Drug Costs

[Guest guest]

Speaking of costs !

I hope our members are following the new hot topic of possible cost savings

for the drugs we are required to purchase.

I received this current document this morning, and it pretty well sums up

the issue that has been on the table for a short while now.

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I will also try to find out if articles from our local newspaper archives

can be found and shared. Been meaning to do this . We now have a store front

working this system. You take your written prescription to this store. They

fax it to a pharmacy in Canada, and the prescription is mailed to you,for a

$13 shipping fee.

Leave it to us Oregonians to once again try to work out new ideas. We do

have a track record, as some of you know. With any luck this can be a winner

Only time will tell.

We can only admire these store front owners for being willing to step

forward and take the heat.

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Now here is the article I originally spoke of:

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Action on Drug Reimportation Moves to States: A Newsmaker Interview With

Osberg, Minnesota Department of Human Services

Cathy Tokarski

Oct. 23, 2003 — Editor's Note: Joining a growing chorus of state officials

distressed by skyrocketing prices of drugs their constituents need but can't

afford, Gov. Tim Pawlenty (R, Minn.) announced a plan last week to help

Minnesotans buy U.S.-manufactured brand-name drugs from Canadian pharmacies.

Federal law prohibits consumers from bringing foreign drugs into the U.S.,

and U.S. Food and Drug Administration (FDA) Commissioner Mark McClellan, MD,

has warned of the " potentially injurious " effect of allowing the purchase of

drugs whose safety and efficacy have not been approved by the federal agency

Nonetheless, governors in Illinois, Maine, Vermont, and, most recently,

Minnesota, are pursuing this option as legalization of drug reimportation

gets bogged down in the Medicare prescription drug benefit still under way

in Congress. Both the U.S. House and Senate passed separate drug

reimportation bills this summer; the Senate bill would allow reimportation

into the U.S. from Canada only.

Under the Minnesota proposal, the state's Department of Human Services would

develop a Web site that would list the prices for specific brand-name drugs

at selected Canadian pharmacies. The state would also negotiate drug prices

with pharmacies that meet safety criteria, although individuals, not the

state, would purchase the drugs directly from the pharmacy. Initially, the

program would be available to residents who are uninsured, covered by

Medicare, or who do not have prescription drug coverage.

Medscape's Cathy Tokarski spoke to Osberg, MA, the state's assistant

commissioner of healthcare, about the proposed reimportation program.

Medscape: What prompted Gov. Pawlenty to develop this plan?

Mr. Osberg: As he looked at the reasons and factors for increasing

healthcare costs, drug costs are the major issue, as they are for everyone.

[The governor] reviewed the work of a task force that was led by [former U.S

] Senator Dave Durenberger, and pharmaceutical costs were one of the driving

factors identified in rising health costs.

Medscape: When do you expect the program to be up and running?

Mr. Osberg: There's no time frame. We're hoping early next year, when the

Web site will be up and running. But we also need to have arrangements with

pharmacies in Canada in place. We have to identify the pharmacies for

negotiating the prices, so the Web site would reflect the rates that we've

negotiated.

Medscape: What steps do you need to take to make this happen?

Mr. Osberg: The Web site will provide information and instructions on how

[consumers] can order drugs from Canada — we won't order or dispense drugs.

We would negotiate the arrangements by which individuals would purchase

drugs. The state will negotiate prices with the pharmacies. We'll be looking

at the prices based on our discussions with pharmacies [that now fill

prescriptions] for the Minnesota Senior Federation.

Medscape: How will the state ensure the credibility and reputations of the

Canadian pharmacies that will fill these prescriptions?

Mr. Osberg: We would look at the regulatory compliance provisions of the

pharmacies in each province. We will make sure that the pharmacies meet all

of the criteria of the regulatory requirements. We have already looked at

the criteria of the [provinces'] boards of pharmacy, and we can tell it is

very similar to what we have in the U.S. We will look at a number of sources

to determine which pharmacies we will select.

Our number-one concern is the safety of the drugs [being dispensed] and that

there is delivery of that drug on a timely basis to the person who orders it

Another factor is cost. Safety, access, logistics, and costs are the key

factors we'll be looking at.

Medscape: What kind of discounts on drugs will the state be able to offer?

Mr. Osberg: The Web site will have a list of prices for brand-name drugs.

There could be multiple pharmacies that sell the drug. The transaction will

take place between the consumer and the pharmacy. We haven't done any price

estimates yet, but based on the arrangements the Minnesota Senior Federation

has, we've heard 50% off the brand-name drug.

Medscape: You're aware of the criticisms that this and other proposals to

reimport drugs from Canada have received from the FDA, from pharmacists, and

from the drug industry. How do you respond to the specific criticism of

safety problems?

Mr. Osberg: Safety is our number-one issue. We would not do this unless we

were very sure of the safety of the drugs that are being sold. We are very

comfortable with the experience that our senior federation has had. Canadian

pharmacies have filled about 4,000 prescriptions a month, and not one safety

issue has come up.

Number two, we're very comfortable with the Canadian regulatory organization

[which] is similar to the FDA in this country. They have very good

provisions related to the safety of these drugs. There is just no evidence

that we've seen that there is a safety problem. We'll continue our analysis

and make sure that arrangements are put into place to oversee safety. We

would not jeopardize the safety of our citizens.

Medscape: How many people do you think will take advantage of this program

when it's up and running?

Mr. Osberg: It remains to be seen now many people would use this. We're

talking initially about those people who don't have insurance coverage or

who have significant out-of-pocket expenses for brand-name drugs. The

uninsured, people on Medicare, or people who have insurance coverage but don

t have drug coverage. In Minnesota, the number of uninsured is approximately

250,000 to 300,000 people.

Stage two, if we get into the business of purchasing drugs on behalf of our

state employees, state hospitals, or maybe Medicaid public health programs,

maybe this could become a vehicle for the private sector. Also, it would be

a function of further logistical analysis of how this works on a broader

scale and a function of what arrangements the FDA and Congress make because

of legalization of reimportation.

Medscape: Has the governor had any discussions with U.S. Department of

Health and Human Services (HHS) Secretary Tommy about this plan?

Mr. Osberg: We are having some discussions with the federal government, with

[HHS] Secretary and Congress about what it would take for them to

be comfortable with going ahead with the reimportation of drugs. We've not

heard any official word back, but they're open to discussing this further.

We're also hoping to play a role in demonstrating that this can be done in a

safe and cost-effective way.

Medscape: Is this the best solution to the problem we're facing of rising

drug costs?

Mr. Osberg: The best solution is to have reasonable prices in the U.S.

available from our drug companies.

Reviewed by D. Vogin, MD

Cathy Tokarski is site editor of Medscape Money & Medicine.

Medscape Medical News is edited by Deborah Flapan, assistant managing editor

of news at Medscape. Send press releases and comments to news@....

Medscape Medical News 2003. © 2003 Medscape