in Quito and see what costs are there and what might be available.

Wow!! That's more than outrageously priced. Yeah, guess my idea isn't very practical.

Your sister can mail you the medication monthly, try to rent a PO Box where you live in Ecuador. She should let you know when she mailed it out to you,the Post Office will leave you a notice in your box, for you to pick it up. I believe they allow once a month deliveries for medications. She will have to fill out a customs form from where she resides. May I suggest she place the pills in a ziplock Baggie with the label of your medication inside to avoid the high cost of shipping, or buy a bubble type of envelope. Good Luck and I hope this medication will kick that cancer out of your body.

Gavilanes Evelyn wrote:

Your sister can mail you the medication monthly, try to rent a PO Box where you live in Ecuador. She should let you know when she mailed it out to you,the Post Office will leave you a notice in your box, for you to pick it up. I believe they allow once a month deliveries for medications. She will have to fill out a customs form from where she resides. May I suggest she place the pills in a ziplock Baggie with the label of your medication inside to avoid the high cost of shipping, or buy a bubble type of envelope. Good Luck and I hope this medication will kick that cancer out of your body.


Thanks for the suggestions, Unfortunately, it is beginning to look like I wont be able to return to Quito for longer than maybe month-long visits. Such is life. I,m dolng well and feeling good, but my treatment requirements wont allow me to return for longterm stays.

Ok then I suppose your Dr.gives you a number of refills,ask your sister to get them for you while your out of the country, carry the amount you'll need while traveling. You can put them in your luggage or carry on bag, best to have the label on the bottles. Hope you feel better soon

BobH wrote:

Thanks for the suggestions, Unfortunately, it is beginning to look like I wont be able to return to Quito for longer than maybe month-long visits. Such is life. I,m dolng well and feeling good, but my treatment requirements wont allow me to return for longterm stays.


Good to know your are feeling well and the treatments are working.
Sorry to hear your status has been reduced to tourist.
I am sure you will make the most of it.

mugtech wrote:
BobH wrote:

Thanks for the suggestions, Unfortunately, it is beginning to look like I wont be able to return to Quito for longer than maybe month-long visits. Such is life. I,m dolng well and feeling good, but my treatment requirements wont allow me to return for longterm stays.


Good to know your are feeling well and the treatments are working.
Sorry to hear your status has been reduced to tourist.
I am sure you will make the most of it.


Ditto what mugtech said. Continue to get well, and hopefully down the road you will be able to return to Quito on a more permanent basis.

j600rr wrote:

Ditto what mugtech said. Continue to get well, and hopefully down the road you will be able to return to Quito on a more permanent basis.


Thanks. I,m still hopeful that I can return long term. But for now, I'll have to be satisfied with visits.

Thanks for the good wishes.