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The dangerous popularity of drug importation

September 30, 2007
By Sally C. Pipes
Today, eight in 10 Americans support the importation of prescription drugs from abroad.

Such a statistic is hardly surprising, given that politicians and the media have spent much of the past few years telling the public that foreign drugs are just as safe as America's -- only much cheaper.

But before adopting public opinion as policy, lawmakers should ask themselves if following the "wisdom of the crowds" is a sensible move. The truth is that the public has been terribly misled. 

Consider safety: More than 10 million packages suspected of containing foreign medicine arrive at U.S. ports each year, but only an extremely small fraction of them are inspected by the Food and Drug Administration. In 2004, for instance, a study found that on any given day at the John F. Kennedy International Mail Facility, only 500-700 of the 25,000 packages suspected carrying drugs are actually searched.

And among the shipments that are searched, the FDA regularly finds a terrifyingly high number of dangerous, unapproved, or wrongly-labeled drugs. In the summer of 2003, for example, the FDA found that 88 percent of the imported drugs it inspected were noncompliant.

So it's likely that a huge quantity of potentially harmful foreign drugs is already making its way into the United States. And that number will surely rise if drug importation is legalized.

As the FDA itself has repeatedly stated, it simply can't ensure that the medicines Americans import are safe because it doesn't have the resources to do so.

Supporters of importation say the FDA's lack of oversight wouldn't be a problem since any measure legalizing importation would only allow Americans to purchase drugs from countries with robust drug-safety regimes, such as Canada.

But Canada's standards clearly aren't as rigorous as ours: During those 2003 inspections, 15.7 percent of the noncompliant drugs the FDA found came from our northern neighbor.

Moreover, even if drugs from Canada and other "safe" countries always passed muster, it would still be impossible to guarantee the safety of imports.

According to the FDA, many online pharmacies headquartered in China and other nations with poor drug-safety records actually claim on their websites that they're located in Canada and other trusted countries. As the number of online pharmacies grows, this scam will only become more common -- and even harder to spot.  

The FDA's inability to guarantee the safety of imported drugs shouldn't surprise. From tainted toothpaste and toys to poisonous pet food, the nation has experienced a string of consumer-safety scares in recent months, all involving imports.

Importation also doesn't make sense because despite conventional wisdom, U.S. medicines are often cheaper than foreign ones.

Proponents of importation always leave out the fact that generics -- which account for more than half of all prescriptions written -- are cheaper in the U.S. than just about anywhere else. And as the patents on a slew of brand-name drugs expire over the next few years, the number of inexpensive generic pills available to U.S. consumers will skyrocket.

This will drive drug prices down significantly in the next several years. This is especially true because of the declining value of the U.S. dollar. Five years ago, for example, just 62 U.S. cents could be exchanged for a Canadian dollar. Today, the exchange rate is about one-to-one, which means Americans are now paying substantially more than they used to for Canadian goods.

Consequently, Americans are increasingly likely to pay less at their local pharmacy than a foreign one. And when U.S. consumers shop at home, they help fund the development of new cutting-edge cures, which will eventually save untold numbers of lives.

Importation is also a self-defeating policy. Because Canada is one-tenth the size of the U.S. market, selling to Canadians at a discount today is more a nuisance than a deal-breaker. But if U.S. pharmaceutical corporations see their drugs returning en masse to the U.S. at Canada's below-market prices, they will respond by refusing to sell drugs to Canada altogether.

That's precisely why Marc Kealey, CEO of the Ontario Pharmacists' Association, asked the Canadian government to ban prescription drug sales to U.S. patients, saying that "Canada cannot afford to become America's medicine cabinet. That threatens the security of our own drug supply and the health and well-being of Canadians."

Finally, the demographic that has the greatest need for prescription drugs -- senior citizens -- can now buy them at very affordable prices, thanks to Medicare's drug benefit. Opinion polls have consistently found that seniors support this program overwhelmingly. 

As more and more Americans learn about the dangers posed by foreign drugs -- and the fact that they often cost more -- the tides of public opinion are bound to shift against drug importation.

Sally C. Pipes is president and CEO of the Pacific Research Institute and author of "Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer."

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