Pressure Mounts on Feds to Allow Imported Drugs

Three Republican governors and the head of a major drugstore chain on Wednesday strongly rejected the arguments of the Bush administration and pharmaceutical manufacturers against importing U.S.-made drugs from Canada and other countries.

“It is simply implausible that the United States of America ... is incapable of designing a system where we could safely import medications from Canada,” Minnesota Gov. Tim Pawlenty told a Department of Health and Human Services panel studying the drug import issue.

“It’s a question of setting a goal and getting it done,” Pawlenty, said, calling high drug prices “a major issue for our country.”

Adding to the sense of political and popular momentum behind the issue, Thomas M. Ryan, the top executive of CVS Corp., which has more than 4,100 drugstores throughout the United States, broke with other top officials in his industry, telling the task force that he also supported legalizing the importation of prescription drugs.

His statement came one day after Health and Human Services Secretary Tommy G. Thompson predicted that Congress eventually would pass legislation legalizing drug imports. Yet administration officials continued on Wednesday to emphasize what they considered to be significant barriers to safe and cost-effective importation and to push the Medicare discount drug card as a better, more immediate alternative.

“There’s a lot that can be done while Congress sorts this out,” Medicare administrator Mark B. McClellan, a member of the task force, told Pawlenty and two other Republican governors who support drug importation, Jim Douglas of Vermont and John Hoeven of North Dakota.

According to a study released Wednesday by the Centers for Medicare and Medicaid Services, seniors using a Medicare-endorsed discount card will pay 10% to 17% less for brand-name drugs than the average prices paid by all Americans. Savings on generic drugs would range from 30% to 60%, the analysis found.

But the administration’s enthusiastic portrayal of potential discount-card savings did nothing to quell the demand of governors and other state government officials for quick federal action to make drug importation legal.

The government must act to “make prescription drugs more affordable for the entire population,” not just for seniors, Pawlenty said.

Spokesmen for state legislatures called for legal drug imports, and the top-law enforcement officials of 19 states, including California Atty. Gen. Bill Lockyer, released a letter to Thompson calling on him to “act immediately to help provide our citizens with affordable prescription drugs while ensuring drug safety and efficacy.”

Although the support of Pawlenty, Douglas and Hoeven for drug importation is well known, their testimony before the drug importation task force brought a new element of urgency and real-world impact to the panel’s deliberations.

In four previous meetings, the 13 panel members have approached their task -- gathering data so they can make recommendations to Congress -- as something like an academic exercise. U.S. Surgeon Gen. Richard H. Carmona chairs the group, which was created during last year’s overhaul of Medicare and consists largely of government officials in health-related fields.

But Pawlenty, whose state launched a website in February that steered residents to two state-approved Canadian pharmacies, told task force members repeatedly that they had the ability and the responsibility to lower drug prices for all American consumers.

Last year, as many as 2 million Americans traveled across the border or used the Internet or other mail-order services to buy their drugs from Canadian pharmacies.

Because the Canadian government controls drug prices, the cost of U.S.-made medications sold there can be as much as 70% lower than prices in the United States.

In an effort to stymie the growing cross-border market, some U.S. drug companies have begun limiting the amount of prescription drugs they sell to Canadian wholesalers and pharmacies. Officials of the U.S. pharmaceutical industry contend that the purchase of their drugs in Canada by American consumers cuts into their profit margins, reducing the funds available for the research and development of new drugs.

Dr. Lester M. Crawford, acting commissioner of the Food and Drug Administration and a member of the task force, echoed that concern.

Figuring out ways to get foreign countries to share more of the costs of pharmaceutical research and development is “something we worry about at the FDA almost as much as we worry about safety,” he said.

Pawlenty dismissed those concerns, saying the three governors were more worried that with “drug companies suffocating supplies” to Canada, the importation debate had become “a race against the clock.”

“There are signs of the debate shifting from whether to how, and the task force is in a position to provide a road map,” Pawlenty said.

He acknowledged that currently “there is an element of risk” in buying prescription drugs from Canada but said that was why “it would be extremely helpful for the federal government to step in” with certifications, inspections and other procedures to standardize drug imports. “You can help with that if you want to,” he told the panel.

Kevin Concannon, speaking on behalf of Iowa Gov. Tom Vilsack, a Democrat, said the safety risks of drug importation were “hysterically overstated” and far smaller than the risks of going without expensive drugs.

“As we sit here today, there will be people who have strokes, people who have heart attacks, people who will die because they don’t have access to medications,” said Concannon, who is director of Iowa’s Department of Human Services.

CVS’s Ryan echoed that concern.

“Pharmacists’ joy” in the medical progress made possible by new drugs “is tempered by the knowledge that there are patients we never see because they cannot afford the drugs we dispense, and others who are unable to enjoy their longer lives to the fullest because purchasing medications soaks up so much of their disposable income,” he said.

Ryan acknowledged that ensuring the safety of imported drugs could be a complex and expensive undertaking, and he called for trade-related measures to address differences in drug prices worldwide.

But “millions of Americans already have opted to import drugs because they can’t afford not to,” he said. “We owe it to them to face this issue head-on and not look the other way.”