Progress on Medicare negotiations has stalled while Congress tries to mop up after a messy midnight deal that the leadership made to get the $400 billion drug benefit bill passed last month. House leaders had to scramble to get the one last vote they needed for the huge Medicare bill (which passed 216-215) and, in the process, cut a dangerous deal with Missouri Republican Rep. Jo Ann Emerson. She demanded a vote on a bill sponsored by Rep. Gil Gutknecht (R-MN) that would make it legal for Americans to take advantage of other countries’ government-imposed price controls by importing prescription drugs from abroad -but without the safety precautions in earlier bills. A vote on the Gutknecht bill is expected within a week. House leaders quietly acknowledge that they got backed into a corner and have created a monster. The new legislation drops requirements that the Food and Drug Administration certify verify that they could continue to keep the U.S. drug supply safe and that seniors would actually save money on their drugs. The Gutknecht bill also would allow drugs to be imported not just from Canada but from 25 other countries, mostly Old and New Europe, but also South Africa, which has a huge drug counterfeiting problem. Canada is bad enough, where the government is tracking at least 50 groups with ties to terrorist organizations, but many of the websites that claim to be Canadian internet sites are actually based in Africa, Asia, or the Caribbean. For example, Robert Goldberg of the Manhattan Institute in New York ordered a prescription – without having to get a script from his doctor – from a Canadian website. When the drug came, it was a knockoff of the real thing, and was shipped from a facility in the African country of Namibia. Politicians are playing with fire. The potential for black market imports, for counterfeited and contaminated drugs, and even terrorist attacks is huge. The congressional leadership knows its dangers, and is very, very concerned the legislation will pass – with considerable conservative support. Nonetheless, they are bound to fulfill the promise to Emerson and call for the vote. Three key issues dominate the debate over the bill: The danger of price controls, the immeasurable damage to future research and development, and the safety of the U.S. drug supply. The Gutknecht bill would import price controls with their inevitable market disruptions. Supplies in countries with the strictest price controls would dry up and savings would vanish as middlemen soak up profits. Further, drug companies would find they have fewer and fewer resources to invest in tomorrow’s cures for cancer, Alzheimer’s, diabetes, epilepsy, and hundreds of other diseases. Risky investments in cutting-edge research and development would slow to a crawl. Europeans have nearly destroyed their pharmaceutical research industry by demanding prices on drugs that are so low that companies don’t have the revenue to invest in major research. We would do the same if we follow the path of price controls, shrinking one of the most vibrant, high-quality industries in our country. Safety also is a serious concern, not only the risk of contaminating, compromising, and endangering our drug supply, but the real threat that this bill would invite terrorists to use this new portal to attack U.S. citizens. Many Americans remember the scare in the early 1980s when someone laced the painkiller Tylenol with cyanide and seven people died. Leaders fear that this bill would open a new portal for terrorists to attack Americans without ever entering the country. They would simply open a website, advertise cheap prescription drugs, and ship contaminated or even poisoned bills to unwitting consumers. Prescription drug dealing is becoming a major concern because it can be very lucrative: Modern “drug busts” have found prescription drugs being dumped out of their packaging into Ziploc bags, loaded into garbage cans, and sent to repackagers. Consumers have no way of knowing where the drugs came from, if the drugs are expired, if they are contaminated, or if they are put back in bottles that indicate what consumers are actually getting. Members of Congress want to assure seniors they are working to get drug prices down. The solution is not to import price controls from other countries. This proposal could be the ultimate poison pill. Legislators should heed the physicians’ creed in considering Gutknecht’s proposal: “First, Do No Harm.” Instead, Congress should focus on the real problem: The 25 percent of seniors who don’t have coverage for prescription drugs or access to privately-negotiated discounts. Providing them with a viable drug benefit as part of the Medicare program is a much wiser and safer solution. Grace-Marie Turner is president of the Galen Institute, a research organization that focuses on health policy issues. She can be reached at P.O. Box 19080, Alexandria, VA, 22320 or galen@galen.org
Dangerous Dealings on Drugs
Progress on Medicare negotiations has stalled while Congress tries to mop up after a messy midnight deal that the leadership made to get the $400 billion drug benefit bill passed last month. House leaders had to scramble to get the one last vote they needed for the huge Medicare bill (which passed 216-215) and, in the process, cut a dangerous deal with Missouri Republican Rep. Jo Ann Emerson. She demanded a vote on a bill sponsored by Rep. Gil Gutknecht (R-MN) that would make it legal for Americans to take advantage of other countries’ government-imposed price controls by importing prescription drugs from abroad -but without the safety precautions in earlier bills. A vote on the Gutknecht bill is expected within a week. House leaders quietly acknowledge that they got backed into a corner and have created a monster. The new legislation drops requirements that the Food and Drug Administration certify verify that they could continue to keep the U.S. drug supply safe and that seniors would actually save money on their drugs. The Gutknecht bill also would allow drugs to be imported not just from Canada but from 25 other countries, mostly Old and New Europe, but also South Africa, which has a huge drug counterfeiting problem. Canada is bad enough, where the government is tracking at least 50 groups with ties to terrorist organizations, but many of the websites that claim to be Canadian internet sites are actually based in Africa, Asia, or the Caribbean. For example, Robert Goldberg of the Manhattan Institute in New York ordered a prescription – without having to get a script from his doctor – from a Canadian website. When the drug came, it was a knockoff of the real thing, and was shipped from a facility in the African country of Namibia. Politicians are playing with fire. The potential for black market imports, for counterfeited and contaminated drugs, and even terrorist attacks is huge. The congressional leadership knows its dangers, and is very, very concerned the legislation will pass – with considerable conservative support. Nonetheless, they are bound to fulfill the promise to Emerson and call for the vote. Three key issues dominate the debate over the bill: The danger of price controls, the immeasurable damage to future research and development, and the safety of the U.S. drug supply. The Gutknecht bill would import price controls with their inevitable market disruptions. Supplies in countries with the strictest price controls would dry up and savings would vanish as middlemen soak up profits. Further, drug companies would find they have fewer and fewer resources to invest in tomorrow’s cures for cancer, Alzheimer’s, diabetes, epilepsy, and hundreds of other diseases. Risky investments in cutting-edge research and development would slow to a crawl. Europeans have nearly destroyed their pharmaceutical research industry by demanding prices on drugs that are so low that companies don’t have the revenue to invest in major research. We would do the same if we follow the path of price controls, shrinking one of the most vibrant, high-quality industries in our country. Safety also is a serious concern, not only the risk of contaminating, compromising, and endangering our drug supply, but the real threat that this bill would invite terrorists to use this new portal to attack U.S. citizens. Many Americans remember the scare in the early 1980s when someone laced the painkiller Tylenol with cyanide and seven people died. Leaders fear that this bill would open a new portal for terrorists to attack Americans without ever entering the country. They would simply open a website, advertise cheap prescription drugs, and ship contaminated or even poisoned bills to unwitting consumers. Prescription drug dealing is becoming a major concern because it can be very lucrative: Modern “drug busts” have found prescription drugs being dumped out of their packaging into Ziploc bags, loaded into garbage cans, and sent to repackagers. Consumers have no way of knowing where the drugs came from, if the drugs are expired, if they are contaminated, or if they are put back in bottles that indicate what consumers are actually getting. Members of Congress want to assure seniors they are working to get drug prices down. The solution is not to import price controls from other countries. This proposal could be the ultimate poison pill. Legislators should heed the physicians’ creed in considering Gutknecht’s proposal: “First, Do No Harm.” Instead, Congress should focus on the real problem: The 25 percent of seniors who don’t have coverage for prescription drugs or access to privately-negotiated discounts. Providing them with a viable drug benefit as part of the Medicare program is a much wiser and safer solution. Grace-Marie Turner is president of the Galen Institute, a research organization that focuses on health policy issues. She can be reached at P.O. Box 19080, Alexandria, VA, 22320 or galen@galen.org