Minnesota Congressman Gil Gutknecht was angry that nothing could be done to prevent cheaper Canadian hogs from flooding across the border and hurting American farmers. So, he decided if U.S. consumers had easy access to cheap Canadian pork, they deserved easy access to inexpensive Canadian drugs.
“We have free trade when it comes to hogs, but not Prilosec,” he said of the popular pill used to control heartburn.
Earlier this year, the conservative Republican pushed a bill through the House of Representatives that would legalize widespread importation of drugs from Canada. Drugs are cheaper there because the Canadian government is the sole purchaser of drugs, and thus, sets the price.
The bill passed by a wide margin, but hasn't been taken up by the Senate. Many senators have said they oppose it, as does the Food and Drug Administration, which says imported drugs can be dangerous.
Mr. Gutknecht isn't daunted, and said his idea is gathering momentum. If recent actions by several states - including Michigan - are any indication, he might be right.
In a sharp rebuke to the federal government, the governors of Illinois, Iowa, and Minnesota have ordered their health departments to look at the feasibility of importing cheaper drugs from Canada for state employees, retirees, and, possibly, the general public. Michigan officials said they're going to study what those states come up with, and if it's feasible, they may try it.
Ohio Gov. Bob Taft, through spokesman Orest Holubec, said he would not join those states.
Mr. Holubec said because the FDA has declared such imports illegal, Governor Taft doesn't want to pursue anything that would result in civil or criminal penalties.
The FDA's stance doesn't dissuade Mr. Gutknecht.
“The FDA works for us, not the other way around,” he said.
The congressman dismissed a recent FDA study showing many drugs imported from Canada could be unsafe or not approved for use in the United States.
“We asked [the FDA] how many people have died taking drugs from Canada. It's a nice round number: zero,” Mr. Gutknecht said. “In the last several years, 2,462 Americans have become seriously ill eating raspberries from Guatemala, and yet today you can still buy raspberries from Guatemala.”
Other than some brief mentions in the media, Mr. Gutknecht's bill and the moves by the states haven't garnered much national attention. But many supporters of importing drugs from Canada insist that a growing resentment over high-priced U.S. drugs makes it likely the federal government soon will be forced to allow cheaper imported drugs.
Betty Thrush certainly hopes so.
The 76-year-old Toledo woman had breast cancer surgery two years ago and began taking the cancer drug tamoxifen. She quickly realized that meant an unpleasant choice: Buy her drugs or eat.
She decided on a third option, traveling to Canada to buy her drugs.
“In the U.S., if I go to the pharmacy, it's $103 for one month. But if I go to Canada I get three months for $34,” she said. “Being able to buy this stuff in Canada is the difference between eating and not eating. I live on Social Security.”
Opponents of drug imports argue that Ms. Thrush can turn to a variety of discount programs offered by U.S. drug companies. In addition, other organizations have discount programs. Ohio recently launched a discount-drug benefit as part of its Golden Buckeye card that state officials said could save buyers 15 to 60 percent.
Billie Johnson, executive director of the Area Office on Aging of Northwest Ohio, said those discount programs are some help, but the savings is often not substantial enough and the programs are often confusing to use.
“I like our Golden Buckeye card. It's another short-term solution, though,” she said. “Right now, seniors could have as many as 10 different [discount] cards in their wallets and they all have different eligibility requirements.”
Abby Ottenhoff, press secretary for Illinois Gov. Rod Blagojevich, said Illinois, like Ohio, recently launched a discount program for prescription drugs. It helps, but it's still not enough for many. She said that's why Mr. Blagojevich is pursuing importing drugs from Canada.
“There's a lot of support for this in Illinois. Everybody acknowledges it's a huge problem,” she said.
Opponents of imported drugs, including the drug industry, say bringing in cheaper drugs won't solve the problem and could damage development of drugs. Representatives from the Pharmaceutical Research and Manufacturers Association could not be reached for comment, but have spelled out their views on their Web site and in other areas.
In the United States, drug companies invest hundreds of millions of dollars in development - money that has to be recouped as part of the sales price - and that's why prescription drugs cost so much, companies argue. Canada and other industrialized countries - the United States is the only industrialized country that doesn't control drug prices - interfere with the free market, meaning companies can't recoup their investments, and thus have a disincentive to develop new drugs.
“I think at the end of the day, this is a slippery slope toward price controls in the United States,” said Nina Owcharenko, a health policy analyst with the Heritage Foundation, a conservative think tank in Washington.
In addition to stifling investment, she said, politicians aren't being honest about the fact that drugs, while expensive, save far more money in the long-term by preventing sick people from needing even more expensive hospitalization.
Politicians should spend their time trying to add a workable and affordable drug benefit to Medicare, she said.
Ms. Ottenhoff said arguments by the FDA and drug companies are falling on deaf ears in Illinois.
“The everyday citizen doesn't have a lot of patience for the arguments you're hearing from the drug companies or FDA,” she said.
Frank Clemente is all for cheaper drugs, but said importing them from elsewhere doesn't make any sense.
“It's crazy,” said Mr. Clemente, director of Congress Watch for Public Citizen, a liberal foundation in Washington. “This is a secondary solution to the problem of high drug costs. Really, our view is the government ought to be able to negotiate with drug companies how much it will pay for drugs.”
If the government was buying drugs in bulk for everyone, that would lower prices, he argued. It would also cut down on one of his group's criticisms of the drug industry: copycat, or “me too” drugs. These are drugs that do almost the same thing as a patented drug, but are just different enough to get their own patent.
“The government could say we'll pay less for drugs that aren't new or innovative, and that would force them to spend more on truly innovative drugs,” he said.
Some entrepreneurs aren't waiting for the states to move on importing drugs. Stores have opened in Michigan, and one opened in Toledo last month, offering help to U.S. citizens who want to order drugs from Canada.
Their efforts previously had been ignored, but the U.S. Justice Department has begun cracking down on some of these private operations. And U.S. drug companies are attempting to cut off supplies to Canadian pharmacies that sell drugs to Americans - a move that would be blocked in the Gutknecht bill.
Ms. Johnson, at the Area Office on Aging, which serves 10 northwest Ohio counties, said she wishes politicians would come up with a national solution instead of resorting to importing drugs from Canada.
“It's only a Band-Aid approach,” she said. “What I want is a long-term solution.”
Sound policy or not, drug importation definitely has a chance of becoming law, critics and supporters agree. The Gutknecht bill passed 243-186 in the Republican-controlled House.
“All I know is, the momentum on this thing continues to build,” Mr. Gutknecht said. “No one wants to go into an election next year facing 40 million angry seniors.”