Q: Have pharmaceutical companies been unfair to American consumers? Yes: Americans should not have to pay significantly more for the same prescription drugs as our friends in Canada and Europe

Insight on the News, August 19, 2003 by Gil Gutknecht

Byline: Rep. Gil Gutknecht, SPECIAL TO INSIGHT

There is little question that increasing health-care costs are a problem that affects all Americans. Small businesses have difficulty hiring new employees because they can't afford to provide health insurance. Seniors are forced to cut prescriptions in half or skip meals. Moms and dads struggle to meet the basic health-care needs of their children. Prescription-drug prices continue to increase at four to five times the rate of inflation.

The Bush administration and congressional leadership, in an attempt to address some of these concerns, proposed a prescription-drug benefit under Medicare. Several weeks ago the House passed HR 1, the Prescription Drug and Medicare Modernization Act of 2003, by a razor-thin 216-215 vote. Unfortunately, this legislation does little to address the driver of increasing health-care costs: exorbitant prescription-drug prices.

I hope I'm wrong, but I am afraid the proposed benefit may only make a bad situation worse. With 40 million baby boomers set to retire in the next 20 years, a benefit that fails to address the price side will result in staggering deficits, dramatic tax increases or both. If tax cuts are supposed to stimulate the economy today, what will be the effect of massive tax increases in coming years?

Fortunately, Congress has passed HR 2427, the Pharmaceutical Market Access Act, allowing market access to Food and Drug Administration (FDA) approved pharmaceuticals from FDA-approved facilities in 25 industrialized countries. This legislation had broad support in the House and had the support of real seniors groups across the country. I say "real" seniors groups to distinguish between groups composed of and funded by seniors and those created by the pharmaceutical industry.

One example of the latter is the Seniors Coalition of Springfield, Va. This organization sent thousands of mailings across the United States but, sadly, the Seniors Coalition is funded by the pharmaceutical industry to protect the industry's interests.

No one disputes that Americans pay as much as 10 times more for the same prescription drugs as our counterparts around the world. I have no problem helping our friends in sub-Saharan Africa, but I do have a problem with American consumers subsidizing the starving Swiss.

Patricia Reinartz of Austin, Minn., is a classic example. She is a senior who takes Protenix and Premarin. Reinartz was spending $360 per month to fill her prescriptions. She now imports these same FDA-approved drugs at a cost of $210 per month. Although $150 per month might not seem like much to a pharmaceutical executive, to seniors living on fixed incomes it can be the difference between despair and dignity. In Reinartz's own words, "Please keep working for prescription-drug importation. I order from abroad; it works great!''

Reinartz has decided to risk FDA prosecution in order to sustain her health. She shouldn't be branded a common criminal because Congress stands between her and the opportunity to purchase pharmaceuticals at world-market prices. If Reinartz can buy imported meat and vegetables from the local grocery store, shouldn't she be able to purchase her medication in a free market as well?

Kate Stahl is an 84-year-old grandmother who volunteers for the Minnesota Senior Federation. Stahl joined me on Capitol Hill when I introduced HR 2427. In the June 9 U.S. News and World Report she said, "I'd like nothing better than to be thrown in jail [for importing prescription drugs]." It's outrageous that she would even have to consider such drastic measures, but she is standing on the shoulders of patriots as she stands up for American seniors.

For every other consumable good, Congress, the FDA and the U.S. Department of Agriculture (USDA) have created standards and regulations to promote safety in importation. Food products are imported in massive quantities. Through cooperative governmental efforts, we drink imported fruit juice and eat imported meats with confidence. We can accomplish the same for prescription drugs.

The FDA's concerns for safety apparently do not extend to seniors who cannot afford their prescribed drugs. Americans such as Reinartz and Stahl are crossing the border for cheaper drugs in order to sustain their health. But the FDA does not look at this issue as if they are sustaining their health. The FDA sees only that they are improperly importing pharmaceuticals. This is outrageous! As my good friend and pharmaceutical-market-access expert Steve Schondelmeyer of the University of Minnesota PRIME Institute says, "A drug you cannot afford is neither safe nor effective."

So true. On a recent trip to Germany, I purchased 10 of the most commonly prescribed drugs from the airport pharmacy in Munich for a total cost of $373.30. Those same drugs cost a whopping $1,039.65 in the United States.

These price disparities are not isolated to a few drugs. My 86-year-old father takes Coumadin, a commonly prescribed blood thinner. A 30-day supply of Coumadin costs $89.95 in the United States, but only $21 in Germany. Tamoxifen, a miracle breast-cancer drug that was developed almost entirely with American taxpayer dollars, costs $360 in the United States, but only $60 in Germany. This, unfortunately, is the rule rather than the exception.