Drug Reimportation Can Kill Americans — We Can Do Better

Posted May 5, 2004 at 4:12pm

Increasingly, it looks as though the reimportation of price-controlled pharmaceuticals from abroad is gaining speed like a runaway train. Republicans are joining Democrats in Congress and in state governments, all rushing headlong to satisfy public demand for cheaper prescription drugs. [IMGCAP(1)]

Even the Bush administration, which not long ago had been adamantly opposed to reimportation on safety grounds, seems to be buckling: Health and Human Services Secretary Tommy Thompson has remarked to reporters that import legalization is “inevitable.”

But before legalizing mass importation of prescription drugs — and risking America’s health in the process — Congress and the White House should let drug discount cards work and get other countries to share in the cost of drug research.

Mass importations are dangerous because they will almost inevitably suck in fake and dangerous drugs that even enhanced government inspections won’t catch. They are also tantamount to importing foreign price controls, which retard drug research and development of new treatments for disease.

In other words, politicians — in their haste to satisfy public demand for cheaper pharmaceuticals — will end up killing people and letting others suffer from delayed cures.

In reality, there are better ways to handle the disparity between U.S. and foreign drug prices — the factor that has been driving the reimportation debate. One is to reduce U.S. prices — something that should happen soon thanks to the drug discount cards now being offered to America’s seniors under provisions of last year’s Medicare overhaul.

Unconscionably, Democratic leaders, in a misguided attempt to make a political point, are urging seniors not to sign up for the cards, even though they could make drugs up to 30 percent cheaper for many Medicare beneficiaries and all but free for many low-income seniors.

Another positive step, urged by Speaker Dennis Hastert (R-Ill.), would be for President Bush to bring up the issue of drug pricing at the G-8 economic summit in June. The president needs to persuade other major countries to contribute more to the enormous cost of discovering and developing new drugs.

The retail price for patented drugs in the United States is typically 25 percent to 75 percent higher than in Canada, Europe and other industrialized countries. This occurs because other nations set prices as close as possible to the drug’s production cost — a decision that ignores the investments made before a drug is ready for market. On average, these costs total $800 million for just one new medicine.

The White House says that the United States “will look for opportunities to raise the issue with other countries.” But other sources say it’s not on Bush’s G-8 agenda.

In the meantime, the House has already passed a bill permitting the mass importation of drugs from Canada and dozens of other countries but includes few if any safety protections.

Two bills pending in the Senate impose stricter safety standards — one by Sen. Chuck Grassley (R-Iowa) and one by Sens. Byron Dorgan (D-N.D.), John McCain (R-Ariz.), Edward Kennedy (D-Mass.), Olympia Snowe (R-Maine) and Trent Lott (R-Miss.)

And Sen. Judd Gregg (R-N.H.) — the Senator designated by Majority Leader Bill Frist (R-Tenn.) to handle the issue for the GOP leadership — is scheduling hearings and drafting another bill that would permit imports, probably with safety standards similar to the other Senate bills but possibly taking a less punitive attitude toward the drug industry.

“You’ve got a large majority of Senators flowing in the same direction right now,” said one Senate aide. “Right now they’re in different tributaries, but if they come together, the dam will break.”

House GOP leadership aides dispute Thompson’s gloomy prediction that reimportation will be inevitable, pointing out that if the Senate agreed on a bill, it likely would have to go to a House-Senate conference, where it could be altered or delayed. But one aide acknowledged that a majority of House Members could sign a discharge petition to bring a Senate-passed bill to the House floor, bypassing leaders opposed to imports.

Under current law, drugs can be imported only if HHS says it can be done safely. Both Thompson and his predecessor, Democrat Donna Shalala, refused to certify imports.

Nonetheless, some 2 million Americans have imported drugs on their own, often via the Internet. And several states have set up Web sites to allow citizens to import drugs. These include Minnesota and New Hampshire, both of which have GOP governors.

Canada’s government will not certify the safety of the drugs being exported from its territory, and the Food and Drug Administration and U.S. Customs Service have seized thousands of fake, out-of-date or adulterated drugs at U.S. ports of entry, often ostensibly from Canada but actually from Latin American or Asian countries with minimal safety standards.

A recent Congressional Budget Office study found that importing drugs might not save consumers much money, especially if demand from the United States causes prices to rise in Canada and European countries, if those countries limit exports or if drug companies limit supply to those countries.

Meanwhile, drug discount cards exist — but House Minority Leader Nancy Pelosi (D-Calif.) and others, as part of a general effort to discredit the Medicare law, are urging seniors not to acquire them.

John Rother, national policy director of AARP, told me that the Democrats “have gone off the extreme end. The cards give poor seniors a $600 credit on their cards, giving them drugs almost for free. You’d think Democrats would want to help this constituency.”

Rother said that while there “are problems” getting the discount card system started, seniors should be able to get a 30 percent discount, “which is almost what they’ll save by going to Canada.”

It’s true that non-seniors lacking health insurance still get hit with high drug prices, although drugmakers are beginning to offer discounts to them too. Former Speaker Newt Gingrich (R-Ga.) has proposed making drug purchasing like using Travelocity, the cheap-airfare Web site.

All of this suggests that better alternatives exist. Congress ought to try them before people die for the sake of political expediency.