HHS Task Force Holds Fifth Meeting on Prescription Drug Reimportation

The HHS Task Force on Drug Importation on Wednesday held a fifth meeting in which state officials and the head of CVS/Pharmacy testified in support of the legalization of reimportation of lower-cost prescription drugs from other nations, the Los Angeles Times reports (Kemper, Los Angeles Times, 5/6). The 13-member task force has held a series of meetings as part of a study -- mandated by the new Medicare law -- on the safety of reimportation and the effect of the practice on prescription drug development. Task force members, who were appointed by HHS Secretary Thompson, can consult with other federal officials and will hold a total of six "listening sessions" with consumer advocates, health care purchasers, providers, health care industry representatives, international stakeholders and the public. In the first meeting, consumer advocates testified that the United States could establish a safe reimportation system. In the second meeting, pharmaceutical company executives testified that reimportation would reduce the incentive for companies to invest in new medications and allow more counterfeit treatments to enter the United States. In the third meeting, the public testified about the effects of reimportation. In the fourth meeting, U.S. residents and Canadian pharmacy groups testified that Canada could not support legalized reimportation and that the practice has affected the Canadian health care system. The task force must report the results of the study to Congress by Dec. 1, although Thompson has said that he hopes to complete the study by mid-summer (California Healthline, 5/5).

Minnesota Gov. Tim Pawlenty (R) told the task force, "It is simply implausible that the United States of America ... is incapable of designing a system where we could safely import medications from Canada" (Los Angeles Times, 5/6). Pawlenty testified that within the next six months, pharmaceutical companies likely would end supplies of some of their products to Canadian online pharmacies that sell them to Minnesota residents. Pawlenty said that as a result, the state has considered reimportation agreements "with Canada-like countries in Europe and elsewhere" (Gordon, Minneapolis Star Tribune, 5/6). Pawlenty acknowledged that "there is an element of risk" to reimportation and said that to address the issue, "it would be extremely helpful for the federal government to step in" with procedures to ensure safety and standardize reimportation operations (Los Angeles Times, 5/6). Pawlenty told the task force, "I think you will be uniquely positioned to provide the road map, the pathway for America as to how to do this in a safe and appropriate manner" (Minneapolis Star Tribune, 5/6). Kevin Concannon, director of the Iowa Human Services Department, said that FDA and the pharmaceutical industry have "hysterically overstated" the safety risks of reimportation, adding, "As we sit here today, there will be people who have strokes, people who have heart attacks, people who will die because they don't have access to medications." Vermont Gov. Jim Douglas (R) and North Dakota Gov. John Hoeven (R) also testified in support of the legalization of reimportation. CMS Administrator Mark McClellan told the governors, "There's a lot that can be done while Congress sorts this out" (Los Angeles Times, 5/6). McClellan said that states could "capitalize on new Medicare-approved drug discount cards and pooled buying arrangements to gain pricing leverage while policymakers wrestle with reimportation safety issues," the Star Tribune reports.

In an "unexpected" move, CVS CEO and Chair Tom Ryan testified that he supports the legalization of reimportation, the Boston Globe reports (Rowland, Boston Globe, 5/6). Rhode Island-based CVS, the second-largest pharmacy chain in the nation, operates more than 4,100 pharmacies throughout the United States (Los Angeles Times, 5/6). "While many in our industry believe that importation is a fundamentally flawed concept and oppose it without exception, I have come to a slightly different view," Ryan said in a statement (Freyer, Providence Journal, 5/6). "Millions of Americans already have opted to import drugs because they can't afford not to. We owe it to them to face this issue head-on and not look the other way," he added (Jones, Chicago Tribune, 5/6). Ryan recommended a two-year reimportation trial, during which time lawmakers could develop proposals to reduce prescription drug costs in the long term (Sherman, AP/San Luis Obispo Tribune, 5/5). According to the Globe, Ryan proposed that U.S. wholesalers and pharmacies could reimport prescription drugs from Canada and other nations and sell them, with a priority toward seniors and those without prescription drug coverage. "To do otherwise, would be to ignore the millions of Americans who, as we speak, are forced to go outside our existing system, which is intended to ensure drug safety, in order to preserve their pocketbook," Ryan said. Ryan added that CVS would not make a profit from reimported medications and would pass savings to customers (Boston Globe, 5/6). However, Ryan said that a long-term reduction of prescription drug costs requires "global pricing that makes drug costs more equitable around the world," the Journal reports. Ryan also said that he opposes government price controls on prescription drugs. "That stifles innovation; it stifles the free market," he said, adding, "I'm asking the U.S. trade representative to raise the noise level and bring it to discussion when we talk about international trade regulation" (Providence Journal, 5/6). Task force member Lester Crawford, acting commissioner of FDA, said that such issues are "something we worry about at the FDA almost as much as we worry about safety" (Los Angeles Times, 5/6).

In related news, officials for Illinois-based Walgreen, the largest pharmacy chain in the nation, said that they would support the legalization of reimportation "if a safe channel can be established," the Globe reports. Walgreen spokesperson Laurie Meyer said, "If importation is legalized, we will actively participate in filling prescriptions for patients. It's a way to provide some relief to what we see every day in our pharmacies." In response, Wanda Moebius, a spokesperson for the Pharmaceutical Research and Manufacturers of America, said, "It's unfortunate that some want to lower the premier American safety standards and bring in drugs from Canada despite the safety concerns of nearly all pharmacies and pharmacists. Doing so can only open the floodgates to counterfeit drugs entering the U.S. drug supply" (Boston Globe, 5/6).

Meanwhile, attorneys general from 18 states on Wednesday sent a letter to Thompson to request that he allow states to reimport prescription drugs from Canada, the AP/Long Island Newsday reports. The letter asks Thompson to allow states to become licensed wholesalers or allow them to contract with licensed wholesalers to reimport medications from Canada. According to the letter, states would only reimport medications manufactured in FDA-approved facilities and shipped to the United States from Canada in their original packages. In addition, states would use technologies to help prevent entry of counterfeit medications into the U.S. prescription drug supply. According to the letter, Thompson should "act immediately to help provide our citizens with affordable prescription drugs while ensuring drug safety." The letter added that "with the assistance of FDA, the undersigned states can work with the Canadian authorities to develop a process for the safe importation of prescription drugs." Attorneys general from Arizona, California, Colorado, Connecticut, Illinois, Iowa, Maine, Maryland, Massachusetts, Mississippi, New Hampshire, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont and Wisconsin signed the letter (AP/Long Island Newsday, 5/6). ABCNews' "World News Tonight" on Wednesday reported on recent statements made by Thompson on reimportation. The segment includes comments from health care industry economist David Dranove, Sen. Byron Dorgan (D-N.D.), Minnesota Senior Foundation Issues Manager Lee Graczyk and Ryan (Stark, "World News Tonight," ABCNews, 5/5). A video excerpt of the segment is available online in RealPlayer.