Pro/Con: Canadian prescription drug import

Pro: Benefits for citizens

By Chuck Jefferson

State Representative-67th District

Americans currently pay the world’s highest prices for their medications, and those without prescription drug coverage pay the highest prices of all.

The average cost per prescription for senior citizens rose by 48 percent between 1992 and 2000, and is expected to continue increasing an additional 72 percent by the year 2010.

Though Congress recently passed a prescription drug benefit for seniors enrolled in Medicare, it will not go into effect until 2006. Further, 50 percent of seniors will not receive any benefits at all.

I am proud to have helped pass legislation here in Illinois last session that creates a buying club for all seniors to lower prices on prescription drugs via negotiation with the drug manufacturers. While this program is important, I believe there is still more we can do in this state to lower prices.

State pharmacy boards are responsible for determining whether pharmacies operating within the state are doing so in compliance with state law. In recent months, the Food and Drug Administration (FDA) has tried to discourage foreign drug imports, such as those from Canada, by seeking injunctions against American clearinghouses that re-import cheaper prescription drugs from outside the United States.

Why are the same drugs cheaper in Canada? The Canadian government regulates the prices. That’s why for years seniors have been going across the border to buy these drugs. Pharmaceutical manufacturers, however, will continue to pressure the FDA into saying re-imported drugs are not safe.

While safety should be a concern, this argument does not hold water because they’re the same drugs, made in the same factories, and shipped in the same boxes as the drugs stocked by U.S. pharmacies. Even the FDA Associate Commissioner has said that he knows of no cases in which Canadian drugs have harmed American citizens.

Because senior citizens should get the lowest possible prices on their prescription drugs, I will push legislation this spring to make re-importation legal in Illinois. In doing this, we will work to ensure the safety of these drugs by restricting re-imports to those deemed clinically appropriate and unlikely to spoil in transit.

Additionally, no patient would be allowed to import a drug until it had been prescribed by a doctor in Illinois, taken for at least a month and shipped directly from the manufacturer in sealed packages.

In the end, this legislation will allow all citizens to purchase prescription drugs from foreign pharmacies—with savings up to 81 percent.

As lawmakers, it is our duty to get our citizens the lowest possible prices so they can take the full prescriptions prescribed. That’s the bottom line. With these new laws, we can start to do this.

In the meantime, until legislation is passed, you can begin to access Canadian drugs if you have access to the Internet. Simply send your prescription and abbreviated medical records to one of the reputable Canadian online pharmacies.

From there, a Canadian doctor on staff will review your records and issue a Canadian prescription. The pharmacy then ships the prescription directly to you in the United States. And you save money. It’s that simple.

I look forward to making this purchasing option recognized by the state of Illinois. With your help, we’ll be able to pass a law this spring for the health of all our citizens.

State Rep. Chuck Jefferson (D) represents the 67th District in Rockford.

Con: Cost for state

By Joseph L. Bast

President of The Heartland Institute and Publisher of Health Care News

By now everyone “knows” prescription drugs in Canada are cheaper and just as safe (or even safer) than in the U.S., and that the Bush Food and Drug Administration (FDA) is exaggerating the safety problems of importation as a favor to big drug companies, which are major donors to Republican candidates.

This is another case where conventional wisdom is wrong.

Start with the first claim, that Canadian drugs are cheaper. Illinois Gov. Rod Blagojevich released a study on Oct. 26 claiming the state of Illinois could save about $91 million a year by importing drugs from Canada for state employees and retirees. The study was widely reported and cited with virtually no evidence that a single reporter actually read it.

The $91 million estimate assumes that EVERY state employee and retiree buys 92 brand-name drugs ONLY from Canada. But the authors of the study admit this won’t happen: They say it is more likely that 33 percent of those drugs would be purchased from Canada, reducing the annual savings to $30 million a year.

So the Illinois governor is misrepresenting his own study, and the national press corps is simply parroting his lie. That’s bad enough, but even this estimate of savings is far too high. It assumes drug companies would not reduce the discounts they already give to the state’s prescription benefit manager. It assumes drug prices in Canada won’t increase, even though drug companies have announced they will limit sales to Canada to discourage reimportation.

The closer one looks at importation, the more likely it seems that costs would actually be HIGHER. Canada and the U.S. would have to invest in new security measures to inspect the dramatically increased flow of drugs across the border. This could easily cost hundreds of millions of dollars. Cheaper brand-name drugs would prompt state employees and retirees to switch from less-expensive generics and over-the-counter medications, which would raise spending.

There is also the matter of rebates and “supplemental rebates” drug companies pay to state public aid departments for permission to sell drugs to Medicaid beneficiaries. In Illinois, these payments total some $500 million a year, according to the governor’s report. A reduction of just 6 percent, which could easily result from renegotiating the voluntary supplemental rebates, would wipe out entirely the projected $30 million savings from importation.

So what about safety? Gov. Blagojevich says his study proves the issue is a “red herring.” It does nothing of the kind. It establishes that drug laws in Canada are substantially equivalent to those in the U.S., and inspections of a small number of Canadian pharmacies failed to reveal evidence of unsanitary conditions or poor record keeping. But what about the real issue: Would drugs imported from Canada still be safe if imports increased tenfold?

The Blagojevich study is mute on this vital question, but Health Canada, the counterpart to our FDA, is not. It admits Canadian authorities cannot detect counterfeit and adulterated drugs entering and leaving the country NOW, even without legal exports to the U.S. How convenient for Gov. Blagojevich, then, that the authors of his study never quite got around to meeting with Health Canada officials to include their official position in the report.

There is no way to ensure that drugs coming from Canada were not manufactured in countries that are hostile to the U.S. or have much lower safety standards. The damage to the integrity of the U.S. drug supply of even one state breaking ranks and allowing the importation of these drugs would be immense, since the complexity of the U.S. distribution system precludes tracing drugs back to their source.

So there you have it. Drug importation is a good idea … except it won’t save money and would endanger the lives of millions of people.

What is truly frightening is that many politicians who support drug importation are probably campaigning for importation only to score points against President Bush. They are counting on the FDA to save their political careers from ruin and the people of the U.S. from a public health catastrophe.

Politics doesn’t get any uglier than that.

Joseph Bast is president of The Heartland Institute and publisher of Health Care News.

Enjoy The Rock River Times? Help spread the word!