This Week in Washington

The Week in Washington

Washington, DC - Americans of all ages share a challenge in how to maintain access to safe and affordable prescription drugs. Because of the differences in how we pay for our drugs, I believe it will take multiple legislative reforms to ensure that all Americans have affordable access to the medications necessary to stay healthy, and in many instances, to stay alive. The ongoing debate over Canadian drugs is simply a part of that larger challenge.

Most Americans - about 161 million - already have prescription drug access through employer-sponsored health insurance plans. This group includes the majority of our Medicare recipients, as most seniors are still members of an employer plan as part of their retirement benefits.

Many self-employed families - roughly 16 million - have drug plans available through individually-purchased health insurance - although, unfortunately today in Georgia, if you or a family member has a pre-existing health problem, you probably aren't able to buy an individual plan. Our state can - and should - fix that problem, and there are federal funds available to help. But that's a state legislative matter.

The group that has been in the worst shape on prescription drugs is those folks without insurance. They break down into two categories - those on Medicare with no drug plan, and those who are not on Medicare. Starting this June, those on Medicare with no drug plan - about 11 million - got some relief, thanks to the kickoff of the Medicare Prescription Drug Benefits program passed by Congress last year.

The sub-group that is still left out - those who have to pay out-of-pocket for their prescriptions, without benefit of any insurance reimbursements or discounts - is where we need some immediate additional relief. There are 44 million uninsured Americans who are part of this group, along with tens of millions more who have insurance without drug benefits, or whose insurance simply won't cover a given prescription. Estimates vary widely on how many people fall into this class, but as good a figure as any is around 70 million Americans.

One solution to provide relief for this sub-group that has been hotly debated over the past two years is to allow access to lower prices through the reimportation of American drugs from Canadian pharmacies. Reimportation is different than importation. Americans should be able to buy FDA approved prescription drugs that were made in America and then exported to Canada, i.e. re-importation.

The savings from reimportation are even better than the discounts available under the new Medicare Prescription Drug Discount Cards that just rolled out this June. For example, a standard Lipitor prescription that would cost $118 at retail, would be available for $67 under the Medicare Discount Card, but can presently be ordered from Canada at just $56.

Now, this may change over the next year, as the Medicare Discount Card is finally forcing prices down through good-old free market competition. In addition, I think most seniors would rather pay $67 for their prescription from their community drug store around the corner than order through the mail out-of-country. But for the folks who will be buying Canadian drugs it's a moot point - they can't use the Medicare Discount Card anyway.

Many members of Congress have been bombarded by industry groups with two primary concerns over Canadian drugs. One, would these reimported drugs be safe? Two, would the lower cost to consumers undermine the profits necessary for drug companies to continue research into new drugs? I believe both questions have now been answered.

On the safety issue, in spite of the fact that both the House and Senate have passed bills allowing reimportation and calling for the Food and Drug Administration (FDA) to develop reimportation safety standards, the FDA has simply refused to comply.

So several of the states and the General Accounting Office (GAO) conducted independent studies of Canadian pharmacy safety standards over the last year. As a result, Minnesota has established its own agency to oversee Canadian drug shipments, with the complete cooperation of Canadian pharmacies, who welcomed the new program. And the GAO study released this June found the Canadian pharmacies to have higher safety standards, including mail order standards, than those within the United States. This was the final word that many Members of Congress demanded before deciding to endorse reimportation. Case closed on safety.

On the issue of price and profits, we found an interesting fact that totally contradicts the argument over profits and research. The pharmaceutical companies are already selling many of their products at or below the Canadian price here in the United States. But just to the large HMOs, who make up the bulk of the drug market. The drug companies then raise the retail price to all remaining consumers to compensate for the discounts. Both the drug and insurance industry raked in record profits the last four years running, with plenty of room to provide decent free-market prices to all Americans and still make money. Case closed on profits.

The nation has been misled on this debate. It is not about research and safety - it is about preserving record profits for just two industries at the expense of 70 million Americans who fall through the cracks of our public/private health care system.

It is ironic that after decades of being told that "free trade" under NAFTA and the WTO is good for the country, even as it costs thousands of workers their jobs and homes, it will somehow undermine the economy of the free world if Grandpa mail orders his Lipitor from Toronto.

The jury is in on both the safety issue and the question of drug industry profits, and Canadian drugs are now 100% cleared of these allegations.

In a show of bipartisan support following the GAO report in June, I joined 388 other House Members on July 13 in voting for Canadian drug reimportation in HR4766, the FY05 Agriculture Department Appropriations Act. The bill prohibits the Food and Drug Administration (FDA) from using any funds to block the reimportation of Canadian drugs.

Its time we started extending the benefits of a global economy to all Americans, not just the insurance and pharmaceutical industries.