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Try this easy way to save on prescription drugs.

By Clark Howard (Action News 2 WSB TV )

August 29, 2001 -- The fastest growing expense in medicine is the cost of prescription drugs. What can you do about it?

Well, you can take your prescriptions to Canada. Iif you can't get there in person, you can go on the Internet.

With web sites like this one you can order your prescriptions for 30 to 70 percent less than you pay at the drug store.

In Seattle, Washington, seniors board a bus bound for Canada. They're destination: discount prescription drugs. Now, metro Atlantan's can do the same without the bus, thanks to the Internet.

Bill Hall found great deals on the Internet from a company called canadameds.com. "Oh, I was shocked," he said. "I just couldn't believe the difference in prices. I figured something has to be wrong.

No, the price is right. Canadian pharmacies are selling medicines to Americans over the internet. And the savings are huge!

For example, Vioxx, I pay on average here for 30 tablets, around $85. In canadameds, I pay $26.71 for the same thing. My wife's cholesterol medicine is $141 dollars. It around $85. (For the) same thing."

So how does it work? All you need is a prescription from your doctor. You, then have to fill out a medical history and waiver form. You fax those forms along with your prescription. Give a credit card number and you're done. Two weeks later you get your medicines.

But you can only order a three-month supply each time, due to U.S. Customs and FDA rules.

"This is what they call free enterprise," said Brian Abrahams. Abrahams, like Bill, saves big buying Candadian medicines. He's creating a non-profit company called Medicines Cheaper.

"I want to help people get their drugs, and not have to worry about paying their rent at the end of the month," Abrahams said. "And I will help them do that at no charge."

"Without this, we would be having a tough time," said Hall.

The savings mean a lot to Bill. He's retired and on a fixed income.

"I'm saving about $2,800 a year," he said. "You can't beat it by far."

Why are these prices so low? Because of a good exchange rate between the Canadian and U.S. dollar. And Canada has price controls, and we don't."

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Bill on Online Drug Sales Raises Hope, Fears
By Benedict Carey and Linda Marsas

Law: Patient advocates favor legislation to make cheaper prescriptions from abroad easier to come by, but some worry it would mean attracting counterfeit sellers.

Stephen Arundel, a 50-year-old Minneapolis executive, was paying $350 a month for a drug to treat his chronic colon condition. This spring, he saw a newspaper story about importing drugs over the Internet.

"I'm not a computer guy," he said, "so I told my 14-year-old son to get on the Net and check it out."

The result: Arundel is now paying $140 a month to buy the same drug, Asacol, from an Internet site called Canadameds.com. Drug prices are often lower outside U.S. borders, because other countries apply different price controls. "When I'm running low, all I have to do is go online and hit refill, and a bag of pills comes to my door," he said. The savings are "dramatic"--about $2,500 a year.

If Congress passes a proposal allowing Americans to import legal, FDA-approved prescription drugs through the Internet or by mail-order, the ranks of people like Arundel will swell, lawmakers say. (The House approved a bill last week, and the measure next goes to the Senate, where its fate is uncertain.) According to the most recent estimate by the Food and Drug Administration, in fact, about 2 million parcels containing prescription drugs enter the country every year, ranging from growth hormones and steroids to garden variety medications.

But while some patient advocates insist that the practice is safe and invaluable to many Americans, others say that the measure, if it becomes law, would open the door to unscrupulous operators. Drug purchases made over the Internet are very difficult to monitor, and the business is virtually unregulated.

"Consumers will be put at risk, because drug re-importation would be a welcome mat for crooks and frauds." said Rep. John Dingell (D-Michigan), ranking member of the House Committee on Energy and Commerce, in a statement released after the House vote. The committee has oversight over interstate commerce and has investigated online pharmacies.

Americans "take drug quality for granted precisely because we are well-regulated," said Lucinda Maine, a spokeswoman for the American Pharmaceutical Assn., a professional group for pharmacists in Washington that has been skeptical of import measures. The vast majority of drugs approved for sale in the United States, purchased from Canada and Western European countries, are safe, advocates say.

"The drugs coming from Canada seem very clean, we haven't heard of any problems," said Frederick Mayer, a pharmacist near San Francisco who runs the Pharmacists Planning Service, a nonprofit group advocating for lower drug prices. "But there are other countries, including Mexico and some Asian countries, which just don't have the same good manufacturing standards that we do here; we worry about sloppiness and about counterfeiting.

" Already, more than 100,000 Americans die each year as a result of adverse drug reactions, according to some estimates, many from U.S.-made products. Mayer thinks the growth of online pharmacies will only increase that number. "A lot of people, especially seniors, just don't know what they're getting," he says. "Sure, we're saving a lot of money, but what we really need to do is talk to a pharmacist about the drugs."

When 2 million bogus birth control pills flooded the U.S. market in the mid-1980s, for example, the pills and the packaging duplicated that of legitimate drug companies. But one product contained so much extra hormone that it caused excessive bleeding, while another had no active ingredient, which resulted in unwanted pregnancies.

The House measure encourages people to deal with legitimate suppliers and include their doctor in the process, to verify prescriptions.

Still, Bush administration officials worry that drug traffickers could camouflage shipments of contraband and escape detection by attaching a phony label to the package. The Food and Drug Administration and the Customs Service, which oversee the importation of pharmaceuticals, don't have the resources to check all of these packages. In a letter to Congress, DEA officials noted that the proposed legislation would place an "undue burden" on these already overtaxed agencies.

But supporters of the bill said that, for some patients, it may be worth the risk. "This shows the lengths people will go to avoid paying high prices for drugs in this country," said Amanda McClosky, who studies drug pricing issues for Families USA, a Washington-based patient advocacy group. "We think it's important that the proposal in Congress becomes law because, technically, many of these people were illegally" importing the drugs.

While the measure passed easily in the House, 324 to 101, legislative analysts believe it faces a tougher test in the Senate.

But there's no lack of support among many people who are fed up with paying high prices for drugs used to treat their ailments. Karen Bergstrom, a Minneapolis secretary in her 40s, buys stomach medication for her mother over the Internet, also from Canada. "It's about half the cost, and it's very simple to do," she says. "My mom has some drug benefit in her insurance, but it's very confusing for an 83-year-old. It's confusing for me. Doing it online is much easier."

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Canadian Web Drugstores Offer Deep Discounts, Legal Quandaries
By LAURA JOHANNES
Staff Reporter of THE WALL STREET JOURNAL

Harriet Joy White wanted to get rock-bottom Canadian prices for her cholesterol-lowering medication, but she was too far away to conveniently hop a bus, as others have done. Instead, she ordered from her home in Fort Myers, Fla.

With a few clicks of the mouse, the 73-year-old connected to a Canadian pharmacy 1,400 miles away and, after faxing her prescription, ordered a three-month supply of Zocor for $220 -- about 20% less than the cheapest U.S. price she could find.

"As a senior citizen living on a retirement income," says the elated Mrs. White, "I think I should get the best price I can."

While politicians stand on their soapboxes and wail about high prescription-drug prices in the U.S., a growing number of Americans are quietly finding a solution. By logging onto three different Web sites owned and run by Canadian pharmacists and entrepreneurs, U.S. residents are saving 20% to 50%, and occasionally more, on prescription drugs, even after dispensing and shipping fees.

The Internet is a far more convenient alternative than the well-publicized bus trips to Canada organized for seniors last year by sympathetic legislators. Government controls in Canada help keep prices low. Customers ordering from Canada also enjoy a favorable exchange rate: about 66 U.S. cents per Canadian dollar Wednesday.

Bargain Prices

Savings for drugs bought from Canadian Pharmacy Link.com over the U.S.-based Drugstore.com

Claritin 46%
Celebrex 27
Glucophage 25
Lipitor 26
Prozac 30
Tamoxifen 64

Note: Canadian prices include US$5.95 shipping fee; U.S. offers free shipping; figures are for 3-month supply.

One catch: Ordering drugs from Canada to save money is technically illegal in the U.S., though authorities so far have mostly looked the other way. Under U.S. Food and Drug Administration guidelines, citizens can import up to three months of medicines for personal use -- but only if those medicines are not available in the U.S.

The FDA, however, is concerned mainly with policing large commercial shipments and isn't able to seize all, or even most, of the small parcels of medication arriving for personal use. "We haven't been going after individuals, because we don't have the manpower," says Tom McGinnis, director of pharmacy affairs at FDA headquarters in Rockville, Md.

Canadian authorities, meanwhile, are considering new rules that would make it harder for Internet pharmacies based there to fill orders from the U.S.

Demand for Canadian imports has been fueled as increasingly expensive drugs have hit the U.S. market in recent years. Since Medicare doesn't cover prescription drugs, only about a third of U.S. seniors have full prescription-drug coverage, according to University of Minnesota's Prime Institute, a research group in Minneapolis studying pharmaceutical-industry economics. Another third have partial coverage, and the rest have no coverage at all.

Last year, Congress passed legislation that would allow pharmacies and wholesalers to import drugs from certain countries and resell them here. But last month, implementation of the law was blocked by the Clinton administration, which said the law's many loopholes rendered it useless.

Meanwhile, TheCanadianDrugstore.com says it is shipping 100 prescriptions daily to U.S. customers, many of whom are uninsured seniors. The Toronto business, started last fall by three entrepreneurs, two of whom are pharmacists, is already scrambling to secure larger office space and hire more employees to fill orders. Co-owner Billy Shawn, a Toronto businessman, says he has gotten little sleep the past month. "If I go to sleep," he says, "we'll get behind."

So far, the number of prescriptions for Americans filled by the two largest operations in Canada, TheCanadianDrugstore and CanadaRX.net, is tiny in comparison with the roughly three billion prescriptions filled in the U.S. each year. However, if orders from Canada continue to grow, they could upset the pharmaceutical industry's pricing system that charges higher prices in the U.S. to recoup discounts offered elsewhere, and to help fund research.

Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America, Washington, D.C., says the growth of such online businesses "just underscores the urgency" of reforming Medicare so that it covers prescription drugs.

If Congress doesn't pass new legislation to legalize importation from Canada, consumers will continue to find loopholes, says Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota, Minneapolis. "You can't keep them down on the farm once they've been to Paris -- or Quebec in this case," says Mr. Schondelmeyer, who is also director of the Prime Institute.

In addition to cheaper prices on brand-name drugs, the Canadian Internet sites allow U.S. citizens to get generic versions not yet available in this country. George Richards, 56 years old, of Glen Ellyn, Ill., says his local pharmacy charges $224 for 90 Prozac pills. But through the internet

, he ordered a generic equivalent of the antidepressant for less than $70. "If this is illegal," he says, "the law is stupid."

A spokesperson for Eli Lilly & Co., Indianapolis, the maker of Prozac, says the Canadian sites are "obviously violating our patent-protection laws" and warns there's no guarantee of the quality of the drugs.

After hearing about CanadaRX from a happy customer, Janice Long, an elder advocate at the Marlborough, Mass., Council on Aging, started helping her clients log onto its site. Since June, Ms. Long says she has helped 20 seniors get discounts collectively worth $14,000 a year. "This has been a godsend for us," says 74-year-old Marlborough resident Eleanor Lacouture, who cut her family's monthly bill for four prescription drugs to about $100 a month from $239 with Ms. Long's help.

In Canada, authorities have begun looking at the practices of the Web sites. However, each of the three says it operates within Canada's laws, which allow pharmacies to fill only prescriptions signed by Canadian doctors. CanadianDrugstore has a local doctor review the U.S. prescription and write a new version.

CanadaRX mails medications to the patients' U.S. doctors. The Web site's owner, Hamilton, Ontario, pharmacist John Lubelski, says what it is doing is legal. Mr. McGinnis of the FDA, however, says U.S. doctors who receive such shipments are probably breaking the law. He says it depends on a complex legal interpretation of whether the doctor is acting as a pharmacy under the terms of the law.

The Ontario College of Pharmacy, the regulatory body for pharmacies in Ontario, says it's looking into CanadaRX, which is run out of Mr. Lubelski's Hamilton-based Kohler's Drugstore. Other pharmacies work with the site as well, but Mr. Lubelski declines to name them.

A committee of the Manitoba Pharmaceutical Association recently recommended adopting a standard that could make it tougher for Internet pharmacies to fill orders from the U.S. Some say the standard could be interpreted as barring Internet pharmacies from filling prescriptions originally written by U.S. doctors but signed by Canadian doctors who never saw the U.S. patient.

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Lauzen looks north for prescriptions
By Mike Norbut

AURORA - Right now, Edward and Alice Oliva spend about $250 a month for prescription medication. With prices constantly on the rise, the drugs aren't getting any cheaper for the Sugar Grove senior citizens.

"They're going up all the time," Edward Oliva said. "We don't see a reason for it, either."
"In fact, we were thinking about driving up to Canada to buy them," Alice Oliva said. If a program suggested by state sen. Chris Lauzen takes root, the couple won't have to make that drive after all.

Lauzen, R-Aurora has established a pilot program for people who feel they pay too much for their medication. The program would allow them to send their prescriptions to a Canadian pharmacy, which many times would be able to fill orders at a markedly reduced rate. "I've read about people taking busloads across to Canada." Lauzen said. "But we're six or eight hours away here, so that's not going to work. Eventually, there's got to be a better way."

The program will start with about 25 participants, how will place their orders through Lauzen's office. Their prescriptions will be faxed to the pharmacy in Canada, and the drugs will then be shipped to Shafer's;s Galena Pharmacy in Aurora.

The program will be open to anyone who has substantial prescription drug bills every month, Lauzen said, although he expects most of the particpants would be seniors. As far as he knows, this type of program is not being tested anywhere else.

Lauzen said they were starting with a small number of people "to shake the bugs out," but, if it were successful, he expected there would be more people willing to help expand it.

"We don't want to create unrealistic expectations right now, "he said. To even think that way is like celebrating before you've won. When no one is trying something like this, it makes you think there must be problems out there.

Lauzen is looking for volunteers to participate. To sign up, call the senator's office at (630) 264-2334.

An initial meeting will be held June 2. Because of the fees attached to the drugs, participants are encouraged to order all the medications they require at one time.

On paper, the plan looks like a can't-miss opportunity for people who have to pay a lot for their medication out of their own pockets. Federal law allows for the reimportation of drugs - products that are shipped to other countries by American manufacturers and then sold back to American consumers - for personal consumption, provided they are approved by the Food and Drug Administration, Lauzen said.

Many well-known, FDA-approved medications have drastically different prices in the United States and Canada. For example, 90 doses of Actos, a Type II diabetes drug, costs nearly $425 in the Unites States vs. about $290 in Canada, according to a list provided by Lauzen's office. Meanwhile, 90 doses of Casodex, a drug to treat prostate cancer, costs almost $1,000 in the United states, while costing about $420 in Canada. "If we send it across the border and if it comes back, even in its original wrapper, that's great." Lauzen said. "I think that would be ideal."

Canadian law, meanwhile requires a physician to review each patient's case, meaning the concerns some people have about receiving tainted drugs because of an unregulated environment can be eased to some extent, according to Bill Murrin, a Geneva resident and volunteer who has researched the idea for Lauzen.

Even with physician's fees, shipping charges and the pharmacy's dispensing fee, the Canadian prices are substantially cheaper, Lauzen said. "There are restrictions in other countries," Murrin said. "But the view of most people is, let the market economy dictate the price."

Contact Mike Norbut at (630) 844-5829
mnorbut@scn1.com

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ONLINE Rx
Overseas sources can slash the cost of drugs, but experts prescribe healthy doses of caution Healthy Living: Your Tuesday guide to medicine and health care

Even proponents of online overseas pharmacies tell horror stories of elderly patients receiving ineffective drugs for arthritis or women becoming pregnant after ordering birth control pills that turned out to be fake. Overseas Internet pharmacies offer prescription drugs at dirt-cheap prices, but medication from questionable sources can be ineffective or downright harmful. It could also be illegal.

Patients ''could find the cheapest drug made by some bathtub operation located in a country without the same regulations as here or Europe, and they'll get an inferior product," said Andrew Canada, a pharmacist for Global RX, an international online pharmacy based in North Carolina.

But advocates for affordable drugs say that reputable international pharmacies can safely save consumers a bundle, even when shipping charges are included.

Access to medication from other countries gained notice in July when the U.S. House passed a bill to legalize the reimportation of U.S.-manufactured drugs. The Senate is expected to consider a corresponding bill in September.

Patients, doctors, foreign pharmacists and legislators are trying to sort out what's legal and what's not. As a result, many people who think they are importing drugs approved by the U.S. Food and Drug Administration are actually breaking the law.

Up to 2 million packages containing prescription drugs enter the United States through the mail every year, many of them as Internet purchases, according to the FDA. The FDA and the Customs Service intercept packages that appear to contain unapproved medications and send letters to the intended recipients. But many packages aren't checked.

"The purpose of the legislation (that passed the House) is to get the FDA to stop sending letters to people and frightening them," said U.S. Rep. Bernard Sanders, an independent from Vermont and a supporter of the House bill.

Unless that bill becomes law, it is illegal to import drugs that were originally manufactured in the United States. But it is legal to import foreign-made generic drugs that are approved by the FDA. The FDA inspects approximately 1,200 applications for foreign foods, drugs and devices every year. Approved drugs are listed in the FDA's Orange Book, available online at http://www.fda.gov/cder/orange/default.htm.

The most frequently imported drugs are those used to treat asthma, depression, heart disease and diabetes, according to Pharmacists Planning Service, a nonprofit organization advocating lower drug prices.

The FDA warns that those who buy drugs from foreign online sources risk getting fake, unapproved, outdated or substandard products, with little or no quality control.

In contrast, U.S. pharmaceutical companies must adhere to rigorous FDA standards, which can raise the costs of drugs. Manufacturers must conduct clinical trials to show new drugs' safety. They also must demonstrate quality control and describe how, where and under what conditions the drugs will be manufactured.

Consumer advocates advise Internet drug buyers to stick to sites in countries with the same pharmaceutical standards as the United States, such as Canada and European Union nations.

The cheapest drugs may not be the best deals if they come from unsafe sources, Global RX pharmacist Canada noted. Some online pharmacies may sell counterfeit drugs as if they were made in the United States.

"If you buy from the United Kingdom or Switzerland or Italy, it will probably be a good drug and you'll save 50 percent," Canada said.

"You'll save 75 or 80 percent from a questionable operation," he said.

Darren Jorgenson, a pharmacist responsible for U.S. business with Canadameds.com, a Canadian online pharmacy, said there is virtually no difference between the drugs his company sells and those made in the United States. ''It's not like you walk into Canada and suddenly there are backroom pharmacies," Jorgenson said. Reputable online pharmacies ensure that the drugs prescribed are proper for the patient, pharmacist Canada said.

To screen for interactions and incompatibility, online sites should ask patients for information such as their weight, allergies, health history and any other drugs the patient may be taking.

"It's absolutely critical," Canada said. "Otherwise, they're just pushing pills."

Drug abuse is an additional concern. Some sites require customers to mail or fax prescriptions written by a physician, but others don't require doctors' approval. A number of sites advertise that they'll sell drugs without a prescription. The FDA advises consumers to determine a pharmacy's legitimacy by whether it requires and verifies prescriptions.

No matter how professional their sites may look, all online pharmacies require careful examination.

For instance, 4 Corners Pharmacy posts drugs' generic and commercial names, manufacturers' inserts and photographs of packaging. But unlike many online pharmacies, 4 Corners does not require prescriptions or health forms, nor does the site tell where the pharmacy is located. When questioned, representatives will say only that the company is in a country in the South Pacific.

But despite the risks, many Americans are buying drugs at significantly reduced prices from online overseas pharmacies.

More are likely to do so if the Senate legislation passes.

"To someone who can afford it, it may be too much trouble to use a foreign country," Jorgenson said. "But I get calls from people who aren't taking their medication because they can't afford it."

Illustration of buying unknown prescription drugs over the internet. / BRIAN WILLIAMSON / Staff

PRICE SHOPPING
Here's how various retailers, including Internet sites that require prescriptions, fared on the costs of some common prescription medications. The legal status of importing drugs from these sites is a gray area that would be resolved by the bill awaiting approval in the Senate. Prices are per usual daily dosage.

Pharmacy................ Country....Zyrtec /Celebrex /Glucophage
Eckerd Drugs (store).... U.S....... $2.46....$5.27.... $1.92
Cyberpharmacy.cc........ U.S.........1.68.... 4.62......1.42
Canadameds.com.......... Canada......0.59.... 1.90......0.32
thecanadiandrugstore.com Canada......1.17.... 3.05......0.84
pharmacie-pradier.com....Switzerland 0.55.... 0.41......1.31
pharmaworld.com..........Switzerland 0.54.... 1.56......0.40

BUYING ONLINE: DO'S AND DON'TS With common sense and simple precautions, buyers can identify reputable foreign pharmacies offering drugs to U.S. consumers. Here are some tips from the Food and Drug Administration on buying medications online. The FDA discourages importing drugs from other countries.

Don't buy from sites that offer to sell a prescription drug without a prescription. The pharmacist should verify each prescription before dispensing the medication.
Don't do business with sites that have no access to a registered pharmacist to answer questions. Beware of sites that advertise a "new cure" for a serious disorder or a quick cure-all for a wide range of ailments. Steer clear of sites that include undocumented case histories claiming amazing results. Talk to your health care professional before using any medication for the first time. When looking for a pharmacy site, apply the same standards you would use for any place of business. Choose sites with easy-to-find, easy-to-understand privacy and security policies. Don't provide any personally identifiable information (Social Security number, credit card number or health history) unless you are confident the site will protect them.
Avoid sites that do not identify whom you're dealing with and do not provide a U.S. address and telephone number to contact if there is a problem.

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For Price Break on Drugs, Congress Looks to Canada
WASHINGTON, Sept. 8 — Congress is taking steps to allow imports of prescription drugs from Canada, in the hope of giving American consumers access to lower-priced medicines.

The Food and Drug Administration and drug companies oppose the legislation, but many lawmakers said they know of no serious safety hazards with Canadian imports.

"It would be very hard for anyone to make a credible case that there is a risk in importing drugs from Canada," said Senator Byron L. Dorgan, Democrat of North Dakota, who is leading efforts to relax restrictions on such imports.

A law adopted last year allowed pharmacists, drug wholesalers and distributors to import low-priced prescription drugs from 26 countries including Canada, Japan, Israel and members of the European Union.

But the law gave broad discretion to the secretary of health and human services. The Bush administration and the Clinton administration both refused to issue rules to carry out the law. They said they could not certify that the import plan would be safe and would save money for consumers.

In an interview, Mr. Dorgan said, "We are narrowing the bill this year to focus on imports from Canada as a first step."

The broader proposal was included in a spending bill approved last year by votes of 86 to 8 in the Senate and 340 to 175 in the House. A measure dealing just with Canada could pass even more easily, Mr. Dorgan and other lawmakers said.

In July, by a vote of 324 to 101, the House approved a bill that would make it easier for people to import low-cost prescription drugs for their own use. Mr. Dorgan plans to offer his proposal on the Senate floor this month.

Proposals to allow drug imports appeared unexpectedly on the House floor last year without much study or analysis by the committees that usually handle health care legislation.

The idea has attracted serious attention in recent weeks as the federal budget surplus has shrunk, making it more difficult for Congress to add drug benefits to Medicare, the federal health program for the elderly and the disabled.

Senators James M. Jeffords, independent of Vermont, and Debbie Stabenow, Democrat of Michigan, are working closely with Mr. Dorgan to push legislation through the Senate.

Drug costs were one of the top issues in Ms. Stabenow's campaign last year. She organized bus trips to Canada for Michigan voters who wanted to buy prescription drugs at the lower prices available there. Prescription drugs are subject to price controls in Canada, as in many industrial countries.

The bill Mr. Dorgan and his colleagues are drafting, like the one enacted last year, says that imported drugs must comply with all the safety and labeling requirements that apply to drugs made and distributed in the United States. Each batch of imported drugs would have to be tested for purity, to make sure it was not adulterated or misbranded.

Stephen L. Giroux of Middleport, N.Y., a pharmacist who owns three drugstores about 40 miles from the Canadian border, said, "I would be totally confident and comfortable buying products from Canadian suppliers."

At a Senate hearing this week, William K. Hubbard, senior associate commissioner of the Food and Drug Administration, said he "would have a relatively high degree of confidence" in drugs purchased in Canada. But he said that large-scale imports from Canada would pose immense challenges to the F.D.A.

Drug manufacturers and distributors said they now had virtually complete control over the custody of prescription drugs, from the factory floor to the retail pharmacy. But after drugs leave the United States, they said, they could not be sure of the conditions under which the drugs are stored and handled.

Canada has a sophisticated system for regulating drugs. But Mr. Hubbard said he could not give assurances about the safety of products imported from Canada because he did not know how the drug distribution system worked there.

"Once a drug goes into the Canadian market, it's outside F.D.A. jurisdiction," Mr. Hubbard said, adding that "all sorts of malevolent things" could happen to drugs there.

Senator Dorgan said he considers the drug-import bill a tool to "put pressure on drug companies to lower their prices."

Congressional aides who have visited Canada and studied the pharmaceutical market there said it was unrealistic to think that the United States could solve its problems by giving United States consumers access to the Canadian market.

Canada has a population of 31 million, compared with the United States' population of 285 million.

Alan Sager, a professor at the Boston University School of Public Health, said drug makers could try to thwart Mr. Dorgan's bill by limiting the supply of drugs available in Canada for export to the United States.

Drug companies would, in effect, be competing with themselves if they sold large amounts of drugs in Canada, only to see the products shipped to the United States for sale here at discount prices.

Mary R. Grealy, president of the Health Care Leadership Council, a coalition of chief executives from large health care companies, said Canada could become "a trans-shipment point" for counterfeit drugs being sent to the United States from third-world countries. "You don't know where drugs in Canada came from," she said. "They could have been made or stored in third-world countries with no regulation at all."

Federal law says that a prescription drug made in the United States and exported may not be imported to the United States except by the manufacturer. The law, adopted in 1988, sought to end a "gray market" for drugs that were counterfeit, adulterated or too old to be used safely.

The 1988 law, drafted by Representative John D. Dingell, Democrat of Michigan, was widely seen as a consumer protection measure. Congressional investigators had documented many cases in which counterfeit drugs, including birth control pills, had been imported.

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Canada Pharmacy

HOUSE VOTES TO PROTECT PERSONAL PRESCRIPTION MAIL ORDER
From Foreign Countries
What follows is part of an article published in 'The Washington Post', Tuesday, July 11, 2000.

"House Blocks Drug Import Curbs"

Amid growing public resentment of high prescription drug prices, the House voted overwhelmingly yesterday to prevent the government from discouraging the purchasing of drugs in Canada or other countries where the medicines are cheaper....The FDA sometimes sends warning letters to those caught doing it.

The [Food and Drug Admin] gives its employees discretion to permit import of drugs that violate its restrictions so long as they are intended for personal use.

The House approved 363 to 12, an amendment to an FDA appropriations bill that would prevent the agency from enforcing the importation ban.... A second amendment, approved 370 to 12, would bar the agency from sending warning letters."

When this is actually signed into law it may affect the way you do business as it effectively removes most import restrictions as long as the drugs are "intended for personal use."


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Drug re-importation makes sense to seniors
WASHINGTON (CNN) -- Charlotte Walton, 66, was one of dozens of seniors who used to travel by bus to Canada to buy her prescription drugs at a fraction of the cost.

"There, I saved half the price of what I would have paid here in the United States," Walton said.

A congressional amendment passed by the Senate on Wednesday will allow Walton's local pharmacist to re-import her prescriptions from Canada at the cheaper price the Canadian government negotiates for its national health care patients.

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Walton says the bill will help many seniors who are having trouble paying for their prescriptions.

"My husband worked five years past his retirement to put a few bucks away so we could live comfortably," she said, "but that isn't going to last long with the price of drugs they have right now."

But the man who organized the bus trips that helped Walton get cheaper medications, John Marvin of the National Council of Senior Citizens, is skeptical the drug companies will go along with the measure.

"I just don't think that they are prepared to give up the profits that the American market represents," he said.

Marvin said there are several ways for drug companies to get around the bill.

"One way is to clearly limit the amount of drugs going into Canada," Marvin said. "A second way is to require FDA (Food and Drug Administration) inspections of all the drugs being re-imported into this country, even though they are being made in this country."

Republican lawmakers defended the bill, saying they have closed as many loopholes as they possibly can.

"The drug companies don't like this bill, and the reason they don't like this bill is they think it's going to be effective," said Sen. Slade Gorton of Washington.

But Clinton Administration officials say the only way to guarantee seniors the relief they need is to allow them to band together under Medicare to negotiate with drug companies for the same kinds of discounts insurance companies and the Canadian government have.

Charlotte Walton says she's never understood why she and other seniors have paid so much more.

"It makes me angry, and I've heard a lot comments on it that other people feel the same way," she said. "Why can't we get it?"

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