June 27, 2010
Billings Gazette
Montana Gov. Brian Schweitzer and U.S. Sen. Byron Dorgan, D-N.D., proposed a pilot program to allow prescription drugs to be imported into their states. Their goal: lower costs for patients.
Unfortunately, Schweitzer didn’t consult the Montana Pharmacy Association, whose members would be dispensing imported medications under the proposal. At its conference earlier this month, the association passed a resolution saying the Schweitzer-Dorgan proposal won’t work.
Pharmacists’ concerns
The pharmacists say the proposal “does not provide details on oversight, licensing, enforcement, logistics, shipping, storage, pedigree (and) ... fails to outline details on patient safety including labeling, identification, as well as details on how patients will access the program.”
“The program would allow for unsafe medication to enter Montana borders,” the association concluded.
Pharmacists’ concerns were first aired at a legislative committee meeting in Helena a week after the importation proposal was announced. However, the pharmacy association held off on making a statement until its executive board drafted a position and the members voted on it, according to board chairman Tony King, a Missoula pharmacist.
In an interview last week, Schweitzer said he doesn’t buy the “unsafe” argument, which has long been made by pharmaceutical manufacturers. He points out that the prescription medications sold in Canada come from the same manufacturers (including U.S. plants) that sell medicine in the United States.
The Canadian import plan was a long shot from the start. If such a program worked for Montanans and North Dakotans it would cost the pharmaceutical industry millions. Moreover, the U.S. Department of Health and Human Services already has a full plate with implementation of other new programs with the health reform law enacted earlier this year. Most importantly, the price of prescription drugs wasn’t addressed in that law. Medicare patients got relief because the new law reduces their out-of-pocket prescription costs by closing the notorious “doughnut hole.” But U.S. taxpayers will foot the bill.
Congressional inaction
Congress could have required Medicare and Medicaid to negotiate prescription prices like government programs do in Canada and other nations — like the Department of Veterans Affairs does. But a majority of lawmakers didn’t want to take on the pharmaceutical industry.
The pricing penalty appears highly unlikely to be resolved anytime soon. Profits in the U.S. market are great and will grow with the aging of our population and more Americans getting insurance coverage.
Although Secretary of Health and Human Services Kathleen Sebelius notified Schweitzer at the beginning of June that “neither a Medicaid waiver nor a demonstration project can be granted at this time,” the governor told The Gazette that he and Dorgan will keep trying.
The law that created the Medicare Part D prescription drug program provided that U.S. jurisdictions could have drug reimportation programs, if they could prove the program’s safety. Schweitzer said that he and Dorgan will go back to Sebelius and ask for specifics on how to meet that standard. When they get answers, Schweitzer should seek the help of Montana pharmacists in proposing a program. The pharmacy association’s resolution also recognizes that costs of medicine can be a barrier to care for Montanans.
“I’m just not going to give up,” Schweitzer said. According to estimates from the governor’s staff, buying prescription medicines at Canadian prices could have saved Montanans $280 million last year, including $41 million in state government spending.