States are finding that business is slow on the Web sites they launched to make it easier for residents to buy cheaper prescription drugs from Canada and the United Kingdom.
Fewer than 15,000 prescriptions have been filled from outside the country through state-run Internet sites in the last year. Minnesota's Web site, RxConnect, has processed 10,000 prescriptions since it was launched in January 2004, while I-SaveRx has processed 4,800 prescriptions since Illinois created the site in October 2004. Wisconsin, Missouri, Kansas and just this year Vermont have since joined I-SaveRx. Compare those tallies to the 22 million prescriptions that the uninsured have ordered online and that were filled in the United States through an industry-based Web site called HelpingPatients.org.
The Bush administration deems imported drugs illegal and possibly unsafe. States don't agree and complain that the White House's meddling and the powerful pharmaceutical industry's lobbying efforts are to blame for residents' confusion about state-run drug importation sites, noting that:
The Bush administration points to the paltry participation with state-run programs as evidence that most Americans don't trust getting their medications from abroad.
"I'd like to think that Americans are looking at the situation and saying, `OK, the drugs are cheaper, but I want someone to tell me that they've been checked out,'" William Hubbard, associate commissioner for policy and planning for the FDA, told Stateline.org . "If this was buying a watch or a handbag and you got a bad one, then you lose a few bucks ... but drugs are a whole different ballgame," Hubbard said.
In spite of -- or maybe because of -- these hurdles, states are trying new strategies to boost interest in their Web sites. In Minnesota, Gov. Tim Pawlenty (R) announced that state-run MinnesotaRxConnect plans to offer drugs from British firms in addition to four mail-order pharmacies from Canada.
"It's become clear that the Canadian government might slam the door on American consumers seeking more affordable prescription medicines from safe Canadian pharmacies," Pawlenty said in a prepared statement.
Pawlenty and five other governors still are waiting for a response after writing Canadian Prime Minister Paul Martin in January, hoping to stave off a possible crackdown from the north. The other governors signing the letter were Kathleen Sebelius (D) of Kansas, John Baldacci (D) of Maine, John Hoeven (R) of North Dakota, Jon Huntsman (R) of Utah and Jim Doyle (D) of Wisconsin.
In Illinois, Gov. Rod Blagojevich (D) kicked off a new advertising campaign earlier this month to encourage more people to use the Web site his state created called I-SaveRx, relying on local unions and free advertising from Clear Channel Communications to get the word out. Blagojevich recently lashed out against what he sees as FDA interference.
"Unless the FDA has concrete evidence that the medications our citizens are receiving through I-SaveRx are not the same as the medicine that they buy here in the U.S., then they should stop standing in the way of our efforts to help people," Blagojevich said in a statement following a press conference earlier this month.
The FDA denies that it is targeting medications that are purchased from another country via state-run Web sites that tell Americans how to buy cheaper medications. "There is no particular targeting," FDA's Hubbard said. Detaining 50 shipments out of the estimated 12 million medications that enter the United States from Canada "is inconsequential in terms of numbers and clearly shows that there's not any large campaign against these drugs," he said.
The FDA hasn't filed a lawsuit against any state for running a Web site that makes it easier for Americans to purchase medications from Canada, but Hubbard said that option "is on the table."
Many state leaders, however, contend the administration's safety concerns are groundless and blame the industry and federal officials for meddling.
Minnesota's Pawlenty recently told a U.S. Senate hearing that the No. 1 complaint patients have had was not?safety or quality of imported drugs but the federal government's interference. "Join us or get out of the way," he told the panel.
Montana Gov. Brian Schweitzer (D), who in 1999 drove busload of seniors to Canada to help them purchase medicine, calls the safety concerns about Canadian drugs unfounded. "We allow free trade across the border for cattle, hogs and logs -- but not prescription drugs," he said during a recent Democratic radio address.
While states and the Bush administration are at loggerheads over whether it should be legal for Americans to import prescriptions from Canada, nearly everyone agrees on one thing: Neither the states nor the White House is expected to back down.
"States are going to continue do this [offer Web sites] because it's very popular in these states; governors are able to say, `Look, we can get you cheaper drugs, and by the way, I'm poking the bad ol' feds in the eye at the same time.' That's a pretty good message in the middle of the country," said Hubbard of the FDA.
Sharon Anglin Treat, executive director of the nonpartisan National Legislative Association on Prescription Drug Prices in Maine, said states will continue to look for cheaper medication because the costs "are a huge budget-buster."
"This is an area where states have to look for savings," she said. "I don't see states abating their interest in importation."
At least 18 states have legislation pending regarding drug importation, according to the Health Policy Tracking Service. Already this year one state has acted: Vermont's Legislature voted to allow the state to join I-SaveRx. Similar measures are pending in Minnesota and Connecticut. Moving in the opposite direction, a Kansas legislator has introduced a bill to remove Kansas from the I-SaveRx program.