Mark McClellan, the FDA chief who warned of dire consequences from importing lower-cost drugs from Canada, appears to have undergone a conversion. That is encouraging for the millions of Americans, especially senior citizens, who would benefit from cheaper prescription drugs. However, senators who are now poised to consider Dr. McClellan’s nomination to run Medicare and Medicaid must ensure that his change in attitude is genuine.

During intense questioning during his confirmation hearing before the Senate Finance Committee Monday, Dr. McClellan sought to assure lawmakers that he would work with them to ensure the safety of imported drugs. “I am absolutely committed to giving the Food and Drug Administration more money, more personnel and more power to police imports,” he told senators.

While far from an endorsement of the policy of importing drugs from Canada and other countries, Dr. McClellan’s remarks before the Senate panel are quite different from what he has been saying as the FDA chief. In that capacity, the doctor and economist led the Bush administration’s efforts to stop unauthorized drug imports. Dr. McClellan warned that such drugs endanger Americans because they could be outdated, contaminated, counterfeit or contain too much or too little of the active ingredient. “Foreign dispensers of drugs to Americans may provide patients with incorrect medications, or improper directions for use – things that can turn even a useful drug into a potentially harmful one,” he said recently.

Never mind that there have been no reports of widespread drug illnesses in Canada and other countries where the cheaper drugs come from.

Sen. Olympia Snowe has long pressed the government to find a way to safely import cheaper drugs. “We need a can-do approach,” she told Dr. McClellan, who also heads a Bush administration panel reviewing drug importation. “What is it going to take to move this forward?” she asked. The doctor’s response was, restricting the scope and type of drugs that can be imported. Not an endorsement of the practice, but, likely, a recognition of the political reality that importation will continue to grow as cities and states turn to such a scheme to hold down medical costs. More than 1 million Americans now illegally buy prescription drugs from Canada where government price controls keep costs lower.

Dr. McClellan will likely be overseeing the largest expansion of Medicare in decades. Lower prescription drug costs must be part of the equation.