In the United States, allergy sufferers spend about $70 for a 30-day supply of Allegra D. In Europe, patients pay only $20 for the same amount.
Here, users of the popular cholesterol medicine Lipitor pay $52 for 30 pills. In Europe, it's $40. Need Biaxin? Here, the respiratory infection drug costs $113. In Europe and other countries, it costs about $61.
The list goes on -- examples of how those in other countries can buy American-made prescription drugs for a fraction of the cost that U.S. consumers pay.
Discrepancies like that are hard to swallow for U.S. Rep. Jo Ann Emerson, who is a co-sponsor of a bill that she says would allow American consumers to pay the same for medicine as the rest of the world.
The Prescription Drug Price Reduction Act would allow pharmacists and wholesalers to import American-made prescription medicine from a specific list of foreign markets including Canada, Australia, New Zealand, England, Germany, France and Italy. Unlike the United States, many other countries in the industrialized world have price controls for prescription drugs.
"We're one of the richest countries in the world. Why is it that we pay the highest prices for these prescription drugs?" Emerson said. "We think there should be a free market, which is what this legislation would do."
The bill, which is expected to be dealt with in the House of Representatives sometime in July, would give the FDA 12 months to implement the law.
Billions at stake
Under current law, pharmacists and distributors in the United States are not allowed access to foreign markets to purchase American-made pharmaceuticals, which are sold for much lower prices abroad.
Emerson said estimates show what she calls reimportation would save $630 billion over 10 years, or about 35 percent of all prescription medication costs.
Only pharmaceutical companies are allowed to reimport drugs made in the United States back into this country, and those companies think it should stay that way.
"Jo Ann Emerson's heart is in the right place, but she has embarked on the wrong approach," said Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America. "There is a better way to get costs down for seniors."
Trewhitt, like Emerson, thinks Congress must allow Medicare to pay for prescription drugs administered outside hospitals. Places like Walgreens and other pharmacies are limited as to what they can accept Medicare for.
Emerson said that the Medicare plan is not enough and that it must be done concurrently with opening up reimportation.
Trewhitt was in Cape Girardeau Monday from Washington, D.C., to talk to area news media about the issue. He said it is dangerous to open the borders to prescription drugs because American-made drugs are out of the scope of U.S. supervision once they leave the country.
"Counterfeiters are alive and well," he said. "There is a good deal of money in it for people who want to make drugs that look like our drugs. It's hard for some pharmacists to tell the difference."
He also pointed out that if prescription medication is not transported or stored properly, it could lose potency.
"It's frankly not safe," he said.
Trewhitt doesn't deny that the pharmaceutical companies are worried about profit. "But that doesn't change the validity of our concerns," he said.
Trewhitt also points out that the Food and Drug Administration and the Drug Enforcement Administration share the companies' concerns. Representatives of the last two presidential administrations have been opposed to a previous version of the bill as well.
No HHS approval
Even though that bill, which was authored by Emerson, was passed in 2000 and signed by President Clinton, it had a caveat that required that the U.S. Health and Human Services Secretary enact the rule.
Neither Donna Shalala, a Democrat under Clinton, and later Tommy Thompson, a Republican under Bush, did so, and that law effectively died.
Local pharmacists expressed concerns and skepticism, though they wouldn't say the bill doesn't have merit.
"I have questions about it," said Keith Middleton, a pharmacist with Broadway Prescription Shop in Cape Girardeau.
Middleton said he was concerned that waiting for shipments overseas may cause longer waiting times. He said that empty shelves translates into fewer sales.
"Of course, if it costs us less, it could be more profits," he said.
Kelley Pipkin, the pharmacist at Thriftway Drug in Jackson, was more critical.
"I don't know a whole lot about it," she said. "I'm pretty skeptical about it. I don't want to put our patients at risk."
Emerson dismisses Trewhitt as someone who is out to protect the big-money interests of the pharmaceutical companies. She does not dismiss some of the points raised by the pharmacists, however.
She said that, under the bill, prescription drugs only will be imported from developed countries that have agencies similar to the FDA, meaning they would be strictly regulated.
Also, Emerson said, there are new technologies that prevent tampering, such as a process that works like the strip that stops money counterfeiters.
"We can uphold the integrity of the product," Emerson said. "These are just bogus issues that they've created to make people nervous about these drugs."
Emerson said that things are only going to get worse, considering that the cost of prescription medicines rises each year by 17 to 20 percent.
"This bill is fair to everybody," she said. "If a pharmaceutical company that has a 27 percent profit margin only sees 20 percent after this law is passed, they'll still be doing pretty good."
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