July 14, 2000 -- It's 7:45 on a steamy Friday morning in June, and the
commuter parking lot on the outskirts of Montpelier, Vermont's capital city, is
filling up with people in need of drugs.
Ramona and Peter Christensen, dairy farmers from East Montpelier, approach
the crowd around the two 15-passenger buses that will take them on the
two-and-a-half-hour ride across the border to Montreal. "I'm a little
nervous with all this money on me," says Ramona, 45, as she flashes a fat
wad of cash. "Are the drug czars here yet?"
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
"Off-label" means the medication is being used in a manner not specified in
the FDA's approved packaging label, or insert...
The Christensens aren't here to score marijuana or cocaine; they're after
drugs for Ramona's high blood pressure, diabetes, and heart disease. And
they're not alone. Drawn by prices that can be a fraction of the cost in this
country, more and more Americans are crossing the border into Canada or Mexico
to buy prescription drugs they cannot afford to buy at home. Indeed, the high
cost of medicine in the United States is emerging as a leading political issue
of the new decade: Congressional and presidential candidates alike are
promising to somehow make pharmaceutical drugs affordable here, in one of the
wealthiest nations of the world.
A Huge Difference in Price
Because other nations have price controls on drugs, savings across the
border can be dramatic: A one-year supply of tamoxifen, a cancer suppressant
widely prescribed for survivors of breast cancer, costs about $1,400 in the
United States but just $125 in Canada. Ramona Christensen's 30-day supply of
Lipitor, a drug used to lower cholesterol, costs $144 here and $85 in
While debate rages in Congress on how to lower U.S. drug costs, seniors and
other people in need of affordable medications are moving ahead with their own
At the parking lot in Montpelier, the "drug czars" -- three
organizers from the Central Vermont Council on Aging (CVCOA) -- pull up in a
minivan and begin transferring coolers full of sandwiches and sodas into the
waiting buses. The three began making drug runs to Canada in April after
Vermont's U.S. Congressman, Bernie Sanders, led several well-publicized trips
there to help people buy affordable prescription medications. Similar trips
have been organized from several other border states, inspired by the huge
price differences. Overall, seniors in Vermont pay an average 81% more than
Canadians for the 10 most widely used prescription drugs, according to a new
Congressional Research Service study.