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>Drug firms oppose reimportation > >Jeff Trewhitt, a spokesman for the Pharmaceutical >Manufacturers of America, visited The Free Press on >Friday and spoke with City Editor Joe Spear about a >variety of issues regarding prescription drugs. > >Q. What is wrong with Americans buying cheaper-priced >prescription drugs from Canada? > >A.There are two major problems. The Food and Drug >Administration has been warning consistently about the >safety risks of imported medicine for years. It's not >a partisan thing. They have been warning both through >the Clinton administration and Bush administrations. >Two federal secretaries of Health and Human Services >from both sides of the political aisle have declined >to certify the safety of imported medicines. ... > >Q. As you know, some people dispute this, that >Canadian drugs are unsafe. Our Congressman Gil >Gutknecht, our governor, as you know, said: Where are >the dead Canadians? How do you respond to that? > >A.Well, there aren't any dead bodies. But there are a >lot of disappointed patients who were defrauded, who >paid for a treatment and did not get the treatment. ... > >Q. As I understand Congressman Gutknecht's >legislation, he is actually advocating the FDA can >just go ahead and approve, go to these places in >Canada and approve them and then you know you're >getting it from an FDA- Seller. What's wrong with that? > >A. Well, because there are better, safer alternatives >to imported medicine. First of all, we need better >coverage in this country ... Congress needs to address >that problem. They have started to address that >problem by passing the new Medicare law ... > >In the meantime, until there is full and better >coverage and until we have a fully implemented >Medicare law by the spring in 2006, we strongly >recommend that patients who are having difficulty >getting their medicines actively explore the many >different patient assistance programs in the country >sponsored by our companies. > >All Pharma member companies have patient assistance >programs. Those programs last year provided free >medicine to about 6.2 million people, and the >companies have signaled that if necessary, there's >room for more ... > >Another viable option is the fact that as part of >competitive marketing, our companies provide free >samples for a wide range of medicines for hundreds of >thousands of doctors all over the country and those >free samples are worth about $12 billion a year, so >there are a lot of free samples ... and those free >samples are generally given to patients who are having >difficulty. ... > >Q. They certainly couldn't get free samples for an >extended period of time, could they? > >A. These are stopgap measures, just as importation is >a stopgap measure. It's not a good stopgap measure, >but it's a stopgap measure. And you're right, a >patient probably could not get a free sample, >indefinitely. ... > >One other alternative, and this is very important to >note, that many studies have been conducted ... in >towns and cities all over the country and those >studies show the same thing ... You can go into any >given town and city and look at the retail pharmacies >and you're going to find wide price disparities ... >among retail pharmacies in the same town. ... >Sometimes the price difference is 50 to 100 percent. > >Q. Does your organization believe the price increases >for prescription drugs are too high? > >A.The pharmaceutical inflation rate has been cut by >more than half over the last 15 years. The average >(annual) pharmaceutical price increase throughout the >1980s was about 10 percent. The pharmaceutical >inflation rate in 2002 was 4 percent. ... > >There's a reason for that. It may be tough on the >companies, but it's good news for patients. ... the >pharmaceutical marketplace in the U.S. is undergoing a >shift from the more expensive one-on-one doctor to >patient fee for service to the different types of >managed health care plans. > >The different types of private health plans today make >up 60 percent of the market and they are continuing to >grow. And they are demanding and getting increasingly >generous price discounts ... (of) between 20 and 40 >percent. ... > >If they can get into a health plan, if they can afford >the co-pay and the premium, many times they are >brought down to the Canadian cost level. > >Q. I'm glad you brought up the bargaining power of >insurance companies and health plans. As I understand >it, the pharmaceutical industry opposed allowing the >federal government to negotiate discounts through the >Medicare bill that was recently passed. Why would they >be opposed to that? > >A. Because you're going to get the best discounts by >using the private health plans to negotiate with the >companies. ... > >Q.You mentioned private-sector solutions. Isn't >importing drugs from Canada a private sector solution? > >A. Here's the problem with it. There's not only the >safety concern, there also is the fact that what you >have in Canada is a very strict price control system. >... > >Those artificially low prices in Canada don't take >into account the fact that the average cost of >researching and developing a new drug has increased >from $231 million about 20 years ago to more than $800 >million per product today. ... > >Q. As you probably heard also, Congressman Gutknecht >has criticized the system we have because it puts all >the cost of developing new medicines on Americans, >whereas everybody else is getting a free ride. > >A. Congressman Gutknecht may be very surprised to hear >this, but we completely agree with him on that. ... > >Q. So why not cut off Canada? > >A. I don't have a definitive answer because I don't >work for a company and because of the federal >anti-trust law I can't get into their pricing >strategies. > >But what I have heard - this is what I've heard, this >is not what I know directly ... - I have heard, and I >read this in a number of places, that the Canadian >government has sort of this kind of implied threat, a >consistent threat, that if companies don't go along >with the nationalized system and the strict price >controls ... then they might consider compulsory >licensing of the patent, meaning in other words, >they'll ignore the brand name company and ignore the >brand name company's patent and go to a copycat >company and have the copycat company make the drug for >less. > >Q. It sounds like a threat that has worked for >Canadians though. > >A.Well, but here's what it's done to the Canadian >pharmaceutical industry. It's killed it. ... > >Q. Well, they don't need an industry because they get >subsidized prices from ours. > >A. But if we have imported medicines ... from Canada >with the artificially low prices, it has the effect of >importing somebody's else's failed price controls and >we can't afford that in this country. And the reason >why we can't afford it in this country is because we >are the most innovative pharmaceutical industry. > >Q. Would re-importing from Canada really hurt the >business of pharmaceutical companies? I hear it's a >very small market. The amount of drugs that come over >would be minuscule. > >A. I have a colleague in Washington who's tearing her >hair out right now because she is monitoring the >different states that have importation proposals and >she's looking at 25-30 state proposals right now. > >And they all have differing approaches. ... So you're >talking about if this happens, and the potential of a >patchwork quilt ... which makes it difficult for the >FDA to monitor and regulate and at that point you >potentially open the floodgate for imported medicines. > >And at that point there could be a threat to >innovation. ... > >Going back to a key point you made: American consumers >should not be subsidizing patients in other countries >who are getting artificially low prices. And we have >suggested to the U.S. government that that practice, >that allowing patients in other countries to have the >benefit of price controls, should be put on the table >in bilateral trade talks because they should be paying >their fair share. > >Q. We talked about the dangers of ordering drugs over >the Internet. Minnesota has recently set up a system >that allows consumers to do this. Is it dangerous? > >A. To be honest with you, I don't know enough about >the Minnesota system. Now we'll be hypothetical >because I don't know enough about it. If you are >talking about a licensed Internet pharmacy with >physicians heavily involved in the process, there may >well be less of a danger.

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