The half-dozen elderly people meeting at Horseshoe Pond Place, an independent living facility in Concord, N.H., were, for once, impressed with a government initiative. In their quest to afford the drugs that, in many cases, keep them alive, they had tried to sort through assistance programs offered by pharmaceutical companies and the new Medicare discount cards, all in a pricing landscape that changes from one day to the next. But when Gov. Craig Benson came to Horseshoe Pond to explain the state's website with links to Canadian pharmacies, Virginia North, 77, voiced approval. "He asked us to throw out the names of drugs we used. I said Lopid." She takes the heart drug to reduce her triglyceride levels. "I pay $150 for 90 days. Through this Internet, I could get it for $50 for 90 days. I think that's great," she says.

Benson is one of seven governors, along with mayors from cities such as Springfield, Mass., and Columbia, S.C., who have kicked off or announced programs in the past year that make it easy to get cheaper medicine from Canada, where price controls keep costs low. "I can't tell you how many seniors I've met who simply cannot afford their drugs," says Benson. And it's not just seniors but young people and new parents and working, middle-aged couples. Many New Hampshire residents used to ride buses across the border to fill their prescriptions. "Why should we make old people sit on buses for three or four hours, when they can do it through the Internet where it's easier and safer?" Benson asks.

Because it isn't safer, answers the FDA; in fact it is downright dangerous. "You can not only lose your money but also your health," says William Hubbard, the FDA's associate commissioner for policy and planning. Drugs from Internet pharmacies, even those in nice, safe Canada, could be counterfeit, tainted, mislabeled, and unapproved (story, Page 46). And Hubbard and others worry that the state programs remove such drugs from FDA inspection. "Apparently these pharmacies will sell you anything," Hubbard says. "And once you tell the FDA to get out of the way, it's 'Katy, bar the door!' "

Is this literally a case of your money or your life? Must people choose between safe drugs and affordable drugs? Not really. There are some risks, but it turns out there are also steps careful consumers can--and should--take to safeguard both wallet and health. Choose Canadian pharmacies wisely: Some of the state programs have actually sent inspectors to specific pharmacies to check their supply and their practices for safety. You should also be careful about the medications you request, using the Canadian sites for refills only after you and your U.S. doctor know how the drugs affect you. "I think our website has stepped in to provide people with quality assurances," says Kevin Goodno, commissioner of human services in Minnesota, which runs an importation program. "We feel the pharmacies we use meet or even exceed the standards of Minnesota pharmacies." Adds Scott McKibbin, who helped design the Illinois plan, set to kick off by the end of the month: "Myself, my wife, and our four kids will be in this program. So there's no way I'm compromising on safety."

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