O Canada! Home of ice hockey, Molson beer and the answer to some U.S. politicians' prayers for a cheap, reliable source of brand name prescription drugs.
As it turns out, the reality is a bit more complicated: The Tampa Bay Lightning are the reigning NHL champs, Molson has merged with Coors and U.S. customers aren't flocking to sites selling Canadian drugs - at least not the ones set up by politicians, anyway.
In the first 12 months after Illinois Gov. Rod Blagojevich (D)
and the governors of Wisconsin, Kansas, Vermont and Missouri launched I-Save-Rx
, the much-touted program filled only 14,000 prescriptions through arrangements with pharmacies in Canada, Ireland, Australia, New Zealand and the United Kingdom. Minnesota RxConnect
, a similar state-sponsored effort, helped residents fill 15,000 prescriptions in 19 months.
Thousands of Americans are still purchasing brand-name drugs in significant quantities over the Internet from Canada, where many drugs are available for less because Canada, like most countries, strictly regulates how much private drug manufacturers can charge. Some senior citizens make bus trips north of the border to refill their medicine cabinets.
These other importation routes - unauthorized and frowned upon by U.S. authorities, but not strictly policed - add up. A task force
on importation headed by the U.S. surgeon general estimated that nearly 5 million shipments comprising 12 million prescription drug orders worth $700 million entered the United States from Canada in 2003, arriving via Internet sales and travel to Canada by consumers.
But the state-sponsored drug import pipelines opened by Blagojevich and others are bringing in a trickle, and efforts in Congress to legitimize imports of lower-priced drugs from Canada and elsewhere also have lagged. With the launch of Medicare's new prescription drug coverage, fewer elderly Americans feel the need to look northward for their medicines.
The pharmaceutical industry, which has fought drug imports at every turn, claims it blunted the consumer movement with charity programs that make medicines available free or at low cost to those who cannot afford to pay for them. Its Partnership for Prescription Assistance
says it has helped supply nearly 1 million patients with free or nearly free drugs.
Drug industry critics dispute such claims. Robert M. Hayes, president and general counsel of the Medicare Rights Center
, was quoted by the New York Times as saying the industry charity programs were rife with red tape and "10 percent help and 90 percent hype."
Officials in Illinois and Minnesota believe pressure from programs like I-Save-Rx spurred the industry to rev up its drug assistance efforts. "We wish they would've done it sooner or lowered drug prices." said Abby Ottenhoff, a Blagojevich spokeswoman.
Wanda Moebius, a PhRMA
spokeswoman, rejoined that some of the drug manufacturers' patient assistance programs are more than 50 years old.
But the industry did make it easier for people to apply and began heavily advertising the availability of the assistance plans. One application now covers more than 100 programs, Moebius said.
It was "feedback from patients and physicians," not criticisms from politicians, that sparked those changes, she said.
In Washington, meanwhile, Democrats made no headway in efforts to lift the ban on importing Canadian drugs. A proposal to bar the Food and Drug Administration
from using any funds to crack down on drugs imported from Canada has languished.
Kevin Goodno, commissioner of Minnesota's Department of Human Services
, said the FDA has become less aggressive in combating state importation efforts.
When Minnesota first unveiled its Web site, "the reactions from the FDA were over the top," he said. But when Gov. Tim Pawlenty (R)
announced last spring that the state had found suppliers in the United Kingdom as well, there was no reaction from the federal agency, Goodno recalled.
Still, federal authorities in March seized shipments to 50 customers who used the Illinois program. And Canada's health minister, Ujjal Dosanjh
, warned he would restrict exports if necessary to ensure "that the supply of affordable prescription medications remains stable and sufficient to meet the needs of Canadians."
Other states' efforts to import medicine from Canada have sputtered, too.
Lawmakers in Maine, Nevada, Texas and Washington passed measures that would pave the way for imports. But all were on hold awaiting federal approval that even proponents of importation concede was unlikely.
Government officials have also adopted other approaches to take the pain out of buying medicine. Ohio and Maine both offer discount drug programs to uninsured residents, while others have expanded Medicaid eligibility.
This article is from"State of the States 2006," which is now in production. Stateline.org's annual publication will be chock full of helpful graphics and maps, in addition to reports on the most significant policy developments in the 50 states. New this year will be a pull-out reference poster with important state dates and political party information.