A Spotlight Shines on Darker Aspects of Drug Reimportation

For years cash-strapped Americans have slipped across the U.S. border into Canada'and even into Mexico'to buy prescription medications that are sold at significantly lower prices than in the United States. The rise of the Internet also brought numerous online pharmacies that ship medications to cost-conscious American consumers who cannot afford to buy the drugs at home. [HIV Plus reported on the disparity of U.S. and foreign drug prices in the article 'Drug Wars' in the October/November 2000 issue of the magazine.] A plan supported by Illinois governor Rod Blagojevich could elevate the practice to an unprecedented public level. Blagojevich directed state officials in September to draft a plan to purchase prescription medications from Canada for as many as 240,000 state employees and retirees, a move that reportedly could save the state tens of millions of dollars. The savings from buying U.S.-made drugs in other countries can be dramatic. A three-drug anti-HIV regimen with a five-figure annual U.S. price tag can cost just half that amount in Canada, which has government caps on the prices drug companies can charge. Depending on the medication, Canadian prices can be 80% lower than what is charged in the United States for the same drugs. Though the Illinois state government would be the largest entity to date to officially circumvent Food and Drug Administration regulations against drug reimportation, the practice is not new'and the issue is not unfamiliar territory. Congress has twice passed bills allowing drugs to be reimported from industrialized countries, and twice the measures were thwarted through an oversight loophole. The House of Representatives approved yet another reimportation bill on July 26 by a 243'186 vote; Senate consideration and a threatened veto by President Bush still await. Advocates of drug reimportation say opponents are merely trying to protect the profits of pharmaceutical companies that sell brand-name medications in the United States. But drugmakers say their chief concern is the safety of the medications shipped back to U.S. consumers, claiming that reimported drugs have the potential to be counterfeit, improperly stored and handled, or even tampered with. A five-part series published in The Washington Post in October and November backs up those worries. A yearlong investigation found rife illegal and unsafe drug trade, which has resulted in HIV clinics receiving fake medications and cancer patients receiving watered-down drugs, among many other serious incidents. But even in light of such safety worries, U.S. consumers still frequently turn to foreign pharmacies for lower-priced medications. And Governor Blagojevich agrees with their rationale for doing so. 'The status quo on prescription drugs is intolerable and unacceptable,' he told the Post, noting that prescription drug spending for Illinois state employees rose 15% over the past year. 'I am optimistic that we will be able to save literally millions of dollars for the taxpayers and set a precedent other states will follow.'