The Montgomery County Council voted yesterday to begin buying medications in Canada, joining a handful of local governments and nearly 2 million U.S. consumers in defying federal law.
The council's decision will give as many as 85,000 county employees, retirees and their dependents the option of obtaining lower-cost "maintenance" medications from a Canadian vendor as soon as February. Proponents say the county could save as much as $20 million a year if members of its health plans fully embrace the initiative.
Montgomery's action reflects rising frustration with the federal government, which declines to approve Canadian imports but does not bar individuals from ordering or bringing in such drugs or stop local governments from facilitating their efforts.
"What we are seeing all across the country is that the credibility of the Food and Drug Administration is being questioned," said Council President Steven A. Silverman (D-At Large).
In many cases, drugs sold in Canada are produced in the United States under the supervision of the FDA and sold at lower prices in Canada as a result of government regulation. But FDA officials say they cannot guarantee the safety of substances that have left the tightly regulated U.S. pharmaceutical industry. Even reimported drugs, in the FDA's eyes, are illegal.
Because the FDA is based in Rockville, the council's action may resonate more loudly than similar steps taken by other communities. "Clearly the fact that the county in which the majority of FDA employees live and work would ignore the FDA's fundamental statutes is an example of the level of concern about the high cost of drugs," said William K. Hubbard, associate FDA commissioner.
He reiterated warnings that the federal government might go to court to block the program but acknowledged that it has refrained so far from using legal action to challenge local governments that have drug importation options for their health plan members.
Council member Tom Perez (D-Silver Spring), the main sponsor of Montgomery's initiative, acknowledged that the council risks court action. "Are we pushing the envelope? You bet," he said. "But there is a significant basis for pushing the envelope."
That basis includes a track record of satisfaction among other local governments that have turned to Canadian pharmacies to reduce health care costs.
Montgomery, Ala., has been offering employees, retirees and dependents the opportunity to buy drugs from Canadian pharmacies for two years. "We have had absolutely no complaints or problems associated with the program," said John Carnell, the city's risk manager. "There are no safety issues -- not a one."