U.S. states looking to Canada for steep discounts on prescription drug prices are increasingly turning to Europe for deals now that the Canadian government is considering shutting off the southbound flow.
Illinois and three other states already help their residents 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 the club.
The move is intended to ensure that customers can get cheaper drugs even if one country decides to stop exports, said Caleb Weaver, project manager of I-SaveRX, the initiative launched by Illinois and now available in Wisconsin, Missouri and Kansas.
Program sponsors have decided to stick to English-speaking European 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.
But 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.
“When you start going outside the U.S., you are opening yourself up to a number of safety issues,” she said.
The U.S. Food and Drug Administration has forcefully objected to efforts to formalize drug purchases from Canada and elsewhere, saying it cannot vouch for the safety of drugs imported outside the federal regulatory system.
Although some purchasers of drugs from foreign sources may receive genuine product, others may unknowingly buy counterfeit copies that contain only inert ingredients, legitimate drugs that are outdated and have been diverted to unscrupulous resellers, or dangerous sub-potent or super-potent products that were improperly manufactured.
Relying on Canada 'doomed to fail'
Still, U.S. lawmakers say it’s important to explore every possible avenue toward cheaper prices now that Canadian Health Minister Ujjal Dosanjh is considering a proposal to prevent Internet pharmacies from selling mail-order prescription drugs to U.S. consumers.
Under current practice, a prescription from a U.S. doctor is faxed to a Canadian doctor who reviews the patient’s health history. The Canadian doctor then signs and faxes the prescription to a so-called Internet pharmacy, which ships the drug.
The Canadian model was developed after U.S. Rep. Bernie Sanders, of Vermont, 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 prescription drugs at significant savings.
Precise estimates are hard to come by, but between 1 million and 2 million Americans get their drugs from Canada. Moebius said 6.2 million consumers have gotten free or reduced price drugs from the industry itself.
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.”