WASHINGTON – The Bush administration and Republican congressional leaders are being forced to take a hard new look at the idea of importing cheaper prescription drugs from foreign countries as an election year clamor grows for removing prohibitions.

Continuing increases in prescription drug prices – the fastest-growing item in health care – and the pitched partisan battle over the new Medicare law have given the topic greater prominence in Congress and on the campaign trail.

AARP, the 35 million-member seniors’ group that gave Republican-backed Medicare legislation a critical endorsement last year, backs allowing imports.

So do two Republican senators, former GOP leader Trent Lott of Mississippi and John Cornyn of Texas, both changing their position in recent days.

And so do nearly two-thirds of Americans, according to a recent AP poll.

Drug importation has become a proxy for talking about the high cost of prescription drugs in the United States.

Spending on prescription drugs is the fastest-growing component of health care costs, rising 15.3 percent in 2002.

Drug costs are expected to outstrip the overall growth in health care spending for the next 10 years, and that projection doesn’t even take into account the new Medicare prescription drug benefit that begins in 2006. Many economists believe the change will lead to an additional increase in costs.

“We’re not talking about an academic situation. We’re talking about seniors who are going to bed tonight making the decision whether to pay for prescription drugs or to eat,” Sen. John McCain, R-Ariz., an author of an importation bill, said at a hearing this week.

While importing lower-cost drugs from abroad has supporters and opponents in both parties, Democrats have used the issue to highlight their political charge that the new Medicare law is too generous to drug companies and insurers at the expense of seniors.

Drug manufacturers strongly oppose imports, which generally carry prices about one-third lower than charged in the United States, according to a survey by the AP last fall.

The pharmaceutical industry made more than $20 million in political contributions in the past election, with roughly $8 of every $10 going to Republicans, according to an analysis by the Center for Responsive Politics.

Lawmakers who supported the Medicare law said they believe the new prescription drug benefit will ease seniors’ burden and act as a brake on price increases.

But there also is a sense among opponents of importation both on Capitol Hill and in the administration that they can no longer simply cite concerns about the safety of imports.

“It’s a very important issue and an issue that, as majority leader, I can tell you we will address. It deserves to be addressed,” Senate Majority Leader Bill Frist said Friday.

It is not clear that congressional Republicans will allow votes on the issue before the election. Sen. Byron Dorgan, D-N.D., said Friday that Frist left him with the impression that the Senate would vote on an importation measure before November.

Dorgan removed his objection to confirming Mark McClellan to lead the federal agency that runs Medicare and Medicaid, after talking with Frist. As commissioner of the Food and Drug Administration, McClellan has been the administration’s leading spokesman against drug imports.

McCain and Dorgan are behind a bill identical to one passed by House last year. It would allow importing FDA-approved drugs from FDA-approved facilities in Canada, the European Union and seven other nations.

The measure also would require imported medicine to be shipped in anti-tampering and anti-counterfeiting packaging. Other senators have similar bills.

Frist, a Tennessee Republican who was a heart-lung transplant surgeon before joining the Senate, has been adamantly opposed to loosening the ban on bringing prescription drugs into the United States from abroad.

His was one of the strongest voices against changing the law during closed-door negotiations last year on the new Medicare law.

Republican leaders in Congress and the Bush administration thought they had successfully put it aside, at least until after the election, by mandating in the new Medicare law a study of whether and how importation could be done safely. The report has a December deadline.

But after one contentious hearing in recent days, Health and Human Services Tommy Thompson acknowledged the issue “is not going away. It’s going to have to be dealt with, one way or another.”