Congress has a clear shot at cutting U.S. drug costs

  • William Raspberry / Washington Post columnist
  • Thursday, September 28, 2000 9:00pm
  • Opinion

WASHINGTON — There are at least two pieces of the problem of the high cost of prescription drugs, Rep. Bernie Sanders, I-Vt., has been saying for some time now.

But most of the political and journalistic focus has been on only one piece: The "outrageously high price" both seniors and nonseniors alike have to pay for their medications. He’d like to call attention to the other half of the problem: The fact that Americans "are paying by far the highest prices in the world for the same exact drug — not a generic, but the same exact drug."

The solution, he says, is simplicity itself. Allow registered pharmacists and drug distributors to purchase FDA-approved drugs anywhere in the world for resale here. Re-importation, he calls it in the bill he hopes will pass Congress before the campaign recess.

That could be as early as Oct. 6.

"This is important stuff," Sanders said in a telephone interview from his Burlington office. "I traveled to Canada with a group of women with breast cancer, and we looked at the price of tamoxifen, a drug that is widely prescribed for the treatment of breast cancer. You could get it in Canada at a tenth of the U.S. price.

"If this bill were to go into effect tomorrow, U.S. pharmacies would be purchasing tamoxifen in Canada and retailing it here at 30 to 50 percent less than they now charge."

Sanders says the same thing applies in any number of countries with any number of drugs — all approved by the FDA and originally manufactured in or exported from the United States.

"Pharmacies should be able to purchase these drugs the same way other companies purchases shoes, slacks or washing machines," he says.

Is his proposal an attempt to derail legislation calling for a prescription drug benefit, at least for senior citizens? Both Democrats and Republicans seem determined to pass such legislation as a way of combating the high cost of medicine.

"There’s no conflict there," Sanders insists. "Even if we were able through my bill to lower the cost of prescription drugs 30 to 50 percent, we would still need the prescription drug benefit. I support that."

Indeed, he argues, his proposal, whose basic concept already has cleared both houses of Congress as part of an agricultural appropriations bill, would make the other legislation more effective. For example, a Democratic bill would require a Medicare beneficiary to pay $288 of the first $1,000 in prescription costs, and half of the next $1,000. Allowing re-importation would make it possible for Medicare to cover up to 80 percent of prescription costs "just because, with lowered costs, there’d be more money to go around."

So who could oppose such a simple notion?

Some early opposition was based on fear that unsafe or bogus drugs would be brought into the States. The Pharmaceutical Research and Manufacturers of America (PhRMA) has run ads warning that re-importation would "result in adulterated, spoiled and counterfeit drugs in America’s medicine cabinets."

But former FDA commissioner David A. Kessler, who earlier opposed re-importation for just that reason, said recently he’s been satisfied that limiting re-importation to drugs already approved by the FDA and manufactured in FDA-approved facilities would eliminate that hazard. Sanders says batch testing of the re-imports should cost between $800 and $3,000 per batch, an "insignificant" additional cost to batches of drugs "worth hundreds of thousands to millions each."

The biggest obstacle to passage this term is the pharmaceutical industry, Sanders says. "They are the most powerful lobbying force on Capitol Hill," he said. "They’ve spent tens of millions in opposition of this bill. They have 300 paid lobbyists and funneled $6 million to the Republicans and $3 million to the Democrats. That’s $9 million in political contributions we’re going up against."

And his best hope for passage? "This is the issue that is of the most concern to the people and to members of Congress. Both parties want to go home saying we did something about the high cost of prescriptions."

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