EMH drug plan still a go Maine, Canada deal revamped

The day after U.S. Health and Human Services Secretary Donna E. Shalala aborted a new law that was supposed to allow broad re-importation of U.S. manufactured drugs from Canada, one Maine health care organization vowed to plow ahead with its own re-importation plan.

Eastern Maine Healthcare, parent of Eastern Maine Medical Center, said patients need relief from high drug prices and it would continue to develop programs to give Maine patients access to some prescription drugs at Canadian prices despite Shalala’s action.

Under a program already being developed, individual Mainers will still be able to save nearly half the costs of drugs like cholesterol-reducing Lipitor, for which a prescription costing $144 in the United States would cost $70 in Canada.

“It doesn’t change our plans,” said Miles U. Theeman, chief operating officer of Eastern Maine Healthcare’s for-profit subsidiary, Affiliated Healthcare Systems.

Shalala said Tuesday that the law, which received wide support in Congress and was signed into law by President Bill Clinton in October, was flawed. She said it could run into Federal Drug Administration labeling complications and didn’t prevent drug companies from mandating higher prices for re-imported drugs.

Clinton said Wednesday he plans to send Congress suggestions next week on how to fix the bill.

Rep. John Baldacci, D-Maine, said there are always loopholes companies work to exploit, but that’s an unacceptable reason to shoot down the broadly supported bill. There are enough regulatory agencies and enforcement arms to assert oversight to ensure compliance with the law, he said.

Sr. Mary Norberta, CEO of St. Joseph Hospital in Bangor, said she wasn’t surprised by Shalala’s action. Drug companies would have been able to skirt it, she said. Now, she said, there’s an opportunity to see if President-elect George W. Bush will make good on his promise to work on health care problems.

“We have to stop politicking and start dealing with real issues in this country and this is a real issue,” she said.

EMH’s Theeman, who’s overseeing the development of Affiliated’s re-importation plan, said Shalala’s decision would hurt those further away from the Canadian border.

“For the millions of Americans that can clearly benefit from this, it’s clearly disappointing,” Theeman said. But even without the law, individual drug importation will still be allowed and Mainers will be helped to find lower-priced drugs, he said.

In October, EMH announced it was developing a joint venture with a Canadian pharmacy that would fill prescriptions for Maine patients. The project is now already a month behind and won’t open for business until January, Theeman said. The snags have been more about creating a smooth system for patients, and there have been “no huge, open manholes,” Theeman said.

Much of the delay has been attributed to administrative delays as patient profile forms acceptable to New Brunswick officials are created and other systems are put into place.

But there have been some changes. Because of FDA concerns over importation rules, couriers will not be used to pick up bundles of prescriptions for delivery in Maine as had been envisioned, Theeman said. That action would be read as “bulk importation” which is not allowed, he said. Instead, each prescription will now have to be sent from Canada to individual patients in Maine.

Making sure refill procedures are in place under this system contributed to the delay, he said.

In order for EMH’s plan to work, doctors need to gain dual licenses in Maine and New Brunswick. That is progressing well with about 100 Maine doctors having received or filed applications for New Brunswick licenses, Theeman said.

The FDA and Canadian officials have had no substantive complaints over the proposed re-importation plan, Theeman said.

The program, which will focus on 300 to 400 drugs, will be a boon to those already forced to make tough choices, such as prescriptions versus food, Theeman said.

According to EMH, tamoxifen, used to fight cancer, costs $203 in the United States and would cost half as much from Canada. Premarin, a hormone used in estrogen replacement therapy, costing $39 in the United States, would cost just $11 from Canada.

Many seniors in Maine have taken bus trips to Canada to get the savings. In Vermont, a program operating since June continues to attract more people. It allows patients to use credit cards to purchase drugs that are then sent to Vermont from Canada.

In a recent letter to physicians, St. Joseph Hospital advised doctors that there are programs, such as that in Vermont, which give their patients mail-order access to Canadian-priced drugs. No other programs are being developed, a spokeswoman said Wednesday.

Baldacci said he’d like to find a more comprehensive solution to prescription drug problems.

“We shouldn’t be forced to do these things the way we’ve been doing them,” he said.

But meanwhile, he hopes for another bipartisan effort in Congress to get some sort of national prescription drug relief next year.