Sam Uretsky

Imagine Affordable Drugs

History has its quirks. The Republicans have been busy naming just about everything that doesn't move after Ronald Reagan (what's the traffic report on Interstate 65 between Decatur and Birmingham?), but someday he'll be known as the president who took the solar panels off the White House and scuttled Jimmy Carter's energy independence program. Neither he nor Vice President Cheney's energy task force could imagine a time when we might want an alternative to Saudi Sweet Crude.

The Republican Party has been marked by a lack of imagination. The greatest tragedies of the current administration have been marked by "no one could have imagined ..." and "I don't think anyone anticipated ..." It's the role of leaders to imagine and anticipate. Even a Tenderfoot Scout learns to Be Prepared -- but our then-national security advisor and our president never learned this lesson.

As if to counter this lack of imagination in the current administrative branch, the Republicans in the legislative branch have gone overboard. Sen. Rick Santorum, R-Pa., retains what may be the all-time record, based on his sexual imagery. Senator Santorum brings new meaning to the phrase "sick puppy."

But Sen. Judd Gregg, R-N.H., has shown dramatic creativity on his own. On July 11, the Senate was discussing a homeland security bill that included provisions for importing drugs from Canada for personal use.

Importation of drugs has been technically illegal in the US, but the Food and Drug Administration has not enforced these rules when the drugs were purchased for personal use, in no more than a 90-day supply.

Drugs, even when manufactured in the US, are so much less expensive in other nations that people without insurance find it worthwhile to buy the drugs there, including round-trip fare. For people who lack prescription insurance, this may be the best answer to coping with the high prices of prescription drugs. For example, one large chain pharmacy in the US lists a 90-day supply of Lipitor 40 mg, the popular cholesterol lowering agent, at $344.99. An on-line overseas pharmacy offers a generic version for $114.00.

The discussion of the safety of imported drugs has taken different approaches over the years. In the second presidential debate of 2004, President Bush said, "Just want to make sure they're safe. When a drug comes in from Canada, I want to make sure it cures you and doesn't kill you." This is consistent with the claim that unless drugs are reviewed and approved by the US Food and Drug Administration, they may be, in some way, substandard.

This argument seems specious. When Vermont tried to develop a program to facilitate reimportation of drugs from Canada, the FDA rejected the state's request, even though several states had visited Canada and reviewed and approved several pharmacies there.

While Congress had passed a bill that would have permitted drug reimportation from Canada, it gave the secretary of health and human services the right to reject the plan. On Oct. 20, 2003, FDA Commissioner McClellan said that "... members [of Congress who favor permitting drug reimportation] are out of touch with the realities of keeping our drug supply safe, and the clear and present dangers to America's drug supply that their bills would create."

Speaking at a US Senate Budget Committee hearing on Feb. 12, 2004, HHS Secretary Tommy Thompson said, "The law requires me to certify that drugs coming in from another country are safe. This is a hurdle I can't meet."

This eloquent call for the safety of the American people was somewhat exploded on June 26, 2006, when Rep. Henry Waxman, D-Calif., issued a report entitled "Prescription for Harm: The Decline in FDA Enforcement Activity." The report concluded that:

• FDA enforcement actions have declined under the Bush administration;

• FDA headquarters officials have routinely rejected the enforcement recommendations of career field staff; and

• the FDA's record-keeping and case-tracking practices are inadequate.

Given the fact that the FDA's performance seems to be typical of every other division of the Bush administration, why shouldn't we be allowed to buy Canadian drugs? The answer, according to an Associated Press report, comes from Sen. Judd Gregg, R-N.H., who said, "If I were a creative terrorist, I would say to myself, 'Hey, listen, all I've got to do is produce a can here that says 'Lipitor' on it, make it look like the original Lipitor bottle, which isn't too hard to do, fill it with anthrax."

Actually, since anthrax is spread by inhalation, a more efficient terrorist might put the bacilli into a drug for asthma, which is becoming increasingly common among children, probably as a result of increased ozone and particulate matter in the air -- but never mind. And, if Sen. Gregg wants to expand his support, he could put the anthrax into a Viagra bottle for Sen. Santorum. Sen. Gregg still gets the silver medal for imagination.

But on July 12, the US Public Interest Research Group reported that people without prescription drug insurance pay 60% more for their medications than they would pay at a Canadian pharmacy. And so far, nobody in this administration has applied any imagination to their problem.

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

From The Progressive Populist, September 1, 2006

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