Battle looms on drugs ban

Montgomery County Council could vote tonight to join spreading rebellion against FDA ban on cheaper imports

September 21, 2004|By Paul Adams | Paul Adams,SUN STAFF

The three prescriptions that Montgomery County schoolteacher Ann Titherington's husband needs to stave off another heart attack cost more than $2,800 a year if the couple get them through a pharmacy in the United States.

If they get them in Canada, the price drops by at least $1,200, said Titherington, who teaches third grade at Brooke Grove Elementary in Olney. That's money that her employer could use to cut the couple's co-pay and put toward keeping more teachers on the payroll.

"It's a very hard decision for me to go to Canada [for prescription drugs], but I will go because ... it will give me a better quality of life," Titherington said.

Faced with stratospheric increases in prescription drug costs, a majority of Montgomery County Council members say they are ready to join a growing nationwide rebellion against the Food and Drug Administration's ban on reimported drugs by giving county employees a chance to buy cheaper medicines from Canada.

The nine-member council is expected to easily pass a resolution tonight that would lead to the establishment of a voluntary drug import plan that could save the county from $6 million to as much as $16 million annually, depending on how many of the county's 40,000 employees and their dependents participate.

County agencies and employees spent an estimated $330 million on health benefits last year, of which $70 million was for prescription drugs. For Montgomery County public school employees, annual prescription drug costs climbed from an average of $833 in 1997 to $1,992 last year.

The county's drug import proposal is similar to those adopted by Boston and Springfield, Mass., and a handful of other municipalities and states. But this time the FDA, headquartered in Rockville, is being defied in its back yard.

The renegade public officials have sounded alarm bells in the pharmaceutical industry and sparked an intense political debate over whether the United States should adopt policies that would put domestic drug costs on par with those in Canada and many European countries, where prices are regulated.

The revolt threatens to spill into the private sector, where many small and large employers are faced with cutting employee benefits to save money.

The FDA has not gone after the public officials behind the efforts, vowing instead to continue a public education campaign that stresses concerns about the safety of drugs flowing across international borders.

No court ruling

Montgomery County officials say they are not worried about prosecution or about the safety of drugs reimported from Canada.

"If a court comes in and says stop saving the taxpayers money, I will respect that, but no court has said that," said Councilman Tom Perez, a leading proponent of the proposal.

"If it is so illegal, why haven't they [the FDA] sued the city of Springfield? Why haven't they sued all of the other municipalities that have done this?"

William Hubbard, the FDA's associate commissioner for policy and planning, said the law makes it clear that what Montgomery County is proposing is illegal and should be stopped for the sake of public safety.

"Just because the FDA hasn't sued anyone among those public officials isn't a sort of tacit approval," he said. "But if this continues, we may well end up in court trying to get a judge to side with us."

The grass roots movement among municipalities can be traced in part to former Springfield Mayor Mike Albano. The western Massachusetts city took action last year after being faced with another double-digit increase in health care premiums for its employees.

Albano decided to test Canadian pharmacies by ordering a batch of insulin for his diabetic son. The experiment shaved $850 off the cost to taxpayers on a 90-day supply and saved the Albano family $250 in co-payments.

The city subsequently started a Canadian drug importation plan in July last year and is on track to save $6 million this year, Albano said.

"It's a very popular program, and the savings are significant," said Albano, who left office in January but continues to consult with other municipalities about adopting programs similar to Springfield's.

Some excluded

Montgomery County's plan would apply only to certain FDA-approved maintenance drugs that patients take regularly for chronic conditions. Participants would not have any co-pays and could order a maximum 90-day supply through a pharmacy picked through competitive bidding.

The plan would probably exclude any drugs that have to be refrigerated, such as insulin, and certain generic drugs that can be purchased just as cheaply in the United States.

The county plans to open the bidding process to U.S. prescription drug suppliers, but pricing controls in Canada would tip the scales in favor of pharmacies across the border.

"We're going to do a lot of due diligence, because if we cannot assure our employees that the drugs they're buying from Canada are every bit as safe as the drugs they buy from their local pharmacy, then we're not going to do it," Perez said.

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