The Montgomery County Council appears likely to endorse a plan that would offer county employees and retirees the opportunity to buy lower-cost drugs -- in all likelihood from a Canadian intermediary -- as early as February of next year.
The council's three-member Management and Fiscal Policy Committee unanimously endorsed the plan Tuesday, bringing to five the number of council members who are on record in favor of the measure. "It's obvious that a majority of the council . . . now supports this proposal," said committee chairman Marilyn Praisner (D-Eastern County).
The other committee members in favor of the plan are Howard A. Denis (R-Potomac-Bethesda), one of the measure's sponsors, and Phil Andrews (D-Gaithersburg). Council member George L. Leventhal (D-At Large) is also a sponsor of the proposal.
The U.S. Food and Drug Administration, which is headquartered in Rockville, has said that any plan to import drugs from Canada is illegal, and the county's attorneys warned last month that a drug-importation program risked criminal prosecution.
On Tuesday, council member Tom Perez (D-Silver Spring), the idea's leading proponent, called those warnings "fig leaves thrown out rather incorrectly," saying that an FDA official has said the agency would not use criminal prosecution to stop a drug-importation program, although it might go to a civil court to ask a judge for an injunction.
In part to shield the county from any legal repercussions, the committee embraced a strategy devised by the city of Boston, which is also attempting to purchase lower-cost drugs for its employees. Even the county's attorneys acknowledged that "Boston's approach provides a very useful model for the county's hypothetical plan."
Boston officials are preparing to award a contract to a company that would provide prescription drugs through the mail. The company -- a "pharmacy benefits manager" -- would guarantee compliance with FDA regulations and federal laws and would "indemnify the city, its officers, agents and employees against any claim or liability arising from or based on" those laws, according to the request for the proposal that the city issued in April. Boston is expected to decide on a vendor this month, Montgomery County officials said.
To achieve significant savings, the contract would have to go to a Canadian vendor because it could acquire drugs far more cheaply than a U.S. supplier. Drugs in Canada -- even U.S.-made pharmaceuticals manufactured under FDA oversight -- are cheaper because of government price regulations.
Drug prices in the United States have risen sharply in recent years, well beyond the rate of inflation; drug manufacturers say the increases are needed to fund research of new drugs. In response, U.S. residents have turned to the Internet to order drugs from Canadian pharmacies. Governments at a variety of levels have established or contemplated programs to facilitate drug importation.
Perez said the committee's decision showed that the council was mindful of its responsibility to taxpayers and "of the health care crisis in our country." The committee recommended that the county issue a request for a proposal "similar to Boston's" and aim to have a program in place by Feb. 1. The full council will take up the matter July 27.
Perez proposed the measure, at first specifically labeled as a plan to import drugs from Canada, primarily as a way for the county to reduce its medical costs.
He estimated that the county could save $6 million a year if 40 percent of eligible county employees and retirees participate in the program; the savings could reach $15 million in the case of full participation.
On Tuesday, the committee took the words "from Canada" out of the title of the proposal, in light of the theoretical possibility that a U.S. company might win the county's contract. But Perez acknowledged that the winning vendor will probably come from "north of the border."
The committee, noting Montgomery's commitment to the biotechnology industry, limited the program to the provision of certain "maintenance" drugs and excluded bio-medications. Praisner also added language to the resolution that would provide a tax credit to biotech companies directly harmed by the low-cost drug program.
After several committee work sessions analyzing the safety, legality and cost effectiveness of Perez's plan, council members said they were satisfied that it would meet all three conditions. Some said the FDA has not gone to court to stop a state or municipality from pursuing a drug-importation scheme.
"If this is considered to be so illegal and dangerous by some," Denis asked, "why hasn't a lawsuit been filed already?"