05/12/2006 11:02 am ET Updated Dec 06, 2017

Psst: Cheap Drugs From Canada Are Baaack!


"We've turned the corner already," said David MacKay, business director for and former executive director of the Canadian International Pharmacy Association, according to CP.

"We saw a hit of some 30 to 40 per cent in sales as a result of Medicare Part D but we're already experiencing a rebound effect. Patients are coming back who are saying: 'This is not the savings I expected.' "

Democratic U.S. Representative Fortney Pete Stark from California told a committee hearing that a review of prices for 10 popular brand-name drugs found Medicare prices are still almost 60 per cent higher than in Canada.

Canadian pharmacies expect to see an even bigger rebound in sales for Canadian drugs in the coming months, when many Americans will hit the so-called "doughnut hole" in the Medicare plan, a gap in price breaks when a patient's annual drug bill is between $2,250 and $5,100.

And to make things worse, next year the Medicare plan premiums and deductibles will rise, which combined with a penalty for signing up late might amount to a 15% increase in prices for elderly Americans.

It's going to be a no-brainer for Canada. David MacKay is jubilant with joy and says, "We've already done studies that show 80 per cent of the time Canadian medications are cheaper than Medicare drugs. The outlook is rosy."

So why is any of this important? It is important because we used to have more than 45 million Americans without insurance for drugs and many of them still don't have coverage. And unfortunately, those elderly who signed up for the Medicare Part D program still pay 60% more than they would if they bought in Canada. Many still don't get the drugs they need because they can't afford them, because drugs cost twice as much in the US as in other countries.

And what really troubles me is that when we in the drug industry charge these high prices to the uninsured, we sell the rest of our drugs, right here in the US, today, at the same low prices we charge in Canada and Europe. It's done through rebates. These are given to those with enough power to negotiate drug prices, such as the Department of Veterans Affairs. And based on the information from U.S. Representative Fortney Pete Stark our elderly do not get those prices, because our elected representatives have made sure that the government is explicitly prohibited from negotiating drug prices on their behalf.

So the fight against reimportation is a fight to continue to charge our uninsured, our elderly, our poor, our weakest, high prices, while giving a rebate to others. This is fundamentally unethical. This is not how we're supposed to treat our grandparents who built this country.

Legalized reimportation can help these people. The biggest argument against reimportation is safety. Former FDA Commissioner Lester Crawford, who is now is now facing a criminal investigation by a federal grand jury over questionable finances and making false statements to Congress, has said that his main concern about drug reimportation was that al Qaeda might attack the supply of Canadian drugs.


But the FDA has forgotten that we have thousands of secondary wholesalers that trade drugs. States license them, not the FDA. All it takes for a terrorist to become a drug wholesaler is a $1,000 and a driver's license, according to Aaron Graham, head of security for Purdue Pharma, quoted in the Providence Journal. Another problem, right here in the U.S., is that our drugs are shipped in big vats to wholesalers, and then poured into smaller, bulk-size containers, from which tablets are dispensed manually to the patient. Lots of entry points for a terrorist. In Europe, drugs are sold in tamper-proof individual bottles or blisters, and no one touches a drug after it leaves the manufacturer.

Legalized and regulated reimportation is about a safe drug supply. It's about getting drugs to consumers who can't afford them. The biggest problem we have today is that drugs don't work if you don't take them. The Kaiser Family Foundation reported in a 2001 study that 15% of uninsured children and 28% of uninsured adults had gone without prescription medication because of cost. The journal Diabetes Care recently reported in February, 2004, on a study of older adults with diabetes. 28% said they went without food to pay for drugs. And based on the high cost of the Medicare Part D program this is how things may continue. Is this how we want to treat our elderly, force them to choose between food and medicines?

And, by the way, not even the drug companies want to pay for brand name drugs anymore. Novartis, one of the largest foreign drug makers, was so concerned about drug costs that the CEO sent a memo to all US employees urging them to choose more generics. He didn't realize the memo would make front page news (NJ Star-Ledger, Oct 15, 2004).

Let's also point out that half of the largest pharmaceutical companies are foreign corporations (Novartis, Glaxo, Astra-Zeneca, Roche and Sanofi-Aventis). Why should we allow foreigners to come in and gouge American tax payers? Perhaps we shouldn't allow them to charge us more than their own governments are prepared to pay for our drugs? In Europe that's called reference pricing.

Every day Americans die because they can't afford life-saving drugs, because we want to protect the profits of foreign corporations. I believe we have to speak out for the people who can't afford drugs, in favor of free trade and against a closed market. Stopping affordable drugs has a high cost. Not just in money, but in American lives.

But today, in American politics, virtually no one gives a shit. Then again, perhaps that will change. This fall the elderly will hit the doughnut hole and start paying full price for drugs again, right before elections. But the only way the shit will really hit the fan is if voters wake up and smell the manure. Not that I can say I'm too hopeful.

Half the American population has already given up and won't even try to vote. And the other half will probably be swayed by another timely "code red alert" indicating their "way of life" and the future of their grandchildren is endangered by "terrorists" in white tennis shoes who don't know that a recently fired maching gun barrel is too hot to hold on to.

They'll never realize that the larger danger, day in and day out, is the lack of affordable drugs.


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