By Tom Easter
March 1, 2004

Conference Past President Boston Mayor Thomas M. Menino convened a meeting of Mayors from New England cities February 20 to discuss the implications of importing prescription drugs from Canada. The mayors also discussed strategies for urging federal officials to work with them to insure the safety and quality of the imported prescription drugs.

Two to three million people are currently importing drugs from Canada and other countries throughout the world where the cost of prescription drugs are as low as 49 percent of what we here in the U.S. spend for the same drugs. The mayors want to take advantage of those cost savings.

In a letter signed by all, the mayors at the Boston meeting requested that Health and Human Services Secretary Tommy Thompson "use the authority granted to him by the Medicare Prescription Drug Improvement and Modernization Act of 2003 to ensure the safety of those drugs imported from Canada." The mayors want the Secretary to enact any regulations necessary to certify the safety of importation under controlled and limited circumstances.

Of the cities being represented, Springfield (MA) is currently getting drugs from Canada. Burlington (VT) will begin its program March 1; Boston and Worcester (MA) will both begin pilot programs July 1. Despite FDA objections, Menino said Friday he intends to move forward with the plan on July 1. He said he expects the city to save about $1.5 million per year.

The types of drugs that are included in these programs are name brand drugs that people must take on a long-term basis and have been taking for a minimum of 90 days. Generic drugs must be considered as a first option. The majority of persons that would be affected by these programs are retirees and others afflicted with long-term health concerns such as high blood pressure and heart disease.

Of the four cities prepared to implement programs this year, each expects substantial savings. Springfield has saved roughly $1 million to date with projected annual savings of approximately $4 million annually. Boston expects to save a minimum $1 million the first year and approximately $1.5 million per year thereafter. Burlington expects to save approximately $146 thousand annually which would be about a 30 percent savings of its overall drug costs. Worcester estimated savings at $1 million of the current $16 million annually being spent on these drugs.

Concerns raised by the mayors were drug safety and quality, Canadian drug availability, and the legal issues associated with importing drugs from Canada. Quality and safety issue is but a "red herring," stated Burlington Mayor Peter Clavelle. "The real safety issue is people not taking the drugs that they need because of prohibitive costs," he continued.

Quality in Canada is believed to be at or above that of the U.S. in most cases and they are each dealing with verified organizations according to the mayors. An information portal between the U.S. and Canadian pharmacy databases is also currently being developed to minimize the danger of drug interactions.

There are concerns that the supply of these drugs in Canada may not be large enough if a large number of people from the U.S. start ordering Canadian drugs. It is believed that there is some possibility of this, however, drug allocation is presently distributed to North America as opposed to a specific country.

Perceived legal concerns were addressed by both the mayors currently implementing programs and those planning to implement programs.

Boston on the other hand is contracting directly with the supplier and is setting up a contract with them to limit liability if there are any quality issues. All of the cities as well as other groups from Illinois and Wisconsin among others, are posting information on web sites to inform individuals of the benefits of importing drugs from Canada as well as how to get in touch with suppliers for this purpose.

The mayors indicated that local reactions have been mostly positive. The mayors continue to reach out to Food and Drug Administration officials and Secretary Tommy Thompson to address the issue of reducing drug costs for the people of the U.S. In their joint letter to Thompson, the mayors stated "We need to structure a safer way to import these lifesaving medications. Certification, with the introduction of new standards, will reduce the harm that Americans are currently exposed to when they purchase drugs over the Internet and through other sources."

"This is not the ultimate answer, but it is a band-aid, and a band-aid that we need to apply today," Clavelle said. The mayors are looking to the Federal government for a more permanent solution.

Those in attendance were Boston Mayor Thomas M. Menino, Worcester Mayor Timothy Murray, Manchester Mayor Robert A. Baines, Revere Mayor Thomas Ambrosino, Methuen Mayor Sharon Pollard, Providence (RI) Mayor David Cicilline, Fall River Mayor Edward Lambert Jr., Brockton Mayor John T. Yunits Jr., Burlington (VT) Mayor Peter Clavelle, Marlborough Mayor Dennis C. Hunt, Haverhill Mayor James J. Fiorentini, Chris Collins representing Springfield (MA), Brian C. Williams representing Bridgeport (CT) Mayor John M. Fabrizi.

On a related note, Thompson announced February 26 the creation of a task force on drug importation. According to an HHS press release, the task is expected to advise and assist HHS in determining how drug importation might be conducted safely and its potential impact, positive and negative, on the health of American patients, medical costs, and the development of new medicines.