Meanwhile, officials from Michigan, Iowa and North Dakota and local leaders from Boston, New York City and Montgomery County, Maryland, were studying Canadian-drug options.
The border-crossing purchases are driven by one goal: Governments want to cut their fast-growing prescription drug bills. Illinois figures importation could save state coffers $91 million a year.
No government is yet proposing to haul truckloads of meds back home from Toronto or Winnipeg, where price controls and the weak Canadian dollar make the same drugs sold in the United States about 30 to 50 percent cheaper. Instead, state and local strategies center on helping individuals to shop Canadian pharmacies themselves. Minnesota, for example, is setting up a Web site pointing consumers to a handful of Canadian mail-order pharmacies that have the state's seal of approval. Springfield's program steers city workers and retirees to a mail-order pharmacy in Ontario, which city officials have inspected and with which they have negotiated low prices for the most popular pills.
Importing prescription drugs from abroad is, for the most part, illegal under U.S. law. The federal Food and Drug Administration, however, winks at individuals who buy Canadian drugs for their own use--a loophole that state and local programs deliberately exploit. Still, programs that "facilitate" Canadian drug sales into the United States are prohibited, the FDA says. The agency is trying to shut down CanaRx, Springfield's Canadian drug mart, but it remains to be seen whether the FDA will challenge the states and localities, too.
It's not just the legal issues that make importation controversial. The FDA says it can't guarantee the quality of drugs coming in from abroad--a point echoed by the pharmaceutical companies. Canadians are worried that Americans are sucking down their pill supplies, creating shortages north of the border. And pharmacists complain that importing drugs means exporting their jobs. Julie Johnson, executive vice president of the Minnesota Pharmacists Association, argues that Governor Tim Pawlenty's pill program will hit the state's rural pharmacies especially hard. "This plan takes the pharmacist out of the system," she says.
None of this seems to faze import proponents, who say the safety concerns are overblown. An official delegation from Illinois visited several Canadian pharmacies in October and reported that regulatory protections north of the border are in some cases sounder than they are south of it. As the states and localities see it, a million Americans are already crossing the border or going online to buy drugs from Canada on their own, and identifying reliable Canadian pharmacies will only make the arrangement safer.
Proponents also recognize that Canadian purchases are only a stop-gap measure. "Long term, we don't believe this is the solution," says Brian Osberg, assistant health commissioner in Minnesota. "We need appropriate pricing for drugs in this country."
