Why Drugs Cost So Much / The Issues '04: Why We Pay So Much for Drugs

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The third noteworthy drug-cost provision in the Medicare bill was one that would affect the lawmakers themselves. Last summer a provision was inserted into the Senate Medicare bill that would have slashed the prescription-drug coverage for lawmakers to whatever level they eventually gave to Medicare recipients. Written into the pending legislation by freshman Senator Mark Dayton, a Minnesota Democrat, the provision drew the support of all but seven senators. The public-spirited act of self-denial was easier to make because many Senators had been assured privately that the provision would be secretly stripped from the bill before it went to conference. It was indeed.

STOPPING SMUGGLERS: IS SAFETY THE ISSUE?

Pfizer Inc., the world's largest pharmaceutical company, wants to shut down the Canadian pipeline used by the likes of Helen Clark and her fellow border crossers. Pfizer is aggressively seeking a pharmaceutical blacklist, warning Canadian pharmacies that if they sell drugs to Americans, Pfizer will halt supplies of all its products. The company ordered Canadian wholesale distributors to prepare reports itemizing past and present sales of its products by individual drugstores. Pfizer declined to comment to TIME. Four other companies--AstraZeneca, GlaxoSmithKline, Eli Lilly and Wyeth--have taken steps to reduce Canadian sales to the U.S.

The companies are backed by some serious muscle. The FDA, charged with assuring the safety of the nation's prescription drugs, has sided with the industry, coming down hard on the Canadians. "The drug-safety laws that Congress has charged FDA to enforce require that drugs be proven to be safe and effective to be legal," says commissioner Mark McClellan. "While FDA will continue to do all it can to make safe and affordable drugs available, we are also committed to enforcing the law against those ... [who] import illegal, unapproved and potentially risky medicines."

The FDA maintains that "consumers who buy prescription drugs from Canada are at risk of suffering adverse events, some of which can be life threatening. These risks include potential side effects from inappropriately prescribed medications, dangerous drug interactions or side effects due to drug contamination." Indeed. But at the same time the FDA is zealously guarding the northern border against errant pill entry, TIME's investigation suggests the real picture is quite different from the one painted by the FDA and some members of Congress.

Influential lawmakers have given unqualified support to the FDA's anti-Canadian stance, among them Orrin Hatch, a Republican Senator from Utah. Says Hatch: "Many of my constituents have written, asking why they cannot use the lower-cost medications from Canada. The answer is easy: it is just irresponsible for Congress to jeopardize public safety by allowing the unchecked reimportation of drugs ... If we truly care about our seniors and other patients who depend upon prescription drugs, we should not expose them to what amounts to pharmaceutical Russian roulette."