Medicare's first prescription drug benefit, created late last year for 40 million people, will make it optional--but not mandatory--for seniors to order drugs through the mail.

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Today a stockbroker or insurance agent can use almost any title they want, or order one through the mail without incurring a fiduciary obligation to their clients or sanction by their regulator.

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Patients who are enrolled in the Avandia-Rosiglitazone Medicines Access Program will receive their medicine by mail order through specially certified pharmacies participating in the program.

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Vivus will at first offer the pill only through mail order, so doctors can't sell it directly, said Dr. Barbara Troupin, Vivus' vice president of scientific communications and risk management.

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However, it is not freely available in the UK, although many people still obtain it through mail-order or internet sites.

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Aside from restrictions placed on it by the FDA (for instance, it will be sold only through a single mail order pharmacy), the drug causes the buildup of fat in the liver, a warning sign that it may also cause liver damage.

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For a while orders were processed through DeArthur's showroom and mail-order business without significant difficulties.

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