July 14, 2000 -- As more Americans trek to Canada or Mexico to buy critical prescription drugs they cannot afford here, some U.S. doctors have a devised a system they say will help. The United Health Alliance (UHA), a physicians' group in Bennington, Vt., that negotiates contracts with health maintenance organizations (HMOs) and other health organizations, has hit upon a system that allows patients to get inexpensive prescription drugs from Canada without crossing the border. Here's how it works:
Doctors fax an order form developed by the UHA to a Canadian pharmacy listing the doctor's license number and Drug Enforcement Agency (DEA) number and the desired drugs and quantities along with the patient's credit card number. The drugs and shipping charges are billed to the patient's personal credit card, then mailed to the doctor's U.S. office (which may be why the Canadian pharmacy will accept U.S. license and DEA information in this case), where the patient picks the package up unopened. This way, the paper trail shows that the patient bought the drugs for individual use, as allowed by the FDA.
The next time your doctor writes you a prescription, consider this: The medication may not be approved for your specific condition or age group.
But you probably shouldn't call the medical board. The practice, called "off-label" prescribing, is entirely legal and very common. More than one in five outpatient prescriptions written in the U.S. are for off-label therapies.
"Off-label" means the medication is being used in a manner not specified in the FDA's approved packaging label, or insert. Every...
Since the UHA system was developed in mid-June, many doctors have said they would offer the service to their patients. Elizabeth Wennar, director of UHA, has received calls about the system from as far away as California and has been asked to explain the system to doctors and seniors groups around New England. For more information, contact the UHA at (802) 447-3170or see the group's web site at www.unitedhealthalliance.com.
Meredith Art, a spokeswoman for the Pharmaceutical Research and Manufacturers of America (PhRMA), the industry's trade organization, was unaware of the UHA system. "That sounds highly illegal," she said when told about it. "We'll look into it."
Vermont's Governor Howard Dean, a physician himself, has thrown his support behind the plan, which he calls "a stroke of genius." He directed the state's attorney general to research the re-importation method to ensure that it's legal. If it passes legal muster, he says, he'd like to see it used widely. "This is totally justified," he told The Bennington Banner newspaper. "There is no reason why Americans should be paying more for prescription drugs that are produced in their own country."
Curtis Ingham Koren writes for national magazines about health, education, business, and travel from her home in Vermont.