Rx: fair price, fair play
Everyone loves Raymond. Raymond Klimczuk of Garfield Heights, Ohio, that is. He's a cheerful, mild-mannered kind of guy. Yet this 49-year-old man is a firebrand on the issue of Canadians getting cheaper drugs than Americans. "How can the exact same medicines in the exact same bottle from the exact same factory be sold at wildly different prices? It's as if a tariff is being put on just because we are Mr. and Mrs. Working America."
During his wife's unsuccessful struggle with ovarian cancer last year, Klimczuk's greatest fear was that he would not be able to afford the drugs to ease her pain and quell her nausea. This son of America's heartland cheers those who board buses in Cleveland to get their prescriptions cheaper in Canada, even if they are technically breaking the law: "Hey, we are not fighting over vacation fares. It's about sustaining life."
And so it is for 13-year-old Mike Albano of Springfield, Mass., who developed diabetes 18 months ago and faces a lifetime of insulin therapy. His father, Michael, who happens to be Springfield's mayor, says that even before his own son's illness, he saw the skyrocketing costs of drugs in his city's health plan. Now Springfield has a voluntary program that helps city workers and retirees get their medicines directly from Canada. It has worked well for his son's insulin and is likely to save his city up to $9 million a year.
Criminal or patriot? In mid-September, the Food and Drug Administration called Mayor Albano on the carpet. Though the agency didn't threaten him personally with legal action, FDA officials are trying to shut down CanaRx, which helps Springfield gain access to Canadian drugs. Ironically, during that same visit to Washington, Albano was celebrated as a patriot by congressmen on both sides of the aisle. Since Albano's act of civil disobedience, the governors of Illinois, Iowa, and Minnesota have declared their interest in joining in this modern-day Boston Tea Party.
What a mess. This grass-roots agitation is stirring up rebels everywhere and putting the FDA in a double bind. Yes, technically Americans can't bring medicines into this country, but for more than 15 years the FDA has winked at the practice if it was for personal use. That's when it was a trickle; now it's a flood. Since jailing geriatric smugglers is not good PR, the Bush administration is using the illegal-and-dangerous card against those who enable the prescription drug trade, even insurance carriers who reimburse patients for Canadian-drug purchases.
But the winds of public opinion are blowing against them. FDA warnings of unsafe, spoiled, and phony medicines are easily seen as disingenuous, since Canada and most developed countries have awfully good drug approval agencies of their own. Also, many of the drugs Americans now consume are made in Third World countries, imported here with the blessing of the FDA. With that in mind, no doubt, the House decisively passed the Gutknecht-Emerson bill this summer, legalizing importation from Canada and elsewhere and instructing the FDA to use new technology to ensure the integrity of such imports. It's now up to the Senate to take action.
What a windfall for Canada. Almost overnight it has a billion-dollar drug resale business with lush profits. Though Canadians are ensured a price negotiated by their government, it's perfectly fine to tack on a tidy sum for others. For example, one two-pill dose of Kytril--the breakthrough antinausea drug Klimczuk bought for his wife--costs $120 here. Canadians pay $31 U.S.; resold to Americans, it's between $44 and $60. As Tommy Janus, pharmacist with mail-order APTECHA Pharmacy in Manitoba, says, "We are beating the U.S. at its own game."
And perhaps Big Pharma, too. The drug industry saves lives every day with new discoveries. But it operates with an outmoded business model, pricing drugs exorbitantly high in the United States to compensate for unrealistic price controls in other countries. The current furor all but guarantees an overhaul of this discriminatory practice by one means or another. Reimportation shouldn't have to be the answer--but for now it is a powerful catalyst for change, inspired by Mr. and Mrs. Working America, with their strained pocketbooks and keen sense of fair play.
This story appears in the October 6, 2003 print edition of U.S. News & World Report.