News Article

Seniors Find Drug Relief in Canada Congress Will Push Again for Law to Allow Pharmacists to Import Cheaper Medication
Detroit News Washington Bureau
April Taylor

WASHINGTON -- It used to be that when Barbara Morgan of Livonia and her husband, Harry, packed up their Mercury Marquis and went to Canada, it would be to visit her younger sister in Toronto.

Now the Morgans head north -- to Sarnia, mostly -- for a different reason: To buy a white cancer pill called Tamoxifen for one-tenth its price in the United States.

A breast cancer survivor, Barbara Morgan must take the drug daily. And while the 200-mile round-trip is a hardship for the 77-year-old great-grandmother, the savings is a great incentive.

Canadian regulations hold most prescription drugs' prices to levels much lower than in the U.S. Morgan's Tamoxifen costs just $30 for a 90-day supply in Canada, compared with $315 in the U.S.

Sen. Debbie Stabenow, D-Lansing, and other lawmakers from both parties are pushing legislation to encourage drug wholesalers and pharmacists to import such medications for resale to customers like Morgan. This could save individuals the trips and put pressure on drug makers in the U.S. to ease prices.

Advocates are also pitching the step as a stop-gap measure for the long-promised prescription-drug benefit for Medicare, which Congress and President Bush haven't yet delivered. Stabenow and her allies plan to bring their proposal to the Senate floor as early as next month.

Fixed incomes

The high cost of prescription drugs affects especially the elderly, who live on fixed incomes and depend on Medicare. According to the AARP, a retirees' advocacy group, about 80 percent of retirees use a prescription drug daily, and as many as 15 million Medicare beneficiaries pay full retail for prescriptions. In Michigan, about 200,000 are estimated to be in that category.

The measure to permit so-called reimportation of medicines from Canada faces a tough fight on Capitol Hill. Last year Congress passed a law permitting wholesalers and pharmacists to reimport U.S.-made drugs from other countries. But the final version of the bill was so loaded up with industry-sponsored safety requirements that the U.S. Department of Health and Human Services couldn't implement it.

This time, Stabenow said her legislation, which she plans to attach to an agriculture appropriations bill this fall, has added safety measures -- such as better labeling on medicines -- that should satisfy critics. It would apply to wholesalers, pharmacists and individuals.

Currently, only U.S. drug makers are allowed to buy and reimport drugs approved by the U.S. Food and Drug Administration at a lower cost from other countries, but wholesalers and retailers cannot. The FDA allows individuals to bring back a 90-day supply of certain experimental drugs and those not available in the U.S. for personal use.

The Tamoxifen that Morgan brings home from Canada doesn't fit this definition, but the U.S. Customs Service isn't conducting a border crackdown targeted at such small-scale activities.

"Opening borders and allowing free trade and business relationships to form with wholesalers in Canada would begin to sort out price," Stabenow said. "When it comes to prescription drugs, there's this artificial barrier that is causing Americans to pay twice as much for their prescriptions. It's not a total solution, but it can provide immediate relief."

All about money

Opponents, particularly the Pharmaceutical Research and Manufacturers Association, contend that re-importation would create safety risks.

"No reimportation on prescription drugs is workable, for safety concerns," said Meredith Art, a spokeswoman for the trade group. "You don't know whether such medicine was stored properly or transported properly, and you never know if it's the actual FDA-approved medicine, since it is coming across our borders."

But that argument is "all about money," rejoined John Rector, spokesman for the National Community Pharmacists Association.

"They're talking about the sky falling for the American consumer if they can get access to imported drugs," Rector said. "But the reality is that most of these companies have been importing prescription drugs in record numbers and selling them at U.S. market prices. We want imports so that the pharmacy can have it available for American consumers at lower prices."

Although lawmakers say they have rewritten the bill this time to deal with concerns over safety, Jeff Shuren, a spokesman for the FDA, said the concerns still aren't being adequately addressed. "We are very sympathetic to seniors and others having difficulty affording prescription drugs here," Shuren said, "but we're not aware of any changes to the system (already in place) that wouldn't increase the risk to public health."

Headed for Canada

In the meantime, with prescription drug costs skyrocketing, employer coverage of retirees eroding, and Medicare choice plans reducing their coverage of prescription drugs, busloads of seniors are rolling into Canada.

The Alliance for Retired Americans, for example, is planning Sept. 22 to take 50 buses from 12 states, including Michigan, to Canada to buy prescription drugs. "The total amount saved is the headline we're aiming for," said the group's spokesman, Keith Wellington.

Frank Murgic, owner of the Provincial I.D.A. Prescription Center in Windsor, said the number of American seniors he sees coming in daily is increasing. "Not just seniors, but people without any drug coverage," said Murgic. "In general, prices here are like buying one, getting two for free."

"Why shouldn't they come here?," asked Darlene Younan, a pharmacist at Provincial I.D.A. "American seniors have every right to take advantage of the exchange rate and the cheaper prices. Many who come here feel overwhelmed by the costs of prescriptions they need to survive on a daily basis."

Like William Finton, a 65-year-old semi-retired accountant in Grass Lake who takes a dozen pills each day ranging from "a few cents to about $4 per pill." Finton was able to save 32 percent recently on four prescriptions filled on his first visit to a pharmacy in Windsor.

"It really doesn't take a rocket scientist to figure out that the drug makers are making excessive profits," Finton said. "Of course, they have a lot of expense in producing these drugs, but once they make the cost back, it really shouldn't be this expensive."

Finton added: "I used to smoke cigarettes. I'm in for way more money in medication than I ever was in cigarettes."

Morgan is planning her third Canadian trip in about a year, this time to Windsor, as soon as her doctor here writes out a prescription. Once in Canada, patients must be re-examined by a doctor and then given a prescription that is valid there.

"When you're a senior citizen, you've got your savings, you've planned approximately how long you have to live," said Morgan, "and you don't want to spend it all on medication."

At a glance

What: Lawmakers from states bordering Canada, including Michigan's Sen. Debbie Stabenow, plan to push a measure to legalize re- importing prescription drugs from Canada by wholesalaers and individuals.

Why: With Congress and President Bush yet to come through on promises to add a prescription drug benefit to Medicare, out-of- pocket prescription costs impose a financial burden on millions of seniors, many of whom trek to Canada for cheaper prices.