Some Northern seniors now buying their drugs in Canada

MONTPELIER, Vt. (April 18, 2000 12:05 a.m. EDT http://www.nandotimes.com) -
Between the steps of the Vermont State House and the winding stairway that
leads up to Nii Quao's clinic in Montreal are 139 long and bumpy miles of
highway. It's a 3 1/2 hour ride that Shirley Wilford never thought she'd
make - least of all to buy prescription drugs.

To Wilford, though, it's not just a bargain-hunting trip, it's a matter of
the utmost importance. Diagnosed with diabetes, she takes three
prescription medications, and her monthly bill - $236 in March - is getting
harder to afford on the fixed income that she and her disabled husband live
on. Her answer: Go to Canada with seven other senior citizens and pay $82
for the same drugs.

Here in Vermont - and in other border states from Maine to Montana -
busloads of people like Wilford are heading north to save money on the
medications that their doctors prescribe. The trips highlight the growing
unease - even desperation - among many Americans over the high cost of
drugs. Moreover, they bring into sharp relief the difference between
America's free-market approach and Canada's subsidized system.

Yet even as many states and Congress move to rein in prescription-drug
costs, critics worry that any move to emulate Canada - enduring a
health-care crisis of its own - could endanger America's system. Whatever
the solution, most observers agree something needs to be done at a time
when Americans are spending $138 billion on prescription drugs each year.

"By any reasonable standard we spend enough to get what we need," says Alan
Sager, a professor at Boston University who has testified before Congress
about government-mandated price controls. "Other nations spend
substantially less, and they make (drugs) available at a huge discount."

Realizing this, lawmakers nationwide are beginning to target the problem.
On Friday, the Maine legislature passed a bill that calls on the
pharmaceutical industry to lower their prices to Canadian levels or face
government price controls. Vermont and several other states are considering
similar laws. Also last week, Republicans in the U.S. House introduced
legislation that would offer subsidized prescription-drug insurance to
senior citizens.

Indeed, drug prices are a powerful issue for millions of voters nationwide.
A report in Health Affairs, a policy journal, found that 42 percent of
Americans without insurance report they do not fill prescriptions for
financial reasons. Even among those who do have insurance, 17 percent
refuse to fill prescriptions for the same reason.

Part of the debate centers around the role of Medicare, which does not
offer a prescription-drug benefit. At a time when many physicians opt to
use drugs instead of surgery, the lack of coverage has become a major
issue. To deal with this and other problems, some lawmakers see Canada as a
model. North of the border, prescription drugs are sold at discounts
ranging from 30 to 80 percent. The Canadian government buys medications in
bulk, and its publicly funded health-care system is both universal and
government managed.

Nor are Canadians the only ones paying less for American-made drugs. In
many nations worldwide, American drugs are sold at substantial discounts.

"Why do you need an American passport to get a 60 to 70 percent discount
for a product made in the United States?" asks Peter Shumlin, a state
senator in Vermont. "America is the laughing stock of the industrial world
on this issue."

Not so, say others. In fact, free-market advocates argue that the way
America's health-care system operates is what makes it the global leader in
pharmaceuticals and medical advancements.

"There are those who will tell you there is no price to pay when you force
pharmaceutical manufactures to sell drugs cheaper," says Tim Ryan,
executive director of Citizens For Better Medicare, a trade organization
funded by the pharmaceutical industry and other groups. "There are real
trade-offs. We have to be honest about consequences if we go down that road."

In Canada, for instance, the introduction of new drugs is often delayed and
research and development is drastically reduced, he says. In addition,
Canadians face long waits for many kinds of treatment, meaning that
thousands are making the opposite trek, heading to America to receive
health care they can't get in their own country.

"If you want to work in a regulated industry environment like a utility,
expect the consequences of a utility environment," says Ryan.

For Vermonter Josephine Gentes, though, her primary concern on this day as
she travels to Canada is her checkbook.

To get her Canadian prescription filled, she first visits a Canadian
physician where she had a full consultation at a cost of about $35. Her
Canadian doctor then prescribes drugs to fill her American prescription.

From the clinic, Gentes, husband in tow, navigates a tight stairway,
clambers into a rented van, and heads to get her prescription filled at a
pharmacy a few blocks away. Half an hour later, looking tired, she emerges
from the store with three months medication - the legal amount that can be
exported to the United States. Her saving: $257.

Though a modest saving, it's a lot for Gentes. "It's worth coming up here
for," she says.


by ALEXANDER COLHOUN,
The Christian Science Monitor
Copyright 2000 Nando Media
Copyright 2000 Christian Science Monitor Service

janet paterson
53 now / 41 dx / 37 onset
a new voice: http://www.geocities.com/janet313/
613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0