Defying FDA, some governors consider Canada drug importation

Drug Cost Management Report, Oct 10, 2003

Legislation that potentially could facilitate the importation of cheaper drugs from Canada and other countries--including the pending Medicare reform bill (DCMR 7/11/03, p. 1)--still is being juggled around by Congress. But illustrating how serious an issue controlling prescription drug costs has become for some payers, several state governors have said recently they would investigate their own plans for a Canada drug importation program.

This is in stark defiance of FDA's continued warnings that almost any such program would be illegal and would expose U.S. consumers to dangers such as counterfeit, expired, subpotent or contaminated drugs, or those that had been manufactured or handled improperly. However, the concept has proved popular with those consumers, particularly with respect to Canada, which is viewed by many as having the most compatible health care system to that of the United States of any potential foreign source of drugs.

After Springfield, MA recently began its own Canadian drug importation program for city employees (DCMR 8/8/03, p. 1), Illinois Gov. Rod Blagojevich (D) in September asked the state's Office of the Special Advocate to prepare a report on how much Illinois could save by allowing health plans to reimburse state employees and retirees for purchasing drugs from Canada. That would be similar, the governor said in a statement, to when UnitedHealth Group decided late last year to reimburse AARP members it covered who bought their prescription drugs in Canada.

Blagojevich then asked FDA to reverse its policy on importing drugs from Canada and urged other governors to do the same, but was quickly rebuffed by the agency. However, Blagojevich has the support of Iowa Gov. Tom Vilsack (D) and Minnesota Gov. Tim Pawlenty (R), who also are drawing up potential blueprints for a Canada drug importation program, as well as legislators such as Reps. Rahm Emanuel (D-IL) and Gil Gutknecht (R-MN), sponsors of the pending H.R. 2427, the Pharmaceutical Market Access Act of 2003 (DCMR 8/8/03, p. 1).

In response to pharmaceutical manufacturers' plans to limit drug shipments to Canadian pharmacies that wholesale drugs to U.S. consumers, Blagojevich asked Illinois Attorney General Lisa Madigan to look into whether GlaxoSmithKline, AstraZeneca, Wyeth and Pfizer are committing antitrust violations by illegally conspiring to limit drug supply to Canada. Also, Minnesota Attorney General Mike Hatch asked the Hennepin County, MN District Court to order GlaxoSmithKline to produce documents regarding its limiting drug supply to certain Canadian pharmacies and wholesalers.

Responding to Blagojevich's example of UnitedHealth reimbursing AARP members who buy drugs in Canada, FDA said "many insurance plans reimburse consumers for drugs purchased while traveling abroad, [but] this is very different from programs that actively encourage consumers to purchase unapproved, potentially unsafe drugs."

Call FDA's Division of Drug Information at (301) 827-4573 or Blagojevich's office at (217) 782-0244.