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Facing budget-breaking increases in prescription-drug bills, the
governor of Illinois took the first step Sunday toward purchasing
lower-cost medications from Canada.
That would put him in direct conflict with federal regulators
and signal 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, non-profit 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 re-importing 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 status quo on prescription drugs is intolerable and
unacceptable," Blagojevich said in an interview Sunday.
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."
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., have decided the financial savings are too large to pass up.
Despite its claim that the practice is illegal, the FDA generally has
looked the other way.
"In my opinion the pharmaceutical corporations and the lobbyists have
an absolute stranglehold on Washington," Springfield Mayor Michael
Albano said. Since July, he has enrolled more than 800 city employees
in a voluntary program that covers maintenance medications bought
from a Canadian wholesaler.
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.
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."
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 medication to 5.5
million patients last year, said Jeffrey Trewhitt, spokesman for
Pharmaceutical Research and Manufacturers of America. He said that
what amounts to importing other countries' price controls endangers
patients and jeopardizes 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 life-saving medicine.
But with private analysts and the FDA estimating $750 million in
prescription drug revenue flowing to Canada, and enterprising
business people capitalizing on the trend, the Bush administration
is shifting to a more aggressive stance.
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 help process drug orders in Canada.
Justice lawyers, working with the FDA, argue that the company's
role makes it a de facto pharmacy that endangers patients by
selling "unapproved" drugs
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