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Thursday, February 17, 2005, 12:00 A.M. Pacific
Canada wants to stem flow of cheap prescription drugs
By Nick Perry
Seattle Times staff reporter
Washington state moved to join the millions buying cheaper prescription drugs in Canada, but it may be too late.
The state House yesterday approved a measure encouraging state employees to buy cheaper Canadian prescription drugs. Two other bills aimed at increasing access to the Canadian drug market are pending in the House, and one in the Senate.
But some parts of the measures could prove impossible to implement. And the bills come at a time when Canadian leaders appear poised to stamp out most of the $1 billion annual prescription-drug trade with Americans.
In an interview, Canadian Health Minister Ujjal Dosanjh said he is considering several measures that would rein in sales to the U.S.
One would require Canadian physicians to establish a relationship with a patient before signing a prescription — putting a halt to Canadian doctors who co-sign thousands of American prescriptions without seeing the patient.
Another would require patients to be present in Canada before a doctor could sign a prescription. A third would ban bulk purchases of Canadian drugs if those drugs were in short supply.
Dosanjh said he wants to protect Canada's cheaper drug prices and stop doctors from unethically prescribing drugs.
"It's not my intent to shut down anything," Dosanjh said. "It's my intent first to ensure that we have good medicine based on good ethics, and that doctors have a doctor-patient relationship for those whom they prescribe medicine."
Prescription drugs are generally cheaper in Canada because of strict price controls and the lower Canadian dollar. Drug prices in the U.S. are among the highest in the world — a premium that drug makers say is necessary to recoup research-and-development costs.
Some people expect drug companies to try to protect their lucrative U.S. market by pressuring Canada into raising prices or cutting supply if the cross-border trade is not stemmed. That would prove expensive for Canadian government agencies that provide drug benefits in health plans.
Dosanjh said drug companies in recent months have already been raising prices, within the range allowed by price controls.
"That pricing regime is very dear to us," he said. "If our prices go up significantly, the provincial treasuries and federal treasury will suffer expenditures of hundreds of millions of dollars, perhaps billions.
"The other thing, of course, is that we are a small country of 30 million people, and we cannot be the drugstore for 300 million Americans. The solutions for your problems lie within your borders."
Dosanjh said he has no timetable for implementing the measures, which are being analyzed for legal, constitutional and international-trade implications.
But the rumblings from Canada have not deterred local lawmakers.
"I don't know how many millions and millions of dollars we have allowed pharmaceutical companies to gouge citizens, but I think it's time to put an end to it," said Rep. Geoff Simpson, D-Covington, who sponsored the measure that passed the House yesterday.
Simpson's bill would offer financial incentives, such as free or discounted co-pays, to qualifying people who choose to buy cheaper Canadian prescription drugs. About 143,000 state employees, dependents and retirees who belong to the Uniform Medical Plan would qualify.
Simpson said he thinks the state could save $10 million a year.
His bill also would give Legislative approval to a Web site established last year by then-Gov. Gary Locke that directs Washington residents to online Canadian pharmacies.
But at least part of Simpson's bill is little more than symbolic. One section would allow state agencies to buy drugs from Canada — if the idea is approved by the federal Food and Drug Administration. Parts of the remaining bills include similar hurdles.
"We don't have any waiver authority ... there is just no such provision in our law," said William Hubbard, the FDA associate commissioner for policy and planning. "Drugs have to be cleared before they come into the country. The FDA was created 100 years ago for that reason."
Hubbard said many Internet sites offering Canadian drugs are scamming customers with substandard medicines from other countries.
Medical authorities in British Columbia already are cracking down on doctors who co-sign thousands of American prescriptions without ever seeing the patients.
Under Canadian law, prescriptions filled in Canada must be signed by a Canadian doctor. So Americans often obtain a prescription from a U.S. doctor, then send it to Canada where it is co-signed by a Canadian doctor.
Since last July, the College of Physicians and Surgeons of B.C. has censured four doctors for unprofessional conduct. Three were fined and a fourth, already on probation, was suspended from practicing medicine for two years.
College Registrar Dr. Morris VanAndel said he doesn't have exact figures but believes that one doctor signed 45,000 prescriptions for Americans. He said he sympathizes with those facing high drug bills in Washington state.
"But the solution is not to compromise the professional standards of B.C. doctors," he said. "We don't think the medical signature is for sale."
Canadian Internet pharmacies yesterday suggested setting a limit on bulk drug sales to the U.S. as a way of safeguarding the Canadian drug supply while preserving their business with Americans, the news agency Reuters reported.
Aside from Simpson's bill, two other bills in the House would authorize the state to inspect and then license Canadian pharmacies and wholesalers, opening the door to greater cross-border trade. But one of the bills requires an FDA waiver, and the other requires cooperation from Canadian health authorities. Neither seems likely.
The bills also might make the state liable should someone be harmed by drugs from one of the state-licensed Canadian pharmacies.
"It is very definitely about sending a message, about standing up for Washingtonians," said Rep. Shay Schual-Berke, D-Normandy Park, who sponsored one of the bills. "If and when the Bush administration relents and allows a waiver, we are set to go."
Sen. Karen Keiser, D-Kent, who chairs the Senate's Health and Long-Term Care Committee, said she expects some version of a Canadian drug bill to pass the Senate and be signed into law by Gov. Christine Gregoire.
Nick Perry: 206-515-5639 or [email protected]
Canada wants to stem flow of cheap prescription drugs
By Nick Perry
Seattle Times staff reporter
Washington state moved to join the millions buying cheaper prescription drugs in Canada, but it may be too late.
The state House yesterday approved a measure encouraging state employees to buy cheaper Canadian prescription drugs. Two other bills aimed at increasing access to the Canadian drug market are pending in the House, and one in the Senate.
But some parts of the measures could prove impossible to implement. And the bills come at a time when Canadian leaders appear poised to stamp out most of the $1 billion annual prescription-drug trade with Americans.
In an interview, Canadian Health Minister Ujjal Dosanjh said he is considering several measures that would rein in sales to the U.S.
One would require Canadian physicians to establish a relationship with a patient before signing a prescription — putting a halt to Canadian doctors who co-sign thousands of American prescriptions without seeing the patient.
Another would require patients to be present in Canada before a doctor could sign a prescription. A third would ban bulk purchases of Canadian drugs if those drugs were in short supply.
Dosanjh said he wants to protect Canada's cheaper drug prices and stop doctors from unethically prescribing drugs.
"It's not my intent to shut down anything," Dosanjh said. "It's my intent first to ensure that we have good medicine based on good ethics, and that doctors have a doctor-patient relationship for those whom they prescribe medicine."
Prescription drugs are generally cheaper in Canada because of strict price controls and the lower Canadian dollar. Drug prices in the U.S. are among the highest in the world — a premium that drug makers say is necessary to recoup research-and-development costs.
Some people expect drug companies to try to protect their lucrative U.S. market by pressuring Canada into raising prices or cutting supply if the cross-border trade is not stemmed. That would prove expensive for Canadian government agencies that provide drug benefits in health plans.
Dosanjh said drug companies in recent months have already been raising prices, within the range allowed by price controls.
"That pricing regime is very dear to us," he said. "If our prices go up significantly, the provincial treasuries and federal treasury will suffer expenditures of hundreds of millions of dollars, perhaps billions.
"The other thing, of course, is that we are a small country of 30 million people, and we cannot be the drugstore for 300 million Americans. The solutions for your problems lie within your borders."
Dosanjh said he has no timetable for implementing the measures, which are being analyzed for legal, constitutional and international-trade implications.
But the rumblings from Canada have not deterred local lawmakers.
"I don't know how many millions and millions of dollars we have allowed pharmaceutical companies to gouge citizens, but I think it's time to put an end to it," said Rep. Geoff Simpson, D-Covington, who sponsored the measure that passed the House yesterday.
Simpson's bill would offer financial incentives, such as free or discounted co-pays, to qualifying people who choose to buy cheaper Canadian prescription drugs. About 143,000 state employees, dependents and retirees who belong to the Uniform Medical Plan would qualify.
Simpson said he thinks the state could save $10 million a year.
His bill also would give Legislative approval to a Web site established last year by then-Gov. Gary Locke that directs Washington residents to online Canadian pharmacies.
But at least part of Simpson's bill is little more than symbolic. One section would allow state agencies to buy drugs from Canada — if the idea is approved by the federal Food and Drug Administration. Parts of the remaining bills include similar hurdles.
"We don't have any waiver authority ... there is just no such provision in our law," said William Hubbard, the FDA associate commissioner for policy and planning. "Drugs have to be cleared before they come into the country. The FDA was created 100 years ago for that reason."
Hubbard said many Internet sites offering Canadian drugs are scamming customers with substandard medicines from other countries.
Medical authorities in British Columbia already are cracking down on doctors who co-sign thousands of American prescriptions without ever seeing the patients.
Under Canadian law, prescriptions filled in Canada must be signed by a Canadian doctor. So Americans often obtain a prescription from a U.S. doctor, then send it to Canada where it is co-signed by a Canadian doctor.
Since last July, the College of Physicians and Surgeons of B.C. has censured four doctors for unprofessional conduct. Three were fined and a fourth, already on probation, was suspended from practicing medicine for two years.
College Registrar Dr. Morris VanAndel said he doesn't have exact figures but believes that one doctor signed 45,000 prescriptions for Americans. He said he sympathizes with those facing high drug bills in Washington state.
"But the solution is not to compromise the professional standards of B.C. doctors," he said. "We don't think the medical signature is for sale."
Canadian Internet pharmacies yesterday suggested setting a limit on bulk drug sales to the U.S. as a way of safeguarding the Canadian drug supply while preserving their business with Americans, the news agency Reuters reported.
Aside from Simpson's bill, two other bills in the House would authorize the state to inspect and then license Canadian pharmacies and wholesalers, opening the door to greater cross-border trade. But one of the bills requires an FDA waiver, and the other requires cooperation from Canadian health authorities. Neither seems likely.
The bills also might make the state liable should someone be harmed by drugs from one of the state-licensed Canadian pharmacies.
"It is very definitely about sending a message, about standing up for Washingtonians," said Rep. Shay Schual-Berke, D-Normandy Park, who sponsored one of the bills. "If and when the Bush administration relents and allows a waiver, we are set to go."
Sen. Karen Keiser, D-Kent, who chairs the Senate's Health and Long-Term Care Committee, said she expects some version of a Canadian drug bill to pass the Senate and be signed into law by Gov. Christine Gregoire.
Nick Perry: 206-515-5639 or [email protected]
-- Science of the almighty dollar and the big money packers and pharmaceutical companies that pore billions into the politicians pockets...........
