Montgomery County plans to distribute to all residents drug cards that can be used for steep discounts on most prescriptions, County Executive Douglas M. Duncan announced yesterday.
The county will be the first in the region to pool the buying power of its residents to give them an average 20 percent discount at 130 participating local pharmacies.
Officials expect that the cards will be used mainly by the 80,000 county residents who don't have insurance coverage for prescriptions.
"Currently, too many people must choose between their health and putting food on the table or paying rent," Duncan (D) said. "In the wealthiest country on the planet, this is simply unacceptable."
Duncan embraced the discount card plan, which had been proposed by the County Council this summer, as he sought to take the offensive in the debate about how to provide residents with cheaper prescription drugs.
The council is expected to easily approve a resolution today that calls on the county to defy the U.S. Food and Drug Administration and permit county employees to obtain lower-cost prescription drugs from Canada.
After staying quiet on the issue most of the summer, Duncan announced yesterday that he supports the concept but wants the FDA to give the state a waiver of the federal ban on importing drugs from Canada. In a letter yesterday, Duncan and council President Steven A. Silverman (D-At Large) formally asked Gov. Robert L. Ehrlich Jr. (R) to apply for the waiver.
A spokesman for Maryland Secretary of Health and Mental Hygiene Nelson Sabatini said the administration would review the request. But in the past, Sabatini has said he does not support importation.
FDA officials said they do not have the authority to grant such a waiver, even if Ehrlich agreed to ask for one. Last month, the FDA rejected Vermont's request for a waiver, prompting that state to file a lawsuit.
"Based upon the Vermont waiver request, we do not see how our law would provide for a waiver," said William K. Hubbard, the FDA's associate commissioner for policy and planning.
Despite intense opposition from drug companies and the biotechnology industry, the council wants Montgomery to be the next jurisdiction to challenge the FDA's ban on Americans receiving drugs from Canada.
Several council members accused Duncan yesterday of trying to dodge the politically volatile issue by requesting the waiver instead of joining them in directly confronting FDA policies.
"This is about leadership, and it's time for the executive to lead on this issue," said council member Tom Perez (D-Silver Spring). "The time for sending letters is over."
Council member Howard A. Denis (R-Potomac-Bethesda), another supporter of the council resolution, also mocked seeking a waiver. "No matter how pure the motives are, surely the defenders of the status quo who oppose drug reimportation could only see it as a stalling tactic," Denis said.
If the council resolution is implemented, up to 85,000 county employees and retirees and their dependents, including schoolteachers and police officers, could have the choice of receiving Canadian drugs.
In recent months, two opinions from the county attorney said the practice would violate federal law, causing Duncan to shy away from the council resolution and instead request the waiver.
"I take an oath to uphold the law of this state, county and country, and as an elected official, I don't support breaking the law," Duncan said.
But Perez is hoping that some units of county government, such as the school system, ignore Duncan's advice and try to obtain the Canadian drugs even without FDA approval.
The Canadian drug issue is a prickly one for Duncan, who has worked to bring biotechnology companies to the county.
"We think importation really sends a mixed message to biotech companies and pharmacy companies that 'while we want your business and your jobs in the county, we really do not value what you do,' " said Wanda Moebius, a Pharmaceutical Research and Manufacturers of America spokeswoman.
Montgomery's plan also could embarrass the Rockville-based FDA, which is trying to prevent states and cities from turning to Canada for prescription drugs.
"It demonstrates the power of this issue that so many people are trying to find cheaper drugs that public officials in FDA's own county would take action in direct confrontation of FDA's own statute," Hubbard said.
The discount card concept that Duncan embraced is based on a similar plan in Nassau County, N.Y. In the spring, Ehrlich announced that Maryland would join a pool of states to save money buying drugs in bulk.
The cards, which will be distributed to residents this month, will not the cost the county or residents any money.