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A Window on the Controversy Over Importing Drugs

By Cameron W. Barr
Washington Post Staff Writer
Sunday, September 12, 2004; Page C04

As Montgomery County prepares to join a growing number of state and local governments endorsing the purchase of lower-cost medicines from Canada, opponents are clearly distressed.

The Maryland Pharmacists Association on Thursday brought a member of former New York mayor Rudolph W. Giuliani's consulting firm and the head of a Florida AIDS advocacy group to a Rockville hotel banquet room to warn the council off the move.

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"It's amazing to me that people are willing to take risks with their health and that the County Council is willing to take risks with its citizens' health," said Cynthia Boyle, president of the Maryland Pharmacists Association, referring to the millions of Americans who purchase medicines from Canada.

The U.S. Food and Drug Administration says importing prescription medicines is illegal, but it has yet to go to court to block a state or local government from referring people to Canadian Internet pharmacies.

Five members of Montgomery's nine-member council support a proposal, put forward by council member Tom Perez (D-Silver Spring), under which the county would contract with a pharmacy benefits manager to provide lower-cost drugs, on a voluntary basis, to county employees and retirees.

To meet the county's cost-saving requirements, the benefits manager would almost certainly have to obtain drugs in Canada, where government regulations limit what drug manufacturers can charge. Perez argues that the program could save the county as much as $15 million a year and still provide the members of its health plans with safe medications.

The council is expected to vote on the issue Sept. 21. If the program is approved, the county would join Illinois, Minnesota, New Hampshire, Wisconsin and a few municipalities in what amounts to a campaign of disobedience against a federal government that so far has not provided significant relief to people burdened by the high cost of medicine.

In Rockville, several speakers acknowledged that the core of the issue is cost, but they questioned whether importing medicine from Canada was a responsible alternative. "We need to be focused on the legal ways and the safe ways to reduce our pharmaceutical costs, without resorting to importation," said Maureen E. Casey, vice president of Giuliani Partners, which has been retained by the Pharmaceutical Research and Manufacturers of America to conduct a study of drug importation.

At a time when the United States is shutting down its borders because of security threats from abroad, Casey said, it's wrong to open them by allowing the importation of medicines. She said there was some risk that organizations fighting the United States might produce counterfeit drugs to raise funds, but added that "there has never been a direct link between prescription medicines and terrorists."

Gene Copello, executive director of the AIDS Institute, called for a more comprehensive approach to high drug costs, arguing that importation would undermine the integrity of the drug-safety system guaranteed by the FDA.

Howard R. Schiff, the pharmacists association's executive director, noted that drugmakers have been accused of greed. But he said that everyone who owns stocks or mutual funds was at least in part responsible for the fact that drug companies -- most of them publicly held -- want to improve their bottom lines every year. "I wouldn't blame the manufacturers for doing what a capitalist society is supposed to do," he said.

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