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U.S. Looks to Europe for Low Drug Prices
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2005-1-21
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January 14, 2005
MONTPELIER, Vt. (AP) -- U.S. states that have looked to Canada to help their residents win steep discounts on prescription drug prices are turning to Europe for the same deals because the Canadian government is considering shutting off the southbound flow.
Illinois and three other states already help their residents to buy prescriptions from such places as the United Kingdom and Ireland, a process dubbed reimportation because many of the drugs are made in the United States. The new Democratic majorities in the Vermont Legislature now want to join.
Yet it's unclear how successful they and other state legislators might be with those efforts because there have been moves in Europe to restrict access to low-cost drugs across national lines. But lawmakers say it is important to explore every possible avenue toward cheaper prices.
States from Illinois and Wisconsin to New Hampshire and West Virginia have either authorized reimportation of prescription drugs from Canada or explored the idea. Several of them now have added Europe to the mix because Canada's health minister has said the government was considering significantly limiting sales to individual U.S. consumers.
"The idea was to spread the risk" of drug manufacturers cutting off supply to an individual country that reimported prescriptions to the United States, said Caleb Weaver, project manager of I-SaveRX, the initiative launched by Illinois and now available in Wisconsin, Missouri and Kansas. Vermont would join that program.
Program sponsors have decided to stick to English-speaking countries to try to avoid confusion that could be created by different languages, Weaver said. The program also could expand to Australia and New Zealand, he said.
Donald MacArthur of England, who until the end of last year was secretary general of the European Parallel Trade Association that regulates trade in pharmaceuticals, said Europe could be a natural source for U.S. individual importation, but the strength of European currencies are reducing the price differential. "It makes it less and less attractive to supply from a euro-zone country," he said.
He also warned that setting up a network similar to what has developed in Canada would take time in Europe. "Europe cannot turn itself on overnight," he said.
Politicians blame the pharmaceutical industry for efforts to choke off supplies from countries where prices are low because of government price controls. They accuse the industry of using its economic muscle to force such national policy decisions.
"You actually have an industry that's bullying around countries," said House Health Care Chairman John Tracy, D-Burlington. "It's bizarre that we're even in this position."
Wanda Moebius, a spokeswoman for the industry trade group Pharmaceutical Research & Manufacturers of America, said manufacturers have always been concerned about the safety of drugs being imported to the United States and those concerns are increased by the possibility of importing from Europe.
"Despite assurances that drugs will be the same drugs Americans get, that's been repeatedly shown not to be the case," she said of Canadian imports.
European imports could threaten safety because they could carry labels in languages that consumers don't speak. "When you start going outside the U.S., you are opening yourself up to a number of safety issues," Moebius said.
The Canadian model developed after U.S. Rep. Bernie Sanders, I-Vt., began staging high-profile bus trips to Canada more than five years ago. He took senior citizens to Montreal and its suburbs, where they got so-called maintenance drugs at significant savings. Maintenance drugs are those that patients must take regularly to care for a chronic disease such as high blood pressure.
What has evolved since then is an Internet-based system in which a prescription from an American doctor is reviewed by a Canadian physician, filled and then shipped to the United States. The savings then are passed along.
Dr. Peter Rost, a marketing vice president with Pfizer Inc., told Vermont lawmakers Thursday that reimportation from Europe was a logical, feasible alternative. Parallel trade, a version of reimportation among European countries, has operated successfully for 20 years, he said.
"Just authorizing a scheme where drugs come from Canada is doomed to fail," said Rost, who emphasized he was not speaking on behalf of his company. "You must look to the European Union."
Despite the myriad obstacles, including opposition in Washington, state legislators continue to push for reimportation because consumers save an average of 25 percent to 50 percent on drugs bought in Canada.
"For very expensive drugs it really can be a lifesaver," said Sharon Treat, executive director of the National Legislative Association. "Unfortunately in this country many people don't have any kind of prescription drug coverage that approaches those savings, or any (coverage) at all."
Prescription drugs are big business and have become a big political issue. A recent federal report said retail sales of prescription drugs amounted to $179.2 billion in 2003. That represented 11 percent of all health care spending. Demonstrating why it's such a potent political issue, though, prescription spending represented 23 percent of individuals' out-of-pocket expenses, the government said.
Precise estimates are hard to come by but between 1 million and 2 million Americans get their drugs from Canada. Moebius of the industry group said 6.2 million consumers have gotten free or reduced price drugs from the industry itself. |
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