Guest guest Posted September 15, 2003 Report Share Posted September 15, 2003 Although I am not favorable to the massive use of big pharm drugs, it is nice to see that there is a move to break up the federal government price fixing. Alobar - " Cackling Grackle " <cacklinggrackle > Monday, September 15, 2003 8:28 AM [cacklinggrackle] Illinois may buy Canadian drugs > > http://www.washingtonpost.com/wp-dyn/articles/A10735-2003Sep14.html > > Illinois May Buy Canadian Drugs > Move Escalates Battle on Prices > > By Ceci Connolly > Washington Post Staff Writer > Monday, September 15, 2003; Page A01 > > Facing budget-breaking increases in prescription drug bills, the governor > of Illinois took the first step yesterday toward purchasing lower-cost > medications from Canada, a move that puts him in direct conflict with > federal regulators and signals a dramatic escalation in the civil war over > U.S. drug prices. > > What began a decade ago with busloads of senior citizens trekking across > the border in search of cheaper medicines has mushroomed into a nationwide > rebellion. It has spread from small, nonprofit groups to the private > sector, and now, to local and state officials who are defiantly ignoring > warnings by the Bush administration and the pharmaceutical industry that > drug reimportation is dangerous and illegal. > > Gov. Rod Blagojevich, a Democrat, said he has directed the Illinois > special advocate to draft a plan for buying inexpensive medications in > Canada for as many as 240,000 state employees and retirees. The change > could save the state tens of millions of dollars. > > " The status quo on prescription drugs is intolerable and unacceptable, " > Blagojevich said in an interview yesterday. This year, the state is > spending $340 million on prescriptions for its workforce, a 15 percent > increase over last year. > > " I am optimistic we will be able to save literally millions of dollars for > the taxpayers and set a precedent other states will follow, " the governor > said. > > Although Illinois would become the first state to pursue Canadian drug > purchases for its workers, Blagojevich joins a much larger trend. Even as > Congress debates whether formally to legalize the practice, millions of > Americans -- including horse breeders in New Jersey, a retirement village > in Ohio and the mayor of Springfield, Mass. -- already have decided for > themselves that the financial savings are too large to pass up. Despite > its claim that the practice is illegal, the FDA has generally looked the > other way. > > " There are a lot of bad drugs out there, " said FDA Senior Associate > Commissioner William Hubbard. " We fear a program like [illinois's] would > put people at risk. " > > " In my opinion the pharmaceutical corporations and the lobbyists have an > absolute stranglehold on Washington, " said Springfield Mayor Michael J. > Albano. Since July, he has enrolled more than 800 city employees in a > voluntary program that covers maintenance medications bought from a > Canadian wholesaler. > > Before launching the effort, Albano traveled to Canada to check out CanaRx > and then became the first client, ordering his son's insulin and diabetes > supplies from the company. To attract participants, the city waived > co-payments on medications bought through the Internet service. > > The switch saved Albano $250 this year and the city $852 for his family's > medications. If a large percentage of the city's 9,000 workers and > retirees join, the mayor estimates the city will save $4 million to $9 > million a year. > > " This is a revenue stream for Springfield, the only revenue stream we > have, " Albano said, noting that budget cuts have forced him to slash 323 > jobs. " I know people have concerns about foreign countries, but we're > talking about Canada here, not Iraq or North Korea or Iran. " > > Depending on the drug, the discounts in Canada can be as much as 80 > percent, savings that have proven especially irresistible to senior > citizens who do not have prescription coverage under Medicare. > > " How pathetic can it be that the solution to the high cost of drugs is to > try to sneak them across the borders, " said Arthur Caplan, director of the > Center for Bioethics at the University of Pennsylvania. " Even our > government doesn't believe the price of drugs the industry is charging. > The Veterans Administration and the Department of Defense don't pay these > prices. " > > One of the vagaries of the U.S. system is that senior citizens -- major > prescription medication users -- often pay the highest prices because they > are not eligible for the bulk discounts government and private insurance > programs provide. > > To ease the strain, the industry distributed free medications to 5.5 > million patients last year, said Jeffrey L. Trewhitt, spokesman for > Pharmaceutical Research and Manufacturers of America. He said that what > amounts to importing other countries' price controls not only endangers > patients but also jeopardizes future investment in research that produces > new drugs. > > Trewhitt cited FDA warnings that medicine bought from another country may > be counterfeited or tampered with, because it does not undergo the same > strict inspections. The agency has said it has little desire to punish > individual patients in need of lifesaving medicine. > > But with private analysts and the FDA estimating $750 million in > prescription drug revenue now flowing to Canada -- and entrepreneurs > capitalizing on the trend -- the Bush administration is shifting to a more > aggressive stance in the legislative and legal arenas. > > " It's complicated and contentious and there's a lot at stake, " said James > N. Czaban, a food and drug lawyer at Heller Ehrman in Washington. " It > looks like we're heading to a multifront war in the courts and on the > Hill. I can easily see this becoming a very significant national case > because of the policy issues involved. " > > Late last week, the Justice Department asked an Oklahoma judge to issue an > immediate injunction against Rx Depot, a chain of 85 storefront businesses > that helps process drug orders in Canada. Justice lawyers, working with > the FDA, argue the company's role as a middleman makes it a de facto > pharmacy that endangers patients by selling " unapproved " products. > > " The fact that you have no drugs in the back room doesn't matter, " Hubbard > said. " We have been told by state pharmacy boards they are selling > unapproved drugs. " > > In some instances, the unapproved drugs are products awaiting licensing in > the United States, though in many others the term " unapproved " simply > means the medicine was bought outside the country. However, many of the > medications sold legally in this country are manufactured overseas. > > Carl Moore, the Oklahoma oilman who founded Rx Depot, rejected the notion > he is acting as a pharmacist and said he is exercising his First Amendment > rights to provide information. " If you can find out how to build a bomb on > a Web site, I should be able to tell people drug prices off the Web, " he > said. > > Moore said his business is the logical extension of the cross-border bus > trips FDA has permitted for a decade: " We developed a concept for people > who live inland. " > > The FDA cannot discuss details of the case, Hubbard said. But he > volunteered that an undercover agent who ordered two medications through > an Rx Depot in Oklahoma received a generic substitute for one that has not > yet been approved in the United States. The second medicine is an > FDA-approved drug, manufactured in this country but " became an unapproved > drug once it came from Canada, " he said. > > The agency conducted a similar undercover investigation into Springfield's > program and asserts that Albano is allied with an unlicensed drug > distributor. Albano counters the FDA " conducted a sting of the wrong > pharmacy. " > > Hubbard acknowledged that FDA's discretionary authority has resulted in > inconsistent enforcement. He said FDA hopes Congress and the courts will > bring clarity to the situation and some financial relief to consumers -- > perhaps before the 2004 elections. > > " The answer is better coverage in this country and a good place to start > is for Congress to finally reach bipartisan agreement on a Medicare drug > benefit, " said Trewhitt. > > The House and Senate have approved 10-year, $400 billion drug plans, but > resolving differences between the two versions has proved difficult. With > final passage of legislation in doubt, Reps. Rahm Emanuel (D-Ill.) and Gil > Gutknecht (R-Minn.) are pressing the Senate to adopt their bill legalizing > drug imports from Canada and the European Union. Although it passed the > House overwhelmingly, the White House, the FDA and some powerful senators > are opposing it. > > In the meantime, a growing number of Americans have decided they can't > wait for Washington. > > Despite the legal uncertainties, the Standard Breeders Owners Association > in New Jersey signed up for a drug-purchasing plan with SUNRx, which > supplies medications from Canada, if the company offers the cheapest > price. > > " After I've seen some of the discounts and realizing how much is added on > to U.S. drugs, I absolutely believe this is the way we need to go, " said > Shay Cowan, the health care consultant at HRH of New Jersey Inc. who > signed the breeders up for the Canadian program. For the first time in > recent memory, Cowan said he has helped a client lower its drug costs. > > " We are actually reversing the trend, " he said. " There is nobody in the > industry able to do that. 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