THURSDAY, May 6, 2004 (HealthDayNews) -- A fierce momentum began building this week to legalize the importation of prescription drugs from Canada to the United States, and even those who oppose the move now admit they may not be able to stop it.
The sea change comes in the wake of surprise remarks by the top U.S. health official earlier this week. Tommy Thompson, Secretary of the U.S. Department of Health and Human Services (HHS), said Tuesday that legislation allowing the importation of prescription drugs was inevitable.
On Wednesday, attorneys general from 18 states sent Thompson a letter asking that he let states import low-cost prescription drugs from Canada.
Also Wednesday, Thomas Ryan, chairman and chief executive officer of the pharmacy giant CVS, called for a temporary legalization of imports -- another sign that Thompson's remarks could signal the beginning of an irreversible shift.
"While many in our industry believe that importation is a fundamentally flawed concept and oppose it without exception, I have come to a slightly different view," Ryan said in testimony before an HHS task force on the matter. "Simply put, there are too many patients our pharmacists never see because they cannot afford the drugs we dispense, and others who are unable to pay for a full regimen of medications because it soaks up so much of their disposable income."
Ryan said importation should be legalized for three or four years while the larger issue of varying drug prices is addressed. Although he told the panel he didn't support price controls, he said something was fundamentally wrong. "We cannot allow millions of our fellow citizens to go without life-sustaining medications due to arbitrary international trade practices," he said. "We don't do it for sugar, rice or corn; we shouldn't do it for lifesaving medications."
The attorneys general, in their letter, urged Thompson to "act
immediately to help provide our citizens with affordable prescription drugs while ensuring drug safety," according to news wire reports. The attorneys general come from Arizona, California, Colorado, Connecticut, Illinois, Iowa, Maine, Maryland, Massachusetts, Mississippi, New Hampshire, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont and Wisconsin.
Under their proposal, all of the imported drugs would be manufactured at facilities sanctioned by the U.S. Food and Drug Administration. Sophisticated tracking devices would be used to thwart counterfeiters, the letter said.
The Bush Administration, however, remains staunchly -- and aggressively -- adamant in its opposition to legalizing the importation of drugs from Canada. The administration and the pharmaceutical industry cite safety concerns as the key to their opposition.
Following Thompson's comments Tuesday, an HHS spokesman termed the statements a personal opinion.
"This does not represent a change in policy," the spokesman was quoted as saying to the Los Angeles Times.
The FDA, which Thompson oversees, has also shown no sign of budging on its directive from the president. The U.S. government has aggressively pursued companies that import drugs, going so far as to try to close their doors. Importing drugs poses "a significant risk to the public health," the FDA stated in one lawsuit against an importer last year.
In his testimony before the task force, Ryan of CVS said drug safety and accessibility "are important questions." He added, however, that "these arguments miss the core issue" of price differences.
Still, the pharmaceutical industry remains staunchly opposed to a Canadian drug bill.
"Importation laws have passed in Congress twice, and two secretaries of Health and Human Services -- including Secretary Thompson -- have said importation cannot be done without compromising patient safety and public health," said Court Rosen, a spokesman for the Pharmaceutical Research and Manufacturers Association.
"That's the current law of the land. We believe the right way to go is to protect patients from tainted, counterfeit and unapproved drugs that can sneak into the country. HHS and the White House have both indicated this is not a policy change that Secretary Thompson was speaking of," Court added.
The industry has tried to stem the flow of drugs from Canada. In 2003, for instance, GlaxoSmithKline cut off sales to Canadian pharmacies that re-sell medications to Americans. The move sparked a boycott of the company, which argued that safety and a shortage among Canadian customers was at issue.
Foreign companies delivered about 2 million prescription orders -- often containing more than one drug -- to U.S. customers in 2002, twice as many as in the previous year, the FDA estimates.
Federal legislation addressing the legalization of importation is pending. Meanwhile, various cities and states, in open defiance of the FDA, have already inaugurated systems to help government employees and residents buy drugs from Canada.
In Springfield, Mass., for instance, city employees purchase drugs through a Canadian vendor at an estimated annual savings of $3 million.
"Mr. Thompson and the HHS are starting to come closer in line with the American public, and they're understanding that this is a financial crisis, and that our neighbor to the north is not a Third World country and that things are just as safe there as they are here," said Christopher Collins, insurance program director for the City of Springfield.
The state of New Hampshire has links to a state-approved Canadian pharmacy on its Web site. "We've had thousands of hits," said Wendell Packard, spokesman for Gov. Craig Benson. "I'm not surprised by" the furor.
Many opponents of the government's policy insist its safety concerns are nothing more than a cover for larger concerns about drug-company profits.
"It's interesting that Canadian drugs have been safe until it became politically unsafe for the Bush Administration to oppose re-importation," said Isaac BenEzra, president of the Massachusetts Senior Action Council. "So much for public health policy being based on taking care of the needs of the American people as opposed to protecting the profits of the pharmaceutical industry .... The only thing unsafe about this whole scheme is that Canadian drugs are unsafe for profits of industry."
"Secretary Thompson is right that the American people are demanding access to drugs at the same fair prices available to Canadians and Europeans," U.S. Sen. Edward M. Kennedy (D-Mass.) said in a statement. "But passage of a real program will continue to be an uphill battle as long as President Bush stands with the pharmaceutical industry against American patients. If President Bush is serious, we have a bipartisan bill that is just what the doctor ordered."
More information
For more on buying drugs online, visit the U.S. Food and Drug Admininstration or the National Association of Boards of Pharmacy.
