Canadian Imports

Reimportation of lower-priced prescription drugs from Canada is a Rube Goldberg process for what should be a straightforward transaction. But because Congress cannot overcome its fear of negotiating drug prices – even as it seeks low bidders for much else that it does – reimportation is one of the few options left to states. Gov. John Baldacci was right this week to announce that Maine would be applying for permission to begin this practice and was smart to join with the Penobscot Nation, making this an economic-development project as well.

Gov. Baldacci has asked Health and Human Services Secretary Tommy Thompson for a federal waiver to reimport wholesale prescription drugs, which would be distributed by the Penobscots from a high-tech warehouse with an operation that could employ 100 people. The prescription drugs would be available first to the uninsured and underinsured and later to the general population. A lot of the details of the plan are still being worked out, but Maine would be the sixth state to reimport drugs, and though Maine’s would be the broadest distribution of drugs yet, similar models are not far away.

No one paying attention to difficult issues of safety, drug availability, pharmaceutical costs and a range of other issues thinks this is a simple process. It will require Maine and the Penobscot Nation to spend a significant amount of time to get this right; so that drug efficacy is assured, all those who need to get paid are and a discount, promised at 25 to 50 percent, remains for consumers.

A federal program of drug negotiation for seniors using Medicare and for the uninsured would simplify the process for everyone, but Congress has shown only minimum interest. It does not, however, seem to object to states piggybacking off the negotiations the Canadians have established with drug companies. Coincidentally, on the same day Gov. Baldacci was announcing the request for the waiver, California Gov. Arnold Schwarzenegger vetoed a similar bill for his state, but said his office would negotiate directly with pharmaceutical companies to obtain discounts for the 4 million low-income Californians without drug coverage. It’s amazing what can be done when the numbers are on your side.

Eventually, when enough states have enough of their own rules, or joint rules within regions, creating more work for everyone, the numbers for Congress and perhaps the pharmaceutical companies will point toward negotiation. Meanwhile, the governor should be supported for trying to bring lower costs to Maine and the Penobscots applauded for pursuing this means of economic development.