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Orlando Sentinel (Florida)



by Robyn Shelton, Sentinel Medical Writer
September 30, 2004

Catherine Mulholland plans to board the "Rx Express" in Orlando next month on a 3,000-mile journey to get cheaper medications in Canada.

Once in Toronto, the 75-year-old Largo resident expects to save at least 30 percent on about nine medicines she takes regularly as a heart-disease patient. But she will pay nothing for the train trip, financed by a consumer group pushing for lower drug prices in America.

The event, which organizers admit is a publicity campaign, nonetheless will provide temporary relief for 25 people who board the train at stops along the East Coast. Supporters say the riders represent a tiny fraction of the millions of Americans who are struggling with high drug costs.

Ultimately, they say, crossing the border isn't the answer. Their real aim is to lower drug costs in the United States.

"We want to raise the profile of this issue so that people will have cheaper drugs for a long, long time to come," said Jerry Flanagan with the California-based Foundation for Taxpayer and Consumer Rights. "Our goal is to make it unnecessary to go to Canada in the future."

The trip is illegal under a 1987 U.S. law that prohibits drugs from being brought into America from other countries because they are not approved by the Food and Drug Administration.

It doesn't matter if a particular drug sold in Canada has FDA approval within the United States. If it's not actually purchased from a U.S. pharmacy, the FDA says it cannot vouch for its safety.

"Medications being made in other parts of the world for the Canadian market may not be the same formulation that America is using," said Thomas McGinnis, FDA director of pharmacy affairs.

Nevertheless, McGinnis said the government has no interest in pursuing individuals -- including the 25 riders on the so-called Rx Express -- who bring back small amounts of Canadian medicines for their personal use.

The FDA may send a letter warning the foundation to stop what it's doing -- the group organized a similar foray on the West Coast earlier this year -- but McGinnis said he doesn't know enough about the trips to say whether they will get attention from his office.

Flanagan disputes the notion that there is a dangerous difference between U.S. and Canadian medications.

"The majority of drugs are made overseas anyway," Flanagan said. "One bottle will come off the drug line and go to Canada and be sold for $40, while the next one will come off the line and go to America and be sold for $120."

The issue of Canadian drugs has become a focal point in health-care politics, with members of Congress from both parties supporting measures that would change the law so Americans could legally buy their drugs from Canada.

But Flanagan said the ultimate answer to the problem is reducing prices in America by following Canada's example. Canadian medications typically run 30 percent to 50 percent cheaper than American drugs because the government negotiates with pharmaceutical companies for lower prices.

The United States should be doing the same thing for all its citizens, Flanagan says. Though some government agencies -- including the U.S. Department of Veterans Affairs -- already negotiate for less-expensive drugs, Medicare was specifically barred from doing so in the new prescription-drug bill.

Flanagan said the U.S. government is being pressured by pharmaceutical companies to keep the status quo. His organization does not think either presidential candidate is doing enough to reduce drug prices.

The Bush administration opposes legalizing Canadian drugs, while Sen. John Kerry supports it. But even Kerry, who talks about negotiating lower prices for people on Medicare, does not go far enough and address the needs of all Americans, Flanagan said.

A spokeswoman for a drug-industry trade group agreed that U.S. citizens are unfairly paying more for their medications -- money, she says, that's needed to fund the estimated $802 million it takes to research and develop a new drug.

But instead of breaking the law and going to Canada for medicine, she said, people would be better served by taking advantage of U.S. programs for reduced or free drugs.

"They're spending more time and money on alerting people to this risky scheme [in getting Canadian drugs] than making people aware of discount programs" that exist, said Wanda Moebius from the Pharmaceutical Research and Manufacturers of America.

She said more than 6 million people got free or reduced drugs last year through an industry-sponsored Web site that helped them access these programs:

Mulholland says she tried to sign up for the $600 in free drugs being offered through Medicare but was told she didn't qualify. She pays about that much every month for her regimen of medications, which includes one that costs $300 alone.

She will board the train Oct. 11 in Orlando, making stops along the East Coast on the way to Canada. Passengers must have prescriptions from their U.S. doctors, and they will visit a Canadian physician in Toronto to get a new order for the medications.

They have to pay for their drugs and a small fee for the doctor, but the trip and most of their meals will be covered by the nonpartisan Foundation for Taxpayer and Consumer Rights. The group will put the passengers up for a night in a Canadian hotel and then fly them back to their home cities. Flanagan estimates the cost at $35,000.

Mulholland has been interested in buying drugs from Canada but didn't feel comfortable doing so unless she could go in person.

"I'm hoping this will become an option," Mulholland said. "I know a lot of people who are retired and on limited incomes, and sometimes, when you get just one more medication added to your list, you can go bankrupt at any time."

For more information, call 1-877-791-2225, ext. 320, or visit
Contact the author: Robyn Shelton can be reached at [email protected] or 407-420-5487