Articles > Online Prescriptions

Gutknecht's drug proposal will come to a vote Thursday

Kevin Diaz, Star Tribune Washington Bureau Correspondent

Published July 24, 2003
DRUG24

WASHINGTON, D.C. -- When farm country Rep. Gil Gutknecht, R-Minn., learned that pork bellies could be freely imported from Canada but prescription drugs could not, a light went on in his head.

Why shouldn't Americans be free to shop around the world for prescription drugs and let the global marketplace be the arbiter of price?

That proposition will come to a vote today in the U.S. House. It's a showdown that will pit senior and consumer groups fighting for access to affordable drugs against a pharmaceutical lobby that says it could be dangerous and counterproductive to import medicine from countries where drugs are subsidized.

Swirling in the background is a major Medicare overhaul bill that passed the House last month by one vote. That vote, provided by Rep. Jo Ann Emerson, R-Mo., came with the demand that Gutknecht's long-stalled drug importation bill get its day in Congress.

Although House GOP leaders oppose the measure, there are signs that Gutknecht's bill is gathering support among rank-and-file Republicans who have historically sided with the pharmaceutical industry, which made more than $20 million in campaign contributions in the 2002 election cycle.

But even if Gutknecht's bill passes, industry experts say it could be a long time -- if ever -- before Americans get cheap prescription drugs from overseas.

That's fine with Gutknecht, who says his ultimate goal is to lower drug prices in the United States, not send folks on shopping expeditions abroad.

"Once the markets are open, [pharmaceutical companies] will have no choice but to offer lower prices here in the United States," he said. "It will have a leveling effect."

Even if Gutknecht's bill passes, it would have to be reconciled with the Senate, whose Medicare package calls only for the importation of drugs from Canada.

His legislation would open the U.S. market to government-approved drugs from 25 industrialized nations -- including Canada and South Africa (though not Mexico). A compromise being floated by Emerson would, like the Senate, allow imports only from Canada.

Risky business

Several difficulties remain, even if Gutknecht's bill passes.

Canada, the destination of many Minnesota seniors who seek low-cost drugs, does not have the supply to meet much increased U.S. demand, according to Neil Palmer, a Canadian regulatory affairs consultant in Ottawa.

"Canada's is less than 10 percent the size of the U.S. market," he said. "We don't have the volume."

There also have been murmurs among drug lobbyists that U.S. pharmaceutical companies might follow the example of GlaxoSmithKline, a United Kingdom-based drug producer that has cut off Canadian pharmacies who supply U.S. customers.

While that could also keep large U.S. pharmacy chains from reimporting U.S. drugs from abroad, some analysts say Gutknecht's bill could spur the development of a robust industry of independent drug stores.

"Capital will go where money can be made," said Kip Sullivan, a Minneapolis health care activist who has worked with the Minnesota Senior Federation.

The U.S. Food and Drug Administration (FDA), whose product reviews are financed by the pharmaceutical industry, has so far opposed the importation of drugs from overseas. FDA Associate Commissioner William Hubbard told a House panel last month that the agency "has serious concerns about proposals that would open America's borders to a stream of imported prescription drugs for which FDA cannot assure safety, effectiveness and quality."

Successive U.S. administrations have blocked the importation of prescription drugs, even after similar legislation passed in 2000 legalizing the importation of pharmaceuticals.

Gutknecht's bill would remove the main obstacle under that law: a requirement that the Secretary of Health and Human Services certify that imported drugs pose "no additional risk to consumers."

Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, the industry's lobby group, has jumped on the less stringent certification requirement, saying it shows that "safety doesn't matter."

Gutknecht says the industry's safety concerns are a dodge, noting that most industrialized nations have much more regulated drug industries than the United States.

Foreign regulations and subsidies, in fact, loom as large in the debate as safety.

Holmer argues that Gutknecht's bill would "import foreign government price controls into the U.S . . . [and] stifle much-needed innovations that create new and better medicines."

One of Gutknecht's fellow Minnesota Republicans, Rep. Mark Kennedy, came out against his bill this week, saying it offers seniors "false promises" while creating a back door to government price controls.

The Taxpayers League of Minnesota has picked up the thread, telling Gutknecht in a letter that it "defies common sense" to import drugs from countries where nonmarket forces determine price.

Gutknecht said he used to feel the same way but has changed his mind. In effect, he said, U.S. consumers are paying higher prices so that pharmaceuticals can be sold more cheaply abroad.

"Either we are going to participate in what other countries are doing, or subsidize what other countries do," he said. "Right now, we are subsidizing what the Canadians do."

Gutknecht's stand has put him at odds with his party's leaders and the Mayo Clinic in Rochester, in the heart of his district, and with groups opposing abortion, which say his bill would make it easier to import the RU486 abortion pill. Gutknecht said his bill won't affect regulation of the abortion pill.

Gutknecht portrays himself as "a guy with charts" up against a vast, well-paid army of lobbyists. "It's a David versus Goliath battle," he said, "but once in a while David wins."

Kevin Diaz is at kdiaz@mcclatchydc.com.