Why Doesn't America Allow Drug Importation?

Fred Upton sold out his Michigan constituents to the drug companies long ago

I spent the holiday season on a ship cruising around the Galapagos, going from island to island. One day the highlight was seeing a sea lion give birth to her first pup and the next was watching an aquatic iguana rape a female iguana. Another day we saw parent frigates take turns caring for their chick while the other one hunted. The Ecuadorean naturalists helped us put the experiences into context. There wasn't reliable internet access on the ship but I did manage to come across the new Pew Poll about how fewer and fewer Republicans now believe in evolution-- which is a theory in the same way that gravity is a "theory." Republicans like certainty, not theories. It would be awesome if they all jumped off cliffs and high buildings to check on the theory of gravitivity. It's less awesome when the people they elect to Congress want to hold back progress-- the opposite of conservatism-- because something is only a theory.

In 2009, 67% of independent voters, 64% of Democratic voters and even 54% of Republican voters reported they believed in evolution. That was just 5 years ago. Today, as more Fox News and Hate Talk Radio brainwashing has destroyed the capacity of more Republicans to deal rationally with reality, the numbers have changed. Among normal people, most still believe in evolution. Among Democrats, the number went from 64% up to 67%. Among independents, it went down slightly from 67 to 65% but among Republican voters-- those most likely to have had their brains warped by Fox and deranged sociopaths like Beck, Savage and Limbaugh-- the number sunk from 54% all the way down to an astounding 43%. What's wrong with these people who do, after all, live among us?

David Graham, at The Atlantic, says it's not surprising Republicans don't believe in reality. "Republicans," he reminds us, "are also less likely to believe that the earth's climate is warming, or, if they accept that it is, to believe that the change is caused by human activity." But why?

One possibility is that respondents who identified as Republican and believed in evolution in 2009 are no longer identifying as Republicans. Fewer scientists, for example, are reportedly identifying with the GOP, and the overall trend is for fewer Americans to call themselves Republicans. But both Gallup and separate polling from Pew found approximately the same party ID in 2009 and 2013.

...Maybe the gap represents an emotional response by Republicans to being out of power. Among others, Chris Mooney has argued that beliefs on politically contentious topics are often more rooted in opposition to perceived attacks than anything else-- an instance of "motivated reasoning." Given that Democrats have controlled the White House and Senate since 2009, this could be backlash to the political climate, though it will be hard to tell until Republicans control Washington again.

So pigheadedness? OK, maybe. The problem is when their backwardness and obstinacy starts impacting normal people through social policy. On New Year's Eve, PBS re-ran a piece about how Maine's Democratic-led legislature is getting around GOP anti-science freaks by allowing cash-strapped seniors to import prescription drugs from Canada, where massive price-gouging is not allowed, unlike in the U.S., where bribed conservatives have made sure massive price gouging on drugs is built into official government policies. Maine is being sued by the avaricious conservative-backed drug companies.

RICK KARR: The battle between the state of Maine and the pharmaceutical industry started in Portland when the city found a way to cut its health care costs. By the time the battle ends, the whole country might feel the effects. If Maine wins, it could get a lot easier for Americans to import cheaper prescription drugs. If the pharmaceutical companies and their allies win, importing drugs could be harder than ever. One side in the battle is made up of employers-- and their employees. They say they’re fighting for the right to spend less on health care... How much money does this save the company every year?

SCOTT WELLMAN:   About $400,000. That's our savings per year.

RICK KARR:  The other side includes Maine’s pharmacists and retailers and the pharmaceutical industry. They say they’re fighting to protect the safety of consumers who might be tempted to try imported prescription drugs.

AMELIA ARNOLD:  The problem is, is that these medicines aren't safe.

RICK KARR:  The battle started in 2004, when Portland offered its 1,400 employees the option of a new prescription drug plan. Instead of going to local pharmacies to get their prescriptions filled-- and paying a share of the cost-- they could get the drugs by mail from licensed pharmacies in Australia, New Zealand, Canada, and the U.K.-- without paying a penny. City employee Jeff Tardif signed his 7-year-old son up for the plan this year to get asthma meds.

JEFF TARDIF:   My big thing is I'm saving money. So, you know, it's 100 bucks that I'm saving monthly-- through this program.

RICK KARR:   Karen Percival gets drugs that treat chronic pain and ADHD. Every three months, a fresh supply from a pharmacy halfway around the world lands on her doorstep.

KAREN PERCIVAL:  It shows up in a box like that.  It's odd that it comes all the way from Australia, and it still costs less money.

RICK KARR:   The program’s managed by a Canadian company called CanaRx. It tracks the prices of prescription drugs in four countries. Whichever country has the lowest price on a drug supplies it-- from licensed, brick-and-mortar pharmacies.

Take the example of a three-month supply of the asthma drug Advair: Under the city’s regular health plan, at Portland pharmacies it costs a little under $600. The CanaRx plan imports it for a little over a $150-- shipping included. With discounts like that, the city of Portland saves $200,000 a year on health care-- and there’s no copay for employees. Two years after the city launched its program, the largest employer in one of Maine’s poorest counties followed suit. Hardwood Products makes food sticks-- the wooden handles that go into popsicles, ice cream bars, corn dogs, and so on. Chief financial officer Scott Wellman says the family-owned company can do a lot with the $400,000 a year it saves on the plan.

SCOTT WELLMAN: That money can be used for employee raises. That money can be used to offset the cost of their health care. It also can be used to invest in equipment so we can produce new products.

RICK KARR:   Early last year, the state of Maine’s employee health care program decided to offer the CanaRx option. Overnight, the number of people eligible for the plan in Maine went from about $3,200 to more than $33,000. And that’s when Maine’s pharmacists decided they had to do something to stop it.

AMELIA ARNOLD:  When we found out that the Maine State Employees Union was going to be contracting with this organization, CanaRx, we realized that it was against both state and federal law at that time.

RICK KARR:   Maine pharmacist Amelia Arnold and other opponents of mail-order drugs say the imports violate the Federal Food, Drug, and Cosmetic Act and that they ran afoul of state law because Maine’s pharmacy board hadn’t licensed the foreign pharmacies to practice in the state. Arnold admits that Maine residents have been crossing the border into Canada for years to get cheaper drugs from retail pharmacies-- like these seniors did in the early 2000s, before the federal government expanded Medicare benefits. But she says mail-order pharmacies in Canada may operate with no oversight and low standards.

AMELIA ARNOLD:  Who's going to police that?  Who's going to find out that the pharmacy's legitimate? Those companies can participate in what we call parallel importation.  So they can get their drugs from other countries. So just because it's coming into the U.S. from Canada doesn't mean that it started in Canada.

RICK KARR: Arnold says the medicines might be old, ineffective-- or even counterfeit. [In September of last year,] Maine’s then-attorney general agreed with the pharmacists that importing drugs violated state law. So CanaRx suspended all three of its programs in Maine.

SCOTT WELLMAN:  We were very angry-- would probably be the best way of putting it.

RICK KARR: Scott Wellman says the ruling inflicted a lot of pain on the employees of Hardwood Products.

SCOTT WELLMAN: They had to make the decisions on, "Okay, do I turn the heat down in the winter?  What do I do?" Because they stopped taking one-- while the program was suspended.

RICK KARR:   Wellman decided it was time to push back, so he reached out to a local firewood dealer.

DOUG THOMAS: You don't get to take advantage of people. "I have this drug, this pill, and it will save your life.  What will you give me for it?" Is that the way we do business in the United States? And, of course, you're going to pay whatever you have to to save your life. And that's not right. It's real close, I think, to holding a gun to people's head.  And it's wrong.

RICK KARR:   Doug Thomas sells firewood and serves as a Republican state senator. He calls himself a conservative, says he hates unions and believes in free enterprise and competition. He also thinks the pharmaceutical industry needs more regulation.

DOUG THOMAS: The drug companies have done a very good job at telling people that they need all this money for research and development, and if we don't give them everything they want, then we're not going to have these new drugs. And that's, I just-- I absolutely don't believe it.  The Canadian system works. The Australian system works.  The drug delivery system in New Zealand works. And it can work better here.

RICK KARR:  Thomas introduced a bill that legalized pharmaceutical imports. So did one of his Democratic colleagues. They rolled their bills into one and joined forces... and both sides of the issue sent their lobbyists to work.

SCOTT WELLMAN: I believe there were four of us that were lobbying on behalf of the bill; there were at least 12 lobbyists from-- representing pharmacies and big pharma.

RICK KARR: The pharmacists and drug companies argued the bill would endanger the people of Maine. But in June, the bill passed both houses with bipartisan majorities. Maine became the first state in the nation to legalize mail-order drug imports. In September-- a month before imports could resume-- the pharmaceutical industry and its allies filed a federal lawsuit to strike down the law.

JOHN A. MURPHY III: There's several things wrong with the Maine law. Not least of which is the fact that it violates the federal Food and Drug Administration's laws prohibiting the importation of prescription medications outside of the F.D.A.'s regulatory construct.

RICK KARR:  John Murphy is a staff lawyer at PhRMA, the drug makers’ trade group and one of the plaintiffs in the suit. He says federal law gives the Food and Drug Administration the authority to regulate drug imports, and that authority’s illegally undercut by the Maine law.

JOHN A. MURPHY III: Effectively, it permits patients to go onto the Internet, which is completely unregulated, and bring prescription drugs into the United States outside of even the F.D.A.'s-- large-- federal preview. It's-- very concerning.

RICK KARR:  Like Maine pharmacist Amelia Arnold, who’s one of the lead plaintiffs in the suit, Murphy says stopping mail-order imports is all about safety. They say most drugs have cheaper generic equivalents, so there’s no need to take a chance on foreign pharmaceuticals. Murphy says that in 2003, the F.D.A. warned CanaRx that it was “put[ting] the health of the American public at risk” after the company mailed an order of insulin-- a perishable drug that has to be refrigerated. CanaRx says as soon as that happened, it stopped offering perishable drugs and that it has safeguards in place to protect its customers.

RICK KARR: What a lot of the people in Maine have been saying to me, they're saying, "These are the same drugs that are available in the U.S. These are drugs that they're getting that are made by members of your organization."

JOHN A. MURPHY III: And they're able to test those drugs when they come home and verify that they are? Or that they just have a label on them that indicates that they are the same drugs? I mean, that's the interesting question, right? I mean, no one who's personally importing a drug into the United States and bringing it to their home has really any idea what's in that drug. And in fact, we've seen even in the past that drugs that came in through Canada, certain cancer drugs, were sold to physicians. And physicians weren't able to verify the authenticity of those products.

RICK KARR: The response that we get from PhRMA and the pharmacist association is you never know for sure how reliable these pharmacies are. And it's too late if somebody gets sick on account of this. Does this concern you at all?

SCOTT WELLMAN: With our experience, it doesn't. The pharmacies that were having to fill these prescriptions are licensed retail pharmacies. If you're getting, for example, Crestor, you get Crestor in the Astrazeneca package labeled with all their information, with a pharmacy label on it, with the seal on the outside of the package, lot number, date code, everything is on the package. You can trace the pedigree just like you can in the U.S.

RICK KARR: Wellman says he knows what he’s talking about  because he’s also CFO of Hardwood Products’ sibling company, Puritan Products, right across the street. It makes medical supplies.

SCOTT WELLMAN: We have lots and date codes. We have expirations. We make F.D.A.-registered devices here. We have F.D.A. audits that come in here. We understand-- how that process works.

RICK KARR:  Wellman says he hopes the state of Maine prevails in court so more of his neighbors can take advantage of the lower prices on foreign drugs. If Maine does win, other states are likely to follow its lead by allowing mail-order imports. The date of opening arguments in the case, when the battle moves to the courtroom, hasn’t been set.

It's convenient for many Members of Congress to "believe" the spurious arguments against importation. Ironically almost all are conservatives and all are on the take from the drug manufacturers. Since 1990, pharmaceutical manufacturing companies in the U.S. have spent $84,901,125 bribing Members of Congress (not counting many more millions on lobbying; this is just what they gave towards campaigns, legalistic bribes). In the last cycle alone, the 10 most corrupted Members of Congress by the drug industry were:

• Fred Upton (R-MI)- $176,365
• Eric Cantor (R-VA)- $159,250
• John Boehner (R-OH)- $131,000
• Leonard Lance (R-NJ)- $126,000
• Joe Pitts (R-PA)- $114,000
• Dave Camp (R-MI)- $108,500
• Steny Hoyer (D-MD)- $108,500
• Anna Eshoo (D-CA)- $102,850
• Allyson Schwartz (New Dem-PA)- $99,000
• Kevin McCarthy (R-CA)- $97,500

All ten have a reputation in Washington for being shills for companies that pay them off. And all are either committee or subcommittee chairs or ranking members or caucus leaders in positions to make sure the big drugs companies' agendas prevail. In the current election cycle, which is just beginning, Big Pharma is already lining up votes by bribing many of the usual suspects. So far this cycle the 5 most corrupt were also on the list from the 2012 cycle:

• Fred Upton- $63,400
• Kevin McCarthy- $58,700
• Eric Cantor- $53,000
• Steny Hoyer- $50,250
• John Boehner- $50,100

These are five of the most corrupt men who have ever been elected to Congress. All of them are in positions to not just sell their own votes but to swing large numbers of other Members away from helping their own constituents towards assisting the industry that is paying off these notorious K Street whores. I might add that the only one of these corrupt congressmen who is electorally vulnerable this cycle is Fred Upton, who is being challenged by an anti-corruption progressive, Paul Clements, in Kalamazoo, Michigan. If you want to see drug importation legalized in the U.S., there is something you can do-- help replace Upton with pro-science/anti-corruption Clements in 11 months. And here's where you can do it.