It is no longer speculation, it's a fact. The U.S. economy is heading into a deep recession, and that means that people who require daily prescription medications are in need of lower-cost medicines. Affording medicine can be a challenge in fair-weather times, but when faced with the loss of one, or even two incomes, this challenge turns into a matter of survival.

Often, when facing financial hardships, people have to make decisions between the basic essentials: food, heat, water, and life-saving medicines. Sometimes, when there isn't enough money to go around, and decisions are made which can adversely affect ones health.

Pill-splitting is a common tactic being employed by people who are attempting to allocate money between the basic essentials. The trouble here is that when a prescription is written, it is meant to be followed to a 'T', and pill splitting actually reduces the effectiveness of the medication by a factor greater than one half! Medications often need to be built up in the blood before they reach their maximum efficacy.

This is especially true in the case of HIV/AIDS medicines. Due to the somewhat 'difficult' nature of the virus (or is it adaptable?), changing, altering, or missing doses gives the virus the opportunity to evolve, or adapt. This increases the likelihood that over time, the medications will become less effective. What may have started out as a one-medicine therapy now turns into a cocktail therapy, or HAART therapy.

There are several combination therapies on the market today. Some of the more common ones are: Combivir ($513/60 tablets), Kaletra ($833/180 capsules), and Atripla ($1200/30 tablets).

The costs of these medicines are quite high, and depending on the individual, it can be difficult to manage the extra pharmaceutical expenses, in addition to, living expenses, and doctors' visits. At the expense of their own health, some are choosing to skip their life-saving medications, in favor of putting food on the table. For some, the option becomes generic medication.

Generic medicine is readily available online. There are a variety of generic products which can replace the brands mentioned previously, and are actually manufactured in FDA approved facilities! Did you know that India has the highest concentration of FDA approved manufacturing facilities outside of the U.S.? In fact, much of the pre-production and precursor products are being made outside of the U.S. by companies in India.

One company has created several generic versions of the top selling brands of the U.S. pharmaceutical companies. Cipla Ltd of Mumbai India has created generic versions of: Combivir - Generic Name Duovir ($94.50/60 tablets), Kaletra - Generic Name Lopimune ($562/180 capsules), and Atripla - Generic Name Viraday ($250/30 tablets). All of these products which Cipla manufactures are currently being used to treat HIV/AIDS in Africa, but are not commonly available in North America as they are currently still on patent. With that being said, the FDA originally altered its policy on personal importation of pharmaceutical products in the late 1980's to address the HIV/AIDS crisis at the time. At a time when treatments were scarce, and people had few options to help manage the disease, the FDA created the personal importation clause for the purpose of importing medicines that were otherwise unattainable in the U.S. It's interesting to note as well that nearly all nations with a similar pharmaceutical regime all carry a similar clause.

For those who need it, the personal importation clause can be a much-needed lifeline. Considering that as a society, we appear to be entering into a era of frugality and saving, the future likely holds that many more people will be invoking this clause for personal health and financial reasons. Could it be that we will also see government itself open the doors and allow people to reach out and make empowered decisions regarding their own health and well being? The latter is somewhat unlikely.

Do not expect government to open up the floodgates to low-cost generic medications, but do expect to see the proliferation of online healthcare to continue.