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.
In Nora Ephron's best-selling book, I Feel Bad About My Neck, she laments the sorry state of her 60-something neck: "Our faces are lies and our necks are the truth. You have to cut open a redwood tree to see how old it is, but you wouldn't have to if it had a neck," she writes.
"Every so often I read a book about age, and whoever's writing it says it's great to be old. It's great to be wise and sage and mellow; it's great to be at the point where you understand just what matters in life. I can't...
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 says.
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.