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Efforts continue for drug reimportation

The Bush administration objects to prescriptions without borders, citing safety concerns.

By Markian Hawryluk, amednews staff. Aug. 12, 2002.

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Washington -- Critics of proposals to allow reimportation of prescription drugs are wondering how many refills the measure's proponents have left.

Lawmakers have passed multiple bills to allow the reimportation of American-made medications to help seniors and people with chronic conditions save money. But none of the measures has been implemented.

That hasn't stopped lawmakers from raising the issue again this year. In July, Senators voted to support a measure that would allow reimportation of drugs from Canada, while a House panel began consideration of legislation that would permit prescription drugs from any country.

At press time, the fate of the bill to which the reimportation measure was amended was uncertain. The issue was mired in a debate over a Medicare prescription drug benefit. The amendment, sponsored by Sen. Byron Dorgan (D, N.D.), would allow pharmacies and wholesalers to reimport low-cost medicines from Canada.

The measure may have been rendered moot, however, when the Senate also adopted an amendment by Sen. Thad Cochran (R, Miss.) requiring the Health and Human Services secretary to certify that drug reimportation will be safe and a cost-saver.

A similar provision doomed a reimportation bill passed in 2000. Both the Clinton and Bush administrations refused to implement the measure because of safety concerns. That bill would have allowed reimportation from 26 countries.

Limiting the new measure to imports from Canada has not won over administration officials. The Bush administration says the proposal "would create unacceptable risks of adulterated, outdated, mislabeled or otherwise unsafe medications."

In a letter to Cochran, Food and Drug Administration Deputy Commissioner Les Crawford said Canada could become a middleman for drug manufacturers, in many cases masking the country of origin.

Crawford also said the intended savings for consumers would be offset by fees charged by exporters, pharmacists, wholesalers and testing labs.

But the House legislation, introduced in July by Rep. Jack Kingston (R, Ga.), could circumvent those objections. Unlike the Senate measure, the Kingston reimportation bill would not require the secretary's approval and would not limit the countries from which drugs could be reimported.

Physician views

The physician community has been split on the issue. Some doctors have safety concerns about drugs from questionable sources and the potential for patients to order drugs without physician oversight. Other doctors are frustrated that an increasing number of patients can't afford to take their drugs as prescribed.

"When a patient cannot afford their medications, it is costly for all of us," said Elizabeth Wennar, president of United Health Alliance, a nonprofit physician health system based in Bennington, Vt. "When patients cannot take their medications, they most definitely will consume services elsewhere in our system, such as the emergency room or by being admitted to the hospital."

UHA established the MedicineAssist program to help its patients secure prescription drugs from Canada without a long bus trip. Wennar said Canadian drug prices are 30% to 90% lower than U.S. prices, and she discounts safety concerns.

"Let's keep in mind that we are talking about Canada, not some Third World country," Wennar said.

The reimportation dispute is being waged within the context of a broader debate on prescription drugs. The measure was offered as an amendment to a bill that would make it easier to bring generic drugs to market.

Proposals for a Medicare outpatient prescription drug benefit are also being offered as amendments to that legislation. At press time, none of the Medicare drug bills had garnered sufficient votes to allow senators to increase the $300 billion figure set for the benefit in the budget plan.

Senate Majority Leader Tom Daschle (D, S.D.) pledged to pass a prescription drug benefit before the Senate left for its August recess and has been huddling with Democratic and Republican leaders to try to work out a compromise.

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 ADDITIONAL INFORMATION: 

Weblink

Thomas, the federal legislative information service, for bill summary, status and full text of the Drug Importation Act of 2002 (HR 5186) (http://thomas.loc.gov/)

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