ARTICLE: The Great Pharmacy To the North

[Murray Charters <mcharters@xxxxxxxxxxxxxx>]

The Great Pharmacy To the North
By Abigail Trafford
Tuesday, September 30, 2003; Page HE01

Roland and Carolyn Watson of Towson, Md., didn't know they were getting into a 
war when they bought prescription drugs
from a pharmacist in Canada, but that's the only way they can afford the drug 
Carolyn needs for her Parkinson's
disease. Instead of a drug benefit under Medicare, the Watsons have the Buy 
Canada Drug Plan.

What looks good to the Watsons is starting to look good to city and state 
governments. This month the governors of
Illinois and Iowa announced that they are designing a Buy Canada Drug Plan for 
government employees and their families -
- with potential savings of tens of millions of taxpayer dollars. Springfield, 
Mass., already has a program for city
employees to get drugs from a Canadian wholesale pharmacy. Meanwhile, the House 
has passed legislation that would allow
imports from Canada and other countries. Last week the governor of Wisconsin 
urged Congress to include the import
provisions in the Medicare prescription bill.

The Bush administration and the pharmaceutical companies are up in arms. The 
Justice Department is seeking an
injunction to block Canadian drug imports by an Oklahoma-based pharmacy depot. 
The Food and Drug Administration (FDA)
has sent a warning letter to officials at CanaRx Services in Ontario that their 
cross-border operations are illegal.

And suddenly another kind of drug war is on.

When buying drugs from Canada was confined to busloads of seniors driving 
across the border from Maine to fill a
prescription, nobody paid much attention. But now this innovative grass-roots 
strategy is threatening to become a
national program.

"Buy in Canada and save money" is a great sound bite. But it is not sound 
policy. At best, the Buy Canada Drug Plan is
a temporary solution to the drug coverage gap in the United States. It may also 
serve as an emergency tourniquet to
help stem the money hemorrhage in state budgets and city coffers.

But turning our neighbor to the north into the neighborhood pharmacy for all of 
Middle America is unlikely scenario.
Prices are lower in Canada because the government negotiates cheaper rates for 
all its citizens. But Canada is not
about to become a kind of drug benefit manager for millions of Americans.

For starters, the drug companies could just stop shipping drugs to Canada that 
are likely to be shipped back to the
United States at a discount. To the pharmaceutical industry, the Buy Canada 
Drug Plan is not about importing drugs, but
importing price controls. As John E. Calfee of the American Enterprise 
Institute explains in an essay: "When Canadian
pharmaceutical wholesalers ask Pfizer, Merck, and their competitors to ship 
them 10 times the usual volumes of Lipitor
and Zocor and other blockbuster drugs, with the obvious intention of shipping 
them right back to the United States, any
manufacturer with a decent regard for its shareholders will refuse."

Even those who support comprehensive changes to restrain costs and provide 
Medicare coverage of prescription drugs are
dubious of the Canadian fix. "I don't think it is the solution," says Marilyn 
Moon, director of health for the American
Institute for Research. "Not a panacea for the problem of soaring drug costs," 
wrote AARP director William D. Novelli
in a letter to Congress.

But as a sound bite, the Buy Canada Drug Plan is a huge success. It says the 
status quo is not acceptable. When the
same drug can cost 50 to 80 percent less in another country, something's not 
right with the marketplace for drugs at
home.

Roland Watson, 74, has diabetes, early renal failure and congestive heart 
failure. Carolyn Watson, 72, suffers from
Parkinson's disease. Together they take 32 prescriptions. They have some drug 
coverage through a Kaiser Permanente
health plan and the Department of Veterans Affairs, but they still face about 
$8,000 a year in out-of-pocket expenses.

One key medication that Carolyn Watson gets from Canada is Requip, a new drug 
to treat symptoms of Parkinson's. She
couldn't hold a pen and write. "When I went on the Requip, my handwriting 
improved," she says. So did their financial
outlook. Roland Watson estimates that they save about $2,000 a year by buying 
medications in Canada.

As the drug war escalates, the FDA has mobilized opposition around the safety 
issue -- a legitimate concern. The drug
companies warn that high prices and healthy profits are necessary to fund 
research on new drugs -- another legitimate
concern. To them, countries like Canada are getting a free ride on American 
research.

But that doesn't explain why the drug burden is spread so unevenly within the 
United States. Health-rich people --
those with comprehensive health coverage -- get the lower prices. Health-poor 
people -- those who are uninsured or
inadequately covered -- have to pay the highest prices. It's as though the rich 
can go to Filene's Basement to get
designer clothes at knockdown prices, but the poor are forced to buy their 
clothes at the most expensive designer
boutique. As Moon says: "Granting a monopoly to drug companies allows for 
discrimination in prices -- but it's not good
discrimination. It's sticking it to the people least able to pay."

All this breeds consumer rage. The drug companies are a target. Like the 
malefactors of great wealth in the past, they
are seen as the malefactors of great health.

"It's kind of amazing we have to get on a soapbox to get medications," says 
Carolyn Watson. Her husband goes further.
He thinks the pharmaceutical industry has crossed a Greed Line, talking about 
profits for research but spending so much
on marketing. He's angry at the government for lack of action on this issue. As 
he says: "I'm fed up with the drug
companies. I'm fed up with the Bush administration. And we're registered 
Republicans."

SOURCE: The Washington Post


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