Experts Debate Relief from Rising Drug Costs

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ALI VELSHI, CNNfn ANCHOR, STREET SWEEP: This week drugmaker GlaxoSmithKline became the latest pharmaceutical company to try to stop Canadian firms from selling prescription drugs to Americans. The lure of lower prices has led U.S. consumers to hop on buses headed north of the border, or to surf the Internet seeking out online pharmacies. Drugmakers and others say the practice is illegal and potentially harmful to consumers. However, not everybody seeing it that way. We have two guests with us to debate the issue. Now joining us from Chicago on the left of your screen is Carmen Catizone. He’s the executive director of the National Association of Boards of Pharmacy, a group represents 50 states’ boards of pharmacy.

Carmen, welcome to the show.


VELSHI: And on the right of your screen with us from Santa Monica, California, is James Court. He is the executive director of the Foundation of Taxpayer and Consumer Rights, the non-profit group tries to protect the rights of consumers and taxpayers.

Jamie, thank you for joining us.


VELSHI: Carmen, I am going to start with you. This is a story that’s filtered down, it’s been in the news for a while. The drugmakers have a few arguments to be made against Americans buying their drugs in Canada. What are some of them?

CATIZONE: Some of the arguments are that all of these products are outside the regulatory system of the United States, both the FDA and the states, and therefore we have no way of knowing whether they’re legitimate products, whether they’re counterfeit products or whether they’re medications that people should be taking.

VELSHI: OK, but Carmen, GlaxoSmithKline says it is going to stop shipping its drugs which means GlaxoSmithKline‘s drugs are being sold to Americans. You and I both know that these pharmaceuticals sold in Canada and the United States are exactly the same drugs made by exactly the same pharmaceutical companies.

CATIZONE: Well, that’s the assumption that’s made. And that’s what is driving people to Canada. If we knew that and if we could regulate that then it would be safe for U.S. consumers, but until we can confirm that, that’s the problem and that’s the concerns that U.S. regulators have.

VELSHI: OK. I’m not part of the debate so I’m not going to get into it. But we do know that GlaxoSmithKline, Merck and all those companies sell the drugs in Canada. So I think let’s just pass that argument by. Jamie Court, what’s your view on Canadians being able – Americans being able to buy their drugs in Canada? We know that more than a million Americans are already doing so.

COURT: Well, actually, I think it’s a shame that Americans actually have to go across the border to get affordable drugs. And it is actually illegal. Although I don’t think grandmother is going to be prosecuted for going across the border to get some arthritis medication. The reality is we need affordable prescription drugs in America, and they’re not available. And Canadian pharmacists, while they’re not regulated by state pharmaceutical boards, are well-regulated in their own country. I think it’s – if you are going with a reputable Internet company, if you are going across the border to Canada, and you are within the normal channels, it is probably safe. The drugs are from the same manufacturers, directly as the same manufacturers in America. But unfortunately it’s just unaffordable here for most people to get their prescription drugs. And until we get Capitol Hill to act on a Medicare prescription drug benefit, we’re going to see more and more Americans going across the border. And I think it’s a practice that is going to save a lot of money. We know from many drugs it’s about a third of the cost in Canada as it is in the United States.

VELSHI: Carmen, let’s talk about this. You represent Boards of Pharmacy, pharmacists are getting hit by this, it may not be by design because the pharmacists aren’t the people behind the issue, but people are going to Canadian pharmacists. And we have actually spoken to Canadian pharmacists who are saying they can’t fill their prescriptions they’ve got so much demand in Manitoba and Alberta from Americans. What’s your view on – really, should we be regulating Americans buying their drugs in Canada or should the drug companies be coming out with more affordable ways to sell their drugs?

CATIZONE: The issue boils down to what the medications are costing U.S. citizens. There has to be a change in the prescription drug prices. There has to be a prescription drug benefit for seniors and for other Americans. Once that’s in place, that will take away the incentive. Our role is to make sure the medications that the people receive are safe. And that means to regulate those pharmacies and those manufacturers. Beyond that, we shouldn’t be regulating U.S. consumers and don’t want to regulate U.S. consumers.

VELSHI: Right. You have actually taken some step – your organization has taken some steps in terms of – I don’t want to call it regulating, but certifying maybe Canadian pharmacies to be able to supply Americans?

CATIZONE: We’ve signed an agreement with our Canadian counterparts to certify Internet pharmacies that are legal and safe. And under this agreement, no Canadian pharmacies that sell medications to U.S. citizens will earn that certification until those laws are changed and until those practices are legal.

VELSHI: So in other words, you are not actually making it easier for Americans to get cheaper drugs, you are doing the opposite, you’re stopping Americans from getting cheaper drugs in Canada.

CATIZONE: We’re making it easier for Americans to make an informed choice and decision about what pharmacies they should use.

VELSHI: Jamie?

COURT: Well, I just think that you’ve got to realize when you go to Canada what you are doing is you are taking money away from the pharmaceutical industry. And this is an industry that 75 percent of the cost of a drug is other than its manufacturing and distribution. So I don’t think there is any great loss in America in making pharmaceutical companies profits a little less by going to a country that gets drugs cheaper. The other people you are bypassing are the pharmacists. But the reality is while pharmacists are concerned that you are going to have – be mixing and matching medications, you know, Rite Aid, these large pharmaceutical prescription dispensers today really don’t take very good care to make sure that you are not mixing and matching your medications. And I think we can trust Canadian pharmacists. The process when you go to Canada is you fill out a waiver, you fill out your medical records. You have a request by a doctor and it’s filled by a pharmacist. It’s pretty safe. And what I think is really tragic and what the message has to be for the pharmaceutical industry is stop blocking a prescription drug benefit in Washington because next year we’re going to see 10 million Americans in a big act of civil disobedience going across the border.

VELSHI: The fact is, Carmen, with all the news that this has been getting, I bet you that number that we’ve been using, a million Americans getting their prescriptions filled north of the border, has increased in the last week alone because so many people now know that that’s an option. Let’s talk a little bit about the issue of drug interaction, about the fact that your argument is that people going to their own pharmacy here in the United States can be monitored for dangerous drug interaction, things like that. Is there some way to at least allow that to happen? Are you not confident that a Canadian pharmacist or doctor authorizing that prescription would do that?

CATIZONE: Well, it’s a question, again, of knowing, and none of these people are regulated in the United States. So even though the United States, at your typical pharmacy, they may receive products from a different manufacturer or a different lot number, those products have all been approved. They are all part of the regulatory system. That pharmacist that dispenses that medication is licensed and regulated by the state board. With a Canadian pharmacist we have no way of knowing whether to license or whether there are even pharmacists who are dispensing this medication.

VELSHI: Do you have relationships with the provincial boards in Canada, because every province has a board?

CATIZONE: They are members of our association. And they are as concerned about this issue as we are. And they are asking us how can we work together to make it safe. And one of the ways to work together is to change the laws that make this illegal at the federal level and to change the pricing of prescription medication.

VELSHI: So it kind of sounds to me like you guys both agree that Americans should be paying less for drugs. Carmen, this seems kind of difficult for you, because on one side you’re involved in having to do things that stop Americans from getting cheaper drugs, and on the other side you fundamentally believe that Americans should pay less for drugs?

CATIZONE: Well, it’s actually pretty easy for us. Because our main purpose is protect the public. And all we are interested in is making sure the public gets safe medications. The other issues that are surrounding this, the political, the economic, the pricing, are confusing the issue. But if the laws would say it was legal, if we can guarantee those medications are within the system, then I don’t think we have a problem with people buying medications from any licensed Canadian pharmacists.

VELSHI: Jamie, one problem that may exist that – I don’t know, if I were representing the drug companies, I may make a bigger stink about, and that is that the research that goes into these drugs. So many drugs that start off don’t make it to commercialization, they don’t make it to the drugstore shelves. There is a lot of money involved in this. And if they are making less money in
Canada, is that compromising the research that the big pharmaceuticals can undertake? Isn’t that a worry at all?

COURT: I think that is a real red herring. We just heard Pfizer‘s profits went up 40 percent, didn’t we, on your network? We just heard in “The New York Times” business section today, Johnson & Johnson‘s profits went up 20 percent this quarter. Pharmaceutical companies are turning great profits. They have got a lot of fat, a lot in administration. And Americans who need basic drugs can’t afford it. And in some cases it can cost them their health. And in very rare cases, but some cases, can cost them their life. And it’s outrageous that we really force people to break the law and go to Canada so that they can be healthy in America. And I do believe that the Canadian system of dispensing prescription drugs is as safe if not safer than in the United States. I’ve been up there, I can tell you it is. But with some New England states now getting together into a purchasing cooperative to try buy drugs on a group basis is a little cheaper. I think we are going to see more efforts like that across the nation. And the message of the pharmaceutical industry is if you try to stop using court, as the pharmaceutical companies have, we’re going to see a whole new market opening up in the north.

VELSHI: Last word to you, Carmen?

CATIZONE: Our concern again is we don’t think American citizens should be taking money away from their food bills or their rent in order to buy medications. What we’re concerned about is making sure the medications that the people take are safe and that people and pharmacies interact appropriately. And that’s our main concern.

VELSHI: Gentlemen, thank you for joining us. On the left, Carmen Catizone, the executive director of the National Association of the Boards of Pharmacy, and on the right, Jamie Court, the executive director of the Foundation for Taxpayer and Consumer Rights. Thank you, both.

Consumer Watchdog
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