WEDNESDAY, Oct. 13, 2004 (HealthDayNews) -- A new joint program in Illinois and Wisconsin to help residents buy cheaper prescription drugs from Canada and Europe is the latest challenge to the United States' ban on drug importation.

A growing number of states and municipalities are openly defying the federal law. Minnesota, the first state to facilitate cross-boarder drug imports, launched a Web site in January providing residents with information on how to buy drugs from Canada. Since then, North Dakota and New Hampshire have joined the fray, while nearly a dozen other states have proposed import programs.

Cities such as Montgomery, Ala., and Springfield, Mass., have gone a step further, running import programs that trim the cities' pharmaceutical spending when their employees and retirees buy from Canada.

Even Montgomery County, Md., where the U.S. Food and Drug Administration resides, has approved a resolution that would allow its 85,000 employees, retirees and dependents to buy prescription drugs from Canada.

"It's clearly emblematic of the issue that you've got this widespread desire to thumb their nose at the feds to get cheaper drugs," said William Hubbard, associate commissioner for policy and planning at the FDA.

The agency had earlier rejected Illinois' request for a waiver to implement its importation program, saying it could not assure the safety of imported drugs. But that hasn't stopped Illinois or several other states and cities from taking matters into their own hands.

Although it may be technically illegally, drug inspectors have made an exception to the import ban for individuals carrying foreign drugs across the U.S. border. The FDA merely warns those people that the drugs may not be safe and advises them to contact their doctor but doesn't arrest them, Hubbard explained.

"That leniency has also meant that folks like this [state officials] are arguing because we act as health professionals, not as cops, that we're acquiescing, and we're not," he insisted.

The Canadian International Pharmacy Association (CIPA) supports state efforts to direct U.S. residents to reputable pharmacies in that country. Its members participate in several so-called "passive endorsement" programs. But CIPA takes a dim view of municipalities that encourage employees to buy from Canada so their governments can realize savings.

"That is unacceptable as far as we're concerned because it changes the whole dynamic. You're no longer involved to supply products to patients who are having difficulties affording their medication; [you're] now subsidizing city or state budget deficits," said David MacKay, CIPA's executive director.

If all 50 states were to institute Canadian drug-buying programs, it would open the floodgates, MacKay maintained, and "the Canadian system would not be able to support that."

The new Illinois/Wisconsin program, called I-SaveRx, touts savings of 25 percent to 50 percent off U.S. retail prices on about 100 brand-name medications. It's also the first program to include pharmacies in Great Britain and Ireland. That's to assure that the drug supply meets demand, said Abby Ottenhoff, a spokeswoman for Illinois Gov. Rod. R. Blagojevich, a Democrat who championed the program.

"It's a well-known fact that the pharmaceutical industry is trying to shut down supply to Canadian pharmacies that are serving American citizens," she said.

Indeed, such major pharmaceutical manufacturers as Pfizer Inc. and GlaxoSmithKline have cut supplies to Canadian pharmacies and wholesalers serving American customers.

CIPA supports states' attempts to tap the European market, but the U.S. government isn't applauding their ingenuity. In Hubbard's view, crossing the Atlantic merely creates new safety concerns. While pharmacies participating in I-SaveRx are explicitly prohibited from dispensing drugs from counties other than Canada, England and Ireland, he worries that drugs from other European Union countries would inevitably slip in.

While the FDA is studying its options in each case, Hubbard couldn't say with certainty whether the agency would prosecute a governor or mayor.

"We have a clash of fundamental values between FDA's mission of safety and these governors' efforts to get price relief for their citizens," he said.

"It may came down to a judge refereeing this," Hubbard added.

The National Association of Boards of Pharmacy (NABP), whose members are supposed to enforce state pharmacy laws and regulations, is at a standstill. Even though its members oppose drug imports on safety and legality grounds, state pharmacy regulators haven't taken action against state- or municipal-sponsored importation programs.

"We're waiting for lawsuits," said Carmen Catizone, the NABP's executive director. "If the FDA could initiate lawsuits, that could certainly reinforce what our members are saying."

Despite the surge in governments and private citizens who say they want to buy cheaper prescription drugs from Canada over the Internet, only 4 percent of Americans say they've ever purchased medications online, a new survey finds.

Of respondents who said they had purchased medications online, most tended to live in higher-income households and had six or more years of online experience, the Pew Internet and American Life Project survey found. Three-quarters of these online buyers said they purchased drugs for a chronic condition like arthritis or high blood pressure. And most were satisfied and planned to order online again, the Associated Press reported.

More information

Visit the U.S. Food and Drug Administration's Web site for more on importing foreign drugs.

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