Oh, Canada! Wherefore art thy drugs so cheap?

A toe-to-toe “people versus profits” slugging match is under way over the issue of importing prescription drugs from Canada. On the side of profit protection are the giant pharmaceutical companies and the Bush administration. Arrayed against them are outraged constituents by the thousands, now joined by state and local elected officials, demanding that Congress act to legalize the importation that is swelling like a river at flood stage.

The drug industry fears the potential collapse of a price structure that allows it to comply with government price controls in other countries while charging all the traffic will bear in the U.S.

In an October Washington Post/ABC News survey, 69 percent of those polled said importing drugs from Canada and European countries should be legal. Responding to this public outcry, a bipartisan House majority has passed HR 2427, a bill allowing importation from the industrial countries. The Congressional Budget Office says it would save consumers $40 billion over ten years.

The bill passed over the strong opposition of the Bush administration and the drug industry, which has spent a record $29 million on lobbying thus far in 2003. The Pharmaceutical Manufacturing and Research Association (PhRMA) alone invested $8.5 million in lobbying in the first six months of the year. Eli Lilly spent $2.9 million; Bristol-Myers Squibb, $2.6 million; Johnson & Johnson, $2.2 million; Hoffman-LaRoche, $2 million; and Pfizer, $1.8 million.

Rep. Gil Gutknecht (R-Minn.) described the drug industry campaign as “the most intensive full-court press,” adding that “members who had been here 20 years said they had not seen anything like it.” The lobbying has paid off richly in that neither the Senate nor the House Medicare prescription drug legislation contains language to curb pharmaceutical prices. In fact, the House bill expressly forbids Medicare from using its bulk purchasing clout to negotiate lower prices.

But the issue of Canada’s lower priced drugs keeps buzzing angrily, like a hornet trapped in a sedan. Ignoring the sour public relations side effects, five major drug companies have now cut back on sales of their products to Canadian pharmacies. Eli Lilly, GlaxoSmithKline, AstraZeneca, Wyeth and Pfizer are limiting their deliveries to an amount calculated to supply the Canadian market – and not one capsule more.

The Food and Drug Administration is piously mouthing the same anti-importation arguments as the industry it is supposed to regulate, contending that counterfeit, over-aged and tampered-with drugs are rife among the imports. The FDA is trying to shut down the largest chain of stores that helps Americans buy drugs from Canada.

But a thorough investigation ordered by Illinois Gov. Rod Blagojevich demonstrated that “Canadian procedures for safety are comparable and sometimes even better” than those in the U.S. “That’s a very powerful finding,” the governor said. The Blagojevich study showed that Illinois would save as much as $90.7 million a year if drugs for active and retired state employees were bought in Canada.

Along with Blagojevich, the governors of Minnesota, Iowa, and Wisconsin are researching the possibility of easing their budget crises by importing drugs. “The reason you have the beginnings of a prairie rebellion here is that there is a crisis and nobody has properly responded,” said Republican Gov. Tim Pawlenty of Minnesota, announcing a program to help state residents purchase drugs from approved Canadian pharmacists. New York City Mayor Michael Bloomberg is also probing the Canadian option.

Senator Edward Kennedy (D-Mass.) and other Massachusetts Congress members have also called on the FDA to reverse its anti-imports stand. “In light of the enormous impact of high drug prices on U.S. citizens, it is simply not sufficient to assert that pharmaceuticals may not be safe or effective without advancing a proposal that would resolve these concerns,” the Massachusetts delegation wrote to FDA Commissioner Mark McClellan.

In Springfield, Mass., Mayor Michael Albano has petitioned McClellan “to waive, change or cancel FDA’s interpretation of statutes and regulations” that bar importation. Blagojevich presented his 70-page report on Canadian drug safety to the FDA and other Bush administration officials on Oct. 27. “We have a lot of ammunition now,” he said. “And it’s hard to stop an idea whose time has come.” The FDA, said Blagojevich, “cannot ignore the people forever.”

The author can be reached at pscsc@qwest.net