Boston Looking to Canada for Drugs

BOSTON — Seeking to reduce this city’s $61-million annual prescription drug costs, Mayor Thomas M. Menino on Tuesday unveiled a health plan that would allow municipal workers to obtain cheaper medications from Canada.

New Hampshire also announced Tuesday that it would start importing some drugs for its prison inmates and Medicaid recipients, making it the first state in the nation to engage in the growing but illegal practice.

“Inflated [pharmaceutical] industry pricing and federal inaction have created an untenable situation for the residents of our city, who should not have to choose between paying for medications and paying for rent,” Menino said. Outlining his proposal at a City Council meeting, the mayor said the voluntary program would begin in July and initially would cover about half of the city’s 15,000 workers and retirees. It would apply to a limited number of prescription drugs.

Boston and New Hampshire -- which said it would begin its program as soon as possible -- announced their intentions one day after President Bush signed into law a Medicare reform package that did not include a provision allowing for the importation of drugs from Canada.

Filling prescriptions across the border, Menino said, was only a small part of the greater issue of affordable medicine.

“We know that importation will not solve the price problem, but it will help,” he said. “It will put pressure on the manufacturers to reduce prices. We need the companies that make these drugs to take fair pricing seriously.”

Boston’s plan mirrors one in the western Massachusetts town of Springfield, which in July became the first city in the nation to allow some of its 20,000 municipal workers to purchase pharmaceuticals from Canada.

Although Menino said he expected Boston to save at least $1 million by importing drugs, Springfield Mayor Michael J. Albano called that figure “very conservative.” Since the “Springfield Meds” program began, Albano said, “We have come close to saving $1 million already. By next July, we will be looking at savings of $4 million to $9 million. If Boston is spending $61 million on drugs, the mayor can save 50% this way, easy.”

Pharmaceuticals are less expensive in Canada because of provincial price regulations. But the U.S. Food and Drug Administration, which has questioned quality-control, repeatedly has asserted that drugs purchased there pose health risks to American consumers.

Importation of pharmaceuticals is illegal, but the FDA has chosen not to prosecute individuals or small groups of citizens who have crossed the border to buy reduced-priced medication.

Tom McGinnis, director of pharmacy affairs for the FDA, said Tuesday that his agency was investigating the Canadian supplier of drugs for Springfield rather than prosecuting the city itself.

Safety, McGinnis said, was his agency’s primary concern when it comes to the importing of drugs from Canada or any other country. “We have no authority outside the United States, so we worry about things we have no data or information on,” he said. “We don’t know how these things are made [in Canada], how they are packaged or stored -- and that bothers us.”

But Andy Troszok, vice president of standards for the Canadian International Pharmacists Assn., said that “not a single U.S. patient has been harmed from the Canadian system.”

“And I don’t see Canadians dropping dead right, left and center because of tainted drugs.” Troszok said. “I just wish everyone would stop talking about the smoke screen of safety and concentrate on the real story: It’s about money.”

In addition to purchasing from Canada the most commonly prescribed drugs for its prisoners and Medicaid recipients, New Hampshire said it would post a Web site with links to Canadian pharmacies, where any state resident can get a prescription filled. The state said it would certify the safety standards at those pharmacies.

Illinois, Wisconsin and Minnesota also are exploring plans to import medication from Canada. Burlington, Vt., and New York City are among a growing number of U.S. cities researching such proposals.

A survey released Tuesday by the State University of New York at Stony Brook showed that 68% of Americans support congressional legislation that would allow U.S. citizens to purchase prescription drugs from Canada. In the same poll, 64% of those surveyed said states should be allowed to import pharmaceuticals from Canada.

Only 10% of those questioned said they believed Canadian prescription drugs were unsafe.