David Coates / The Detroit News
William Finton of Grass Lake saved 32 percent on the cost
of drugs by buying them from Frank Murgic, pharmacist
and owner of Provincial I.D.A. Prescription Centre in Windsor.

Seniors find drug relief in Canada
Congress will push again for law to allow pharmacists to import
cheaper medications

By April Taylor / Detroit News Washington Bureau

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
wholesalers 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.

When: Legislation will most likely be attached to an
appropriations bill next month when Congress returns.

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 reimportation
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."

Consider: A 30-day supply of cholesterol-reducing Zocor
costs roughly $109.73 in Michigan and $46.17 in Canada;
a similar supply of Prilosec, a stomach acid-reducing drug,
costs $115.37 in Michigan and $55.10 in Canada, according
to Stabenow's office.

"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."

You can reach April Taylor at (202) 662-7373
or [log in to unmask]

Washington Correspondent Gebe Martinez
contributed to this report.

SOURCE: The Detroit News
http://www.detnews.com/2001/health/0108/25/a01-272793.htm

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