Cheap Drugs From Canada: Another Political Hot Potato

[Guest guest]

> October 23, 2003

>

> New York Times

>

>

> Cheap Drugs From Canada: Another Political Hot Potato

>

> By GARDINER HARRIS

>

> 554265e.jpgEXINGTON, Ky., Oct. 21 For years, just about the only Americans

> regularly buying drugs in Canada were thrifty gray-haired New Englanders.

> Now, with state budgets squeezed, it is the nation's governors who are

> demanding access to Canada's cheap drugs. Here in Kentucky, the issue has

> become central to a tight governor's race.

>

> The state's Democratic attorney general, Ben Chandler, has spent much of

> his remaining funds on an ad campaign that reminds voters that his

> Republican opponent, Representative Ernie Fletcher, voted in Congress

> against legalizing drug imports from Canada.

>

> In a televised debate Monday night, Mr. Chandler accused Dr. Fletcher of

> " being in the pocket of prescription drug manufacturers. "

>

> Dr. Fletcher, a nonpracticing family physician, denies the charge. But he

> has had to spend precious money and time explaining why he voted against

> legalizing drug imports.

>

> " I knew when I voted against it that it would be an attack issue, " Dr.

> Fletcher said in an interview after the debate. " But as a physician, I

took

> a Hippocratic oath to do no harm, and some of these drugs are dangerous. "

>

> Drug makers long ignored the trickle of patients who trooped across the

> border to buy drugs cheaply, but that trickle is threatening to turn into

a

> flood. The growing political support for drug imports has galvanized the

> industry against one of the most serious threats to its profits since the

> Clinton health care proposals of 1993.

>

> The governors of Minnesota, Illinois, Iowa and Wisconsin have said in

> recent weeks that they want to import cheaper medicines from Canada,

saving

> state budgets and their citizens millions in the process.

>

> " The reason you have the beginnings of a prairie rebellion here is that

> there is a crisis and nobody has properly responded, " said Minnesota's

> governor, Tim Pawlenty, a Republican.

>

> Illinois's governor, Rod R. Blagojevich, a Democrat, is stumping for an

> online petition to persuade federal officials to allow drug imports.

> " There's nothing that can stop an idea whose time has come, " he said.

>

> State officials in Massachusetts say they are also considering imports,

and

> the city of Springfield, Mass., is using a Canadian pharmacy for its

> employee health plan. John Taylor, the top enforcement official of the

Food

> and Drug Administration which opposes such efforts calls the push for drug

> imports a " tsunami " that the agency is having trouble tracking.

>

> A measure legalizing imports is part of the Medicare prescription drug

> legislation that House and Senate negotiators are trying to reconcile in a

> conference committee. The proposal passed the House in July, but 53

> senators signed a letter circulated by the drug industry saying they

oppose

> drug imports. Since the measure is also opposed by the House's Republican

> leadership, its prospects in the conference committee at first seemed dim.

>

> But F.D.A. officials and industry lobbyists say that conference members

are

> searching for a compromise that would allow drug imports for a trial

> period, perhaps a year. That such a deal is being considered at all is a

> measure of how far the politics of the issue have evolved, after years in

> which the drug industry's determined opposition seemed the final word.

>

> Drug makers remain adamantly against any compromise. " A pilot program with

> American patients as guinea pigs is a proposition that no responsible

> lawmaker should support, " said Jeff Trewhitt, a spokesman for the drug

> industry's trade association, PhRMA.

>

> But support for the industry has eroded as the gap between drug prices in

> the United States and the rest of the industrialized world has grown.

> Surveys by a Canadian health agency have found that American prices are,

on

> average, about twice those in Canada and nearly three times those in

Italy.

> With price controls in most other countries, the industry last year made

> half its sales $200 billion worth in the United States for the first time.

>

> In Kentucky, the drug price gap has many people grumbling. Mark Nickolas,

> Mr. Chandler's campaign manager, said that the campaign had focused on the

> issue of drug imports because polling found that it resonated with voters.

>

> Last month, Mr. Chandler filed suit on the state's behalf against five of

> the nation's largest drug makers, claiming they had cheated Kentucky out

of

> millions of dollars. With the suit, the state belatedly joined a

> longstanding effort, spearheaded by federal prosecutors, to crack down on

> certain drug-pricing practices.

>

> Mr. Chandler castigates drug makers at almost every opportunity. He tells

> voters that he intends to cut $150 million from the $700 million that

> Kentucky spends on drugs for Medicaid beneficiaries by " taking it out of

> the hide of drug companies. " He supports efforts to obtain drugs from

> Canada and wants to establish a drug buying pool with other states.

>

> On the stump, he also points out that Dr. Fletcher, in his 2000

> Congressional campaign, benefited from more than $500,000 in ads paid for

> by the drug industry.

>

> In an interview Monday, Dr. Fletcher said he did not believe that the

> drug-import issue would sway many Kentucky voters. He said that he was

> concerned that American consumers were the only ones being asked to pay

for

> drug research, and said the state's drug bill could be cut by reducing the

> number of prescriptions that some Medicaid recipients receive.

>

> Drug prices are by no means the only issue in the campaign. Taxes,

gambling

> and a fierce fight over negative campaigning are in the foreground, too. A

> recent poll by The Courier-Journal of Louisville found the candidates

> virtually tied.

>

> Dr. Fletcher's worries about the safety of drug imports are echoed by the

> F.D.A., which has begun a very public effort to illustrate the dangers.

> Last month, the agency announced that spot inspections of 1,153 mailed

> packages containing drugs from abroad found that most were counterfeit and

> many were dangerous. The F.D.A. is seeking to shut the largest chain of

> stores that helps Americans buy drugs from Canada.

>

> But many import proponents say that the F.D.A. is exaggerating, and they

> point to the growing popularity of imports as proof of their benefits.

>

> Governor Blagojevich of Illinois said in a telephone interview Tuesday

that

> the state spent $340 million last year on prescription drugs for 230,000

> state employees and retirees a tab he said could be cut by tens of

millions

> with drugs from Canada. Mr. Blagojevich said that Washington gave the drug

> industry steep tax breaks to support research and asserted that drugs sold

> in Canada were as safe as those sold in the United States.

>

> Governor Pawlenty of Minnesota said that the states could resolve any

> safety worries by identifying Canadian pharmacies that can be trusted to

> provide safe products. " We could bring some due diligence to the process

> and help bring about consumer protection, " he said.

>

> Bob Leitman, a pollster with Harris Interactive, said that a recent survey

> found that 7 percent of Americans said they had purchased drugs from

> Canada, up from 5 percent last year. With more Americans aware of the

sharp

> cross-border price differences, he said, the issue will only grow in

> political importance.

>

> Should a bill legalizing drug imports pass Congress and be signed by

> President Bush, the drug industry still could defend its profits. Already,

> some drug makers are limiting sales to Canadian pharmacies so they can

only

> get enough drugs to fill prescriptions written in Canada.

>

> " I think there'd be a longtime game of cat and mouse in which the industry

> limits the damage, " said Richard Evans, an analyst with Sanford C.

> Bernstein. Even if its tactics lead to drug shortages in Canada and

Europe,

> he added, " the industry is clearly going to defend its most profitable

> market at the expense of less profitable markets. "

>

>

http://www.nytimes.com/2003/10/23/business/worldbusiness/23DRUG.html?th= & pag

ewanted=print & position=