Michael Albano had big budget problems. As mayor of Springfield, Mass., the
fourth largest city in New England, Albano faced massive cuts in state aid,
forcing him in February 2003 to announce layoffs of more than 300 city workers,
including police officers and firefighters.
As father of a 13-year-old boy with type 1 diabetes, Mike Albano also had a
personal financial crisis, caused by the skyrocketing cost of his son's daily
insulin, needles, and blood sugar testing supplies.
Patients often have trouble talking to their doctors. It can be hard to get the words out when the topic is emotionally charged or one you’d never bring up in polite conversation.
And for various reasons, sometimes including their own embarrassment, doctors may find it hard to bring up certain topics -- and that can compromise the care their patients receive.
“Communication is an inexact science,” says Bob Arnold, MD, professor of medicine at the University of Pittsburgh School of Medicine and...
As a partial solution to both problems, Albano did what no other U.S. city
leader until then had dared to do: he went to Canada.
In July of 2003, Albano launched an innovative, voluntary program that
allows city employees and retirees to purchase maintenance medications -- such
as drugs to treat high cholesterol, high blood pressure, and diabetes -- from
Canadian suppliers. Because the Canadian government -- like the governments of
nearly all industrialized nations except the U.S. -- mandates price controls on
medications and limits the prices that Canadian pharmacies can charge, drugs
sold in Canada often cost substantially less than the identical medicine sold
in the U.S.
He's not alone. By September 2004, one-third of American adults who use
prescription drugs said they already buy or intend to buy drugs from online
Canadian pharmacies, according to a survey by the Results for America (RFA), a
project of the nonprofit and nonpartisan Civil Society Institute.
The reason is simple economics. According to the Congressional Budget
Office, brand-name drugs on average cost from 35% to 55% less in other
industrialized nations than they do in the U.S. The CBO also estimates that if
Americans in 2001 could have bought brand-name drugs at Canadian pharmacies,
they would have saved more than $38 billion (under the new Medicare
prescription-drug benefit, the government is expressly forbidden from
negotiating lower drug prices on the behalf of beneficiaries).
As for Springfield, Mass., the city saved more than $3 million in the
start-up year, and is on track to save $6 million this fiscal year, Albano
In an interview with CBS's 60 Minutes earlier this year, former FDA
commissioner Mark McClellan said that "under current law we don't have the
authority to ensure the safety of foreign-produced, foreign-distributed
drugs." He warned that the practice of "drug reimportation," as
it's called, violates federal law and puts patients at risk because they can't
be sure about the source of the drugs they receive.
But advocates for cross-border drug buying point out that most medications
purchased from reputable Canadian or European pharmacies are the identical
medications -- brand names as well as generics -- that are available at your
local drugstore. In addition, those medicines, including some of the
blockbuster drugs advertised on the network evening news programs, may be made
not just in North America but also in Europe, South America, the Middle East,