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.
'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.
Drug prices in America vary greatly depending on who pays the bills.
Insurers and employers pay most prescription costs, but this is changing as
managed care plans impose caps on prescription reimbursements. Some companies
are putting expensive drugs off- limits or reducing drug benefits, requiring
workers to make larger copayments. And people who rely on Medicare, which
serves senior citizens, are on their own, since Medicare does not currently pay
for any outpatient medications.