Let Prescription Drugs Cross the Border

Health-care reform has always been a tough issue in U.S. politics, but a public relations nightmare is quickly turning into a national crisis for American seniors.

    Americans are the best customers of the pharmaceutical industry, purchasing more than half of the world’s supply of prescription drugs. Yet the prices we pay for these medications are also the highest in the world–not good publicity for drug-makers.

    Congress has passed, and President Bush has signed, a prescription-drug-benefit bill to spend at least $400 billion to lower prescription drug costs for Americans over the next 10 years. During the same time frame, however, the Congressional Budget Office estimates that American seniors alone will spend $1.8 trillion on filling their prescriptions. Clearly, this is also not good press for the government.

    Unfortunately, the new law overlooks commonsense solutions to the problem of skyrocketing prescription drug prices. It may even encourage inflation in U.S. drug costs. Without a variety of proven cost-saving solutions, we are left with a one-dimensional approach.

    Market access to imported prescription drugs would represent unprecedented savings in the American pharmaceutical markets. For example, Prevacid, used to prevent and manage acid reflux, costs $126 from Walgreens.com and $53.18 from a Canadian pharmacy, according to a report in theSan Diego Union-Tribune. The same scenario plays out for medicines to fight high cholesterol, cancer, depression and other ailments that require an intensive treatment regimen including prescription drugs.

    The smiling faces in drug ads belie this sad situation.

    Overseas, the same medicines sold at home cost consumers an average of 35 percent less than they cost in the United States, according to estimates by my staff based on prevailing price differentials. Of that $1.8 trillion in expected prescription drug costs, a 35 percent savings would mean $630 billion back in the pockets of American senior citizens on fixed incomes.

    Even though crossing the border to bring back large supplies of prescription drugs is illegal in the United States, millions of Americans go to Canada or Mexico to see their pharmacists. Even more purchase re-imported medicines online. A policy of market access would make legal for these Americans and for certified pharmacies and wholesalers in selected foreign nations what is now permissible only for large drug companies. Supplemented by other measures I support–including better access to generics and better information for doctors–market access would be a powerful shift of purchasing power to the American consumer.

    In combination, these measures provide the right prescription to put significant downward pressure on drug prices. Drug companies spend millions of dollars each year on advertising, but it is not enough to make us forget the images of American senior citizens skipping months of medications, cutting pills in half and forgoing good nutrition in favor of expensive prescription drugs.

    As a member of a bipartisan coalition of House and Senate members, I am working in Congress to make importation legal for Americans who rely on prescription drugs.

    A policy of importation would require that the Food and Drug Administration assure that the supply of prescription drugs be subject to a strict set of “chain of custody” requirements that makes sure drugs are handled properly as they move to market. In fact, the standards for pharmaceuticals would be stricter than existing regulations for imported food products.

    Drug manufacturers already import 40 percent of the pharmaceuticals consumed in the United States from overseas, according to a statement relayed to me by Lester Crawford, acting FDA commissioner, at a House Subcommittee hearing. By extending this privilege to a network of licensed wholesalers and pharmacists, we could begin importing the lower prices that ought to accompany the drugs.

    Importation would be much safer than the existing alternative for American seniors who now rely on the Internet to fill their prescriptions. Advanced technologies, such as blister packs (foil packaging where you push the pill out with your finger) and the same anti-counterfeiting ink used on the $20 bill, are mandated in the bill. The best defense against counterfeits, however, is lower prices to eliminate a lucrative black market.

    Lastly, even drug companies would benefit from reasonable prices and safe supplies. There is no better publicity for the value of good pharmaceuticals than a lower price tag. Now there’s an ad campaign everybody could be happy about.