How Far Would You Go for Cheaper Drugs?
Thousands of Americans are crossing the border to get the best deal on their prescriptions. Our reporter tags along.
Taking Half-Doses to Save Money
Cliff Bates, a 60-year-old retired paper mill worker, pays about $300 per
month for five medications he needs to treat knee problems, high cholesterol,
and high blood pressure, and hopes to save quite a bit. He says he's tried to
save money by splitting his pills and taking half a dose, but that "doesn't
work so good -- I got dizzy."
Technically, the Food and Drug Administration (FDA) prohibits the
importation of prescription drugs from other countries. But the Canadian trips
take advantage of an FDA loophole that allows individuals to import a limited
supply of approved drugs for personal use. Still, the agency has broad
enforcement discretion, and as the bus approaches the border, there are jokes
about what reasons to give for going to Canada. The "drug czars" opt
for the truth and explain the mission to sympathetic border guards. The guards
wave them through, noting that plenty of people are doing the same thing on
While the FDA is not currently trying to prevent drug-buying in Canada, that
could change. In an effort to head off an FDA crackdown and to draw attention
to the huge price differences, the House of Representatives on July 10
overwhelmingly approved a bill barring the agency from enforcing the general
ban on drug reimportation.
'My Job Is to Take Care of Patients'
It's noon when the group arrives in Montreal. They troop up a winding
stairway to the packed waiting room of a health clinic where the Americans fill
out forms, see a doctor (for a $24 fee), and present their American
prescriptions. Nii T. Quou, MD, the clinic's medical director, says he's been
warned about possible legal liability from seeing American patients, but he
welcomes them all nonetheless. "I'm a physician," he says simply,
"and my job is to take care of patients."
The Vermont organizers hand out the sandwiches and sodas, then begin
ferrying batches of people to a family-run pharmacy nearby. The pharmacist and
his family welcome the group with pastries in a homey back room where the
travelers rest and wait for their precious supplies.
Drug Companies Offer a Caution
Drugmakers have been angered and embarrassed by the publicity the bus trips
have drawn. They warn consumers against crossing the border for medications,
saying they can never be sure what they're getting, even when drug labels are
the same as in the United States. The companies also say higher U.S. prices are
justified because of the high cost of research that has produced so many wonder
drugs. They've been fighting back with television ads and a web site to make
the case that the U.S. health care system is preferable to Canada's.
The industry has also worked hard to fend off attempts by Congress and some
states to impose price controls on prescription drugs. Indeed, the United
States is the only industrialized country without some form of controls on drug
prices. In Canada, provincial authorities negotiate bulk discounts with
pharmaceutical companies and establish allowable prices for most prescriptions.
The Mexican government also sets price ceilings for medicines.