A New Kind of Drug War
The battle over re-importation heats up in an election year
Beth Desautels
Background
Although the debate over re-importation is steeped in politics, at the heart of the matter is the cost of prescription drug prices in the United States. Prescription drug costs rose 15.3 percent in 2002 and are the fastest-growing component of health care costs. Expenditures on retail prescription drugs in the U.S., which were $162 billion in 2002, account for 10.5 percent of the nation's total health care costs, while health care expenses, in turn, consume 14.9 percent of the GDP. Additionally, drug costs are expected to climb more than the overall growth in health care spending for the next 10 years. Concerns over these rising costs have caused many Americans to look to their northern neighbors for relief. Canadian drugs are less expensive than those in the U.S., because a federal board sets ceilings on the prices of patented drugs, while each province creates reimbursement criteria and caps compensation under the country's social insurance plan.
The issue as portrayed in the media
Based on an examination of coverage in a variety of mainstream U.S. consumer
publications, journalists presented the issue of re-importation
objectively. Reporting addressed recent developments, presenting both sides
of the argument, although specific topics in relation to various groups showed
definite bias. Almost all the articles mentioned the
strain of the cost of prescription drugs either on the government or on seniors
and low-income individuals.
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The media has presented drug re-importation as a divisive issue
among politicians at the federal, state and local levels. A majority
of the articles noted that re-importation is illegal and that
agencies, such as the Food and Drug Administration (FDA), have
serious concerns about the safety of imported drugs. However,
reports abounded regarding governors and mayors who were starting
re-importation programs of their own, or at least looking into
the starting of such programs. Additionally, concerns from Canadian
associations over potential shortages, due to possible pharmaceutical
company reactions in reducing export volumes, were also prevalent.
While drug re-importation was the basis of the study, several
articles pointed out that other alternatives to re-importation
would also save money. Purchasing generic drugs was presented
as one of these options, because the significant price differential
between the United States and Canada exists only with name brand
drugs. Another was instituting a system where all people currently
uninsured would have access to insurance, even if it must be subsidized.
Additionally, some of the articles mentioned that re-importation
is only a temporary stopgap, not the magic solution to escalating
drug costs in the United States.
Interested Parties
A variety of parties weighed in on this issue,
with journalists citing several government and civic
organizations, all with a vested interest in the outcome. Of these,
federal, state and local governments figured most prominently,
followed by the pharmaceutical industry, pharmaceutical
trade groups and pharmacies themselves. Consumer groups
were the least prominent, although journalists often
provided perspective on the impact of drug costs from
the point of view of individual patients. Not surprisingly, pharmaceutical
companies and the federal government tended most to oppose
re-importation, while state and local governments and consumer
groups were reportedly more favorable.
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As the newly formed “Centers for Medicare and Medicaid
Services” studies whether or not re-importation can be done
safely and whether the inspections to determine safety are being
done cost-effectively, the debate continues – with citizens,
corporations and governments having their own ideas about how
to proceed. No doubt the media will remain interested in this
controversial topic for some time to come.
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