The shouldn’t-be-shocking-but-still-is news out of Canada last week that their health minister will attempt to ban the shipment of drugs to the US has the hands of the pharmaceutical manufacturers written all over it. I had an opportunity to discuss this bad news on TV a couple of nights ago on CNN's Lou Dobbs Tonight show. Currently the business of “re-importing” drugs from Canada back to the US is a $700 million dollar leak in Pharma’s stranglehold over total control of drug sales in the US and is getting in the way of their maintaining their status as the most profitable industry in the world.
It is just this simple -- Canada, like virtually every other country in the world, negotiates with the pharmaceutical manufacturers to set a reasonable selling price for medications in their country. (To be perfectly clear -- this is not “socialized medicine,” not a “subsidy”...this is just a government seeking the best price for its citizens.) And, if your home is in a border state like mine (Maine), the contrast is striking. I have “ridden the bus” to Canada more than once with a group of seniors. For some of them the ride is six to eight hours long, but filling their prescriptions at a Canadian pharmacy can be well worth the trip -- and, for a growing number of Americans, the only way to get what they need. The last time I shared the bus with this hearty band, there were 25 seniors buying a three- to six-month supply of the drugs we will all need someday -- for heart problems, blood pressure, arthritis. After making their purchases in a cross-border drug store that looked just like one back in Maine, they sat down over coffee to compare their receipts to the ones they had brought from home. Their collective savings were $18,000. I once sat next to a woman taking Tomaxifin, a wonderful drug that has made a life-saving difference for many women with breast cancer. She paid $110 for her 30 day supply at her local pharmacy in Maine, yet in Saint Stevens, New Brunswick, the same amount only cost $12.35. As far as I am concerned, that is criminal and there is just no excuse for it, period. For many people these are life-saving drugs and people really do make choices between buying food and medication every day.
Anyway, you no longer have to “ride the bus” to get the best price. Internet web sites have made it possible for people all over the country to get some of the same discounts, and, as they become more widely used and talked about, the more politicians have been hearing from their constituents telling them that they want to pay the discounted prices. Because of this, there are no less than four bills in Congress that would sanction and expand the process of “reimportation” and they have a lot of support from both sides of the aisle. Of course, they also have a lot of powerful opposition from the administration (complete with “embedded” former members of the industry in key positions) and, oh yeah, millions of dollars of opposition from Pharma -- spent in a wide variety of ways to influence the process including lobbying, campaign contributions, paying people to write op-eds supporting their position, huge “aren’t we benevolent” media campaigns... I could go on.
(Now I want to be careful not to make too big of heroes out of these same members of Congress. Many of those “fighting” for reimportation of cheaper drugs back to the US were the same legislators who voted for the provision of the Medicare bill that specifically prohibits any negotiating for better prices ... so much for government acting “more like a business.” Can you imagine a law telling Wal-Mart that even thought they were one of the largest purchasers in the world of any product, they were not allowed to ask for a discount??)
Well, in spite of the tremendous opposition, the practice of bringing prescription drugs back from Canada has been growing. Seeing the increasing difficulty of beating the policy makers, Pharma just decided to use their best weapon -- fear and intimidation. There have been growing threats that Canada would experience “supply problems” if the volume of drugs shipped back to America continued to increase. Imagine how that feels to a Canadian sitting home wondering if their local drugstore was going to run out of their vital heart medication thanks to Americans looking for cheap drugs -- Americans who are only trying to purchase their medications in Canada because American lawmakers have not been as willing to play tough as Canadians.
Anyway, it is all a scare tactic -- the only reason that there would ever be a short supply in Canada is if drug manufacturers stopped sending them. And what honest argument could they possibly make for shipping boxes of a critical drug to Detroit but not Alberta??
I watched them do this once back in Maine. When I was a state senator, we passed a bill allowing us to negotiate for better prices (just like they do in Canada). Well, that made them mad. You can probably imagine that “made them mad” is an understatement. So, while they tried to kill the law in court (which, by the way they never did -- all the way to the Supreme Court), they threatened to cut off our major wholesale distributor of medications and sent letters to the Department of Health and Human Services. Just to prove they were really tough, instead of marking the shipping labels “Maine,” they just delivered the same drugs to the Pennsylvania branch of the distributor... and let them ship back to Maine.
Here is the long and short of this: What the Canadian Health Minister is doing is wrong and what the pharmaceutical manufacturers are doing is even more wrong. Sadly though, our collective fingers have to be pointed back at the many gutless politicians who have, once again, let themselves be influenced by those handing out campaign contributions and the legions of lobbyists who sadly wield more influence than the millions of frustrated Americans still paying the highest prices in the world for medicine. When we were debating our bill in Maine I think that our governor had the best analogy -- he said that it is like you are the one person on the airplane who paid full fare and everyone else is in the cheap seats. Welcome to America -- time for a new travel agent.