The Bush administration opened the door a tiny crack today to granting consumers legal access to lower cost prescriptions from abroad, but set restrictive conditions that angered congressional backers of the idea.
"I don't know whether to describe this as an insult or an embarrassment," said Rep. Gil Gutknecht, R-Minn. He is among a growing number of Republicans who say they are willing to confront President Bush over the right of Americans to buy imported brand name drugs at prices from 30% to 70% below what they cost here.
"If Congress is willing to consider imports from Canada, then it must be regulated much like the FDA regulates the American movement of pharmaceuticals, so that manufacture, storage and shipment are all within U.S. guidelines," said Surgeon General Richard Carmona, who led an administration task force that spent some ten months studying the issue.
"It could be done safely if it is structured, if it is regulated," Carmona added. "Right now the only trading partner we could possibly see doing that safely with would be Canada."
The administration letter accompanied a report from Carmona's task force that was mainly a compilation of arguments against allowing freer access to drugs from abroad. The report cited many concerns, including anecdotal evidence of safety problems, and worries about taking away the drug industry's economic incentive to develop new medications. It also predicted middlemen would get most of the profits, resulting in meager savings to patients here.
Americans are currently importing an estimated 10 million shipments a year of medicines from abroad, valued at close to $1.5 billion, although it is technically illegal to do so. About half the trade is with Canada.
Defying the federal government, several local governments have set up programs for their employees to buy drugs from abroad. In California, Gov. Arnold Schwarzenegger recently rejected legislation that would have brought Canadian prescriptions into the state.
Brand name drugs are cheaper in many other industrialized countries, because their governments set the prices that pharmaceutical companies can charge. That forces drug makers to seek the bulk of their profits from U.S. consumers.
The importation debate has split Republicans, pitting populists against pro-business lawmakers. Bush had hinted during the presidential campaign that his administration might soften its stance against imports, but today's bid appeared to fall short.
"If you think there is a single senior in Minnesota who is going to read this report and say, 'Oh boy, I guess I'll stop getting my Prilosec from Winnipeg,' then you're living in a fool's paradise," said Gutknecht. Prilosec is a medicine for heartburn.
Democrats sensed a political opening. Sen. Byron Dorgan, D-ND, said he would reintroduce legislation next year to allow importation of FDA-approved drugs.
Dorgan has also hinted that he may try to hold up the confirmation of Mike Leavitt as secretary of Health and Human Services unless Senate Majority Leader Bill Frist, R-Tenn., agrees to a vote on drug imports.