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Date Posted: 22:14:44 12/25/03 Thu
Author: Jimmy
Subject: More opt for Canadian drugs
In reply to: Bennie 's message, "Canada: New Hampshire to put Canadian drugs mere click away for its residents" on 08:48:56 12/12/03 Fri

Illinois Gov. Rod Blagojevich, left, and Rep. Rahm Emanuel, D-Ill., asked for permission to set up a program to import drugs from Canada, but federal officials said they could not certify a program's safety.

More opt for Canadian drugs

Growing numbers of communities help residents, employees get cheaper prescriptions over the border

By Julie Appleby / USA TODAY

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For a year, the city of Montgomery, Ala., has been quietly saving money on its employees’ health insurance costs — with a little help from Canada.

Although New Hampshire, Boston and Springfield, Mass., have grabbed headlines over programs aimed at helping residents buy drugs from Canada, Montgomery beat them all.

“Quite honestly, we’ve not sought attention on this,” said Jeff Downes, executive assistant to the mayor.

The program — a voluntary part of the city’s health benefit program for city employees and retirees who wish to get their drugs from a Canadian pharmacy — began last December and will save the city $400,000 to $500,000 in its first year, Downes said.

A growing number of cities, counties and states say they want to allow employees, retirees and ordinary citizens to buy prescription drugs from Canada, where prices are lower because the government controls what drugmakers can charge.

* Illinois Gov. Rod Blagojevich asked for federal permission to set up a pilot program that would import medications from Canada, but federal officials said they could not certify that such a program would be safe.

* Boston Mayor Thomas Menino met with the Food and Drug Administration but was not dissuaded from his plan to launch a program to help city employees and retirees buy drugs from Canada.

Challenging the FDA

If several municipalities and states launch cross-border drug-purchase programs, the efforts will present one of the most serious challenges to FDA authority in the agency’s history. The FDA has warned cities and states that aiding U.S. residents in buying drugs from abroad could be illegal and unsafe, but it isn’t clear the agency will be able to stop them.

“We’ll evaluate any program that starts,” warned the FDA’s William Hubbard, associate commissioner for policy. Hubbard said he hopes city and state leaders talk with the FDA before launching any programs.

“We don’t intend to wait for their blessing,” said Burlington, Vt., Mayor Peter Clavelle, who wants his city to have a program under way by March 1.

Many legal observers say the FDA may have little recourse but to fight each city and state.

“The administration has staked out a position they can’t afford not to defend,” said attorney Jim Czaban, who specializes in drug law for the Washington, D.C., firm Heller Ehrman.

But the growing momentum may make that effort futile.

“There are probably 60 cities and counties we are talking with,” said Tony Howard, chief executive of CanaRx, a Canadian pharmacy that coordinates the city of Springfield’s program that began earlier this year to help employees buy prescriptions in Canada.

He says if enough cities and states enact cross-border drug programs, it will prompt Congress to change drug law and bring costs for medicine in the United States down to the level they are in the rest of the world.

“If the U.S. were to drop costs to the average of the world, and then the pharmaceutical industry said it needed more money for research and development, then add a dollar to every prescription filled throughout the world,” Howard said. “But be fair. Why should the U.S. pay twice as much as what everyone else does?”

Debate in Congress continues. Some lawmakers want to make it easier for residents to bring drugs in from Canada. But others fear that if enough individuals, cities and states buy from Canada, it could further raise prices in the United States as drug companies seek to make up for lower revenue. They want to see other countries raise their prices, rather than impose price controls in the United States.

Canadians are also split on the moves, with some supporting the business cross-border sales brings to some local pharmacies, which collect a commission on each sale to the United States, while others fear it will lead to higher drug costs or shortages in Canada.

The FDA has made a move to halt one city’s program. After Springfield, Mass., began offering its cross-border drug program earlier this year, the FDA sent warning letters to the city’s drug coordinator, CanaRx, based in Windsor, Ontario. But the FDA’s effort was dealt a setback when CanaRx closed all its U.S. storefronts, effectively removing itself from FDA jurisdiction.

FDA Commissioner Mark McClellan last month flew to Canada to meet with Health Canada officials, who the FDA says are reviewing CanaRx to ensure it is not violating Canadian laws. That investigation could take months, Hubbard said.

In the meantime, the FDA is working with some states to help them take action against commercial storefronts that help individuals buy drugs from Canada. The FDA in November won a key court battle, shutting down Rx Depot, which operated a chain of storefronts. The FDA argued that Rx Depot, and other firms like it, endanger patients by importing unapproved drugs from Canada.

“More than half the states have taken action against these storefront pharmacies or Internet operations within their state boundaries,” said Tom McGinnis of the FDA.

In Alabama, for example, the state’s pharmacy board has succeeded in shutting down every storefront business it has learned of that helps residents buy drugs from Canada, mainly for operating without a license.

Jerry Moore, executive director of the Alabama pharmacy board, says safety is the issue.

“If there is one adverse event (from a drug purchased through Canada), all the money you save would not be worth having a person end up in the hospital because a drug was subpotent, tainted or counterfeit,” Moore said.

He says his agency has not taken action against Montgomery because the pharmacy the city deals with is outside the state’s jurisdiction, but the agency has referred the matter to the FDA.

Safety of Canadian drugs

Supporters of Canadian drug purchases say the safety issue is misleading. Drugs from Canada, they say, are just as safe as drugs bought in the United States.

Downes in Montgomery said the city’s program “ensures that all safety precautions are in place.”

City employees and retirees who wish to participate submit information on their medical history and the drugs they take. Then, if the prescriptions they need are included on a list of about 750 drugs it covers through Canada, the employees can buy the drugs by sending their doctors’ prescriptions to the city’s pharmacy benefit manager. The management firm, which is in Texas, handles all the city’s drug claims.

Drugs from Canada must be at least 20 percent cheaper than what can be found locally to be included on the city’s list. Downes says most of the drugs cost 40 percent to 60 percent less than in the United States. The pharmacy manager sends the prescription to a Canadian pharmacy, which fills it and mails it to the employee.

The program has been so successful in saving money, Downes said, that a 15 percent co-payment patients were charged was dropped in November. So employees who choose to get their drugs through Canada get them free.

“Employees save money and the city saves money,” Downes said.

That’s certainly what Clavelle wants in Burlington. “Municipalities are overburdened with the high cost of health care,” he said. He admits that buying drugs from Canada will help only so much. “Believe me, I don’t view this as a solution. This is a Band-Aid. But we need some Band-Aids.”

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  • Re: Canada: New Hampshire to put Canadian drugs mere click away for its residents -- Debby, 02:03:06 12/27/03 Sat
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