Portland Press Herald (Maine)
11-16-2003
State explores drug imports ; Government leaders turn to Canada in their quest to lower prescription drug costs.
Byline: JOSIE HUANG Staff Writer
Edition: FINAL
Section: Maine & New England
State leaders running out of ways to drive down prescription drug costs are taking a hard look at importing cheaper drugs from Canada.
Gov. John Baldacci's administration has begun to contact Canadian government officials, as well as the handful of U.S. cities and states that have announced plans to buy prescription drugs from Canadian pharmacies for government employees and retirees, his top health official said.
Other groups exploring the option include a state-sponsored committee of state and municipal employee groups hoping to purchase drugs in bulk, as well as a national, bipartisan association of legislators led by a Maine lawmaker.
The National Legislative Association on Prescription Drug Prices is considering buying Canadian drugs as it sets up a nonprofit, multi-state entity. The agency would negotiate drug discounts for such clients as state employees and Medicaid patients, said Rep. David Lemoine, D-Old Orchard Beach, who chairs the organization.
"There are not many available remedies," said Lemoine, noting that the pharmaceutical industry has put up legal roadblocks to Maine's prescription drug discount programs. Healthy Maine Prescriptions has been shut down by the courts, while there is a lawsuit pending against Maine Rx Plus.
Importing drugs from Canada, he said, "is one of the few options standing."
The federal government and drug companies view drug importation as illegal, unsafe, and vulnerable to counterfeits, but the practice has gone largely unregulated.
Since the late 1990s, Maine seniors have used the Internet and taken bus trips to buy Canadian drugs, which cost up to 50 percent less because of government price controls and a favorable exchange rate.
For the last several years, Affiliated Healthcare Systems in Bangor has helped thousands of local residents order Canadian drugs through its mail-order program. In September, the Penobscot Indian Nation and the Maine Council of Senior Citizens announced they wanted to set up a system to import medicines from Canada and sell them to pharmacies in Maine.
Now government leaders are following the lead of private citizens.
"I think it's a good idea," said Pearl Wislin, 86, who has ordered prescription drugs over the telephone from her independent living home in Portland. "It'd be very convenient if we could get (Canadian drugs) right here."
The governor's Health Policy and Finance Office expects to produce a report on the feasibility of drug importation within a month and make a presentation to the Legislature's Health and Human Services Committee, said Trish Riley, director of the office.
Drug importation, Riley said, may help alleviate the state's health care spending crisis. Each year, the state spends several hundred million dollars on prescription drugs for state and municipal employees, their dependents and people on MaineCare, the state's Medicaid program.
"We're No. 10 in per capita health care spending (in the country)," Riley said. "We need to do anything we can to bring down the cost of health care spending."
Riley said that her office was inspired by a critical mass of state and municipal governments that are now considering drug importation because rising prescription costs forced them to cut services and jobs.
The city of Springfield, Mass., has been buying Canadian drugs for its workers since July. In recent months, states including Illinois, Michigan, Iowa and Minnesota announced they are considering ordering medicines from Canadian pharmacies for their employees.
The senior citizens lobbying group AARP Maine has long envisioned financial relief for seniors through a comprehensive prescription drug benefit in Medicare. But the group said that it supports Maine government's study of drug importation.
"We don't think it is a panacea for the problem of soaring drug costs," said spokeswoman Phyllis Cohn. "But it does hold the potential to place some downward pressure on the double-digit increases Americans face each year."
But trade group Pharmaceutical Research and Manufacturers of America maintains that drug importation is a risky scheme unlikely to result in major savings for state governments. Spokeswoman Wanda Moebius criticized states that want to develop agencies to regulate Canadian drugs for employees, akin to the federal Food and Drug Administration.
Any savings seen by the state "would get sucked up by the new 'F.D.A' and any liability that comes out of it," Moebius said.
Moebius said state efforts would be better spent promoting existing drug companies' patient assistance programs and a prescription drug benefit in Medicare.
"We know that people are having trouble paying for drugs," Moebius said. "We just feel there are better, more safe ways to help those people than opening the border and the drug supply."
The state will continue to pursue lower drug costs on a different front. The Maine Rx Plus program, to be launched in January, is expected to help roughly 275,000 Mainers buy prescription drugs at the same lower costs that are paid by the state Medicaid program known as MaineCare. Even deeper discounts would be made available to Maine Rx Plus members if drug companies agree to rebate deals with the state.
But the future of the program seems unclear. PhRMA's lawsuit against Maine Rx Plus is pending, largely because the drug industry is unhappy with a provision of state law that penalizes uncooperative companies. Those companies' products may be put on a list of drugs that require doctors to seek state authorization before they can be prescribed to Medicaid patients.
PhRMA has not ruled out seeking an injunction against the program.
State officials say they are optimistic that Maine Rx Plus will stand up against legal challenges, but say it doesn't hurt to look north for savings.
"I don't think we can afford to ignore any strategy that is out there," said Sen. Majority Leader Sharon Treat, D-Gardiner.
State government may not have given drug importation this much attention until recently, but Canadian pharmacies have slowly been gaining a foothold in Augusta in the last several years.
The Senate Majority Office has posted links to Canadian Internet pharmacies on its Web site for almost a year. Meanwhile, the state Department of Human Services has included Canadian Internet pharmacies in its fourth annual survey of pharmacy prices in Maine. The survey is available at
http://www.state.me.us/dhs
/beas/drug_html/drug_survey.htm.
Treat said that state government is not leaning for or against drug importation.
"We are trying to be an information resource for our constituents," she said.
Josie Huang can be contacted at 791-6364 or at:
jhuang@pressherald.com
Copyright 2003 Blethen Maine Newspapers Inc.
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