Each year, thousands of Americans are getting their prescription drugs filled illegally over the Internet from pharmacies in Canada. Now, more than two-dozen states are considering joining them.
Many of the drugs that come over the border are actually made in the United States and shipped to Canada. But with Canadian price controls, even shipping the drugs back to the United States is cheaper for Americans than ordering them at home.
But even cheaper, officials dispute whether they are safer.
"When you import drugs over the Internet, you just don't know where those drugs are coming from. It becomes a real buyer-beware situation," said Peter Pitts, associate commissioner of the Food and Drug Association (search).
"There's just no evidence of danger as applied to reputable Canadian pharmacies," said Minnesota Republican Gov. Tim Pawlenty (search), who is encouraging residents of his state to go the Canadian route. "They have all these scare tactics about other kinds of pharmacies, even the ones in the United States that are on the Internet."
Industry expert Sally Pipes, president and CEO of Pacific Research Institute (search), said not all drug shipments meet U.S. requirements. Even if Canada is safe, other nations that export drugs may not be.
"Eighty-eight percent of packages examined in September coming through border points were counterfeit, not up to standard or mislabeled," Pipes said, referring to an FDA investigation of re-imported drugs.
Pipes also said that even if U.S. consumers wanted to buy their drugs from Canada, they may not be able to find them.
"The problem we have is the Canadian pharmaceutical market is about $8 billion. If California and Illinois imported all the drugs they would need that would take the whole Canadian market. So cities and 25 states talking about importing drugs from Canada — if this is going to happen, drugs will be coming from countries around that are not safe," she said.
Even so, Minnesota has put up a Web site with instructions on how to order prescription drugs from Canada, including a link that helps people place their orders with Canadian pharmacies. The FDA has told the governor that the site is ill-advised.
"When the governor of Minnesota sent a team to Canada to visit with Internet pharmacies, he found dozens of very dangerous pharmacy practices. One of the pharmacy presidents told the team not to worry where the drugs come from, the pharmacy has creative ways to get drugs," Pitts said.
"We think what [Pawlenty] has done, putting up this Web site is unsafe, unsound and ill considered," he added.
Pitts said the FDA could take legal action against the state, but would prefer to work in a "collegial" manner to resolve the dispute. But Pawlenty said he is doing nothing illegal, and the state has no plans to shut down the site.
"The federal law says anyone who's engaged in causing the sale or transaction or purchase of prescription medicines, may be in violation of the law, we're not causing the transaction, we're just offering out citizens information so they can make better choices," Pawlenty said.
"We've checked out a couple of pharmacies, we think they're safe and credible and reputable, and we're providing them with information. I don't think that's something the federal government should get their undies in a bunch about," he added.
Last year, six state legislatures — Maine, Vermont, Rhode Island, Illinois, Massachusetts and Florida, considered laws to re-import drugs from Canada. Governors in seven other states — New Hampshire, Michigan, Wisconsin, Minnesota, Iowa and West Virginia, have made similar proposals. So far, none has passed but a few are getting close.
In the meantime, Congress is now getting into the fight. Some members of the Senate Commerce Committee think the FDA is going overboard trying to stop Americans from getting drugs from Canada.
They are threatening to stall the nomination of FDA Commissioner Mark McClellan to head the Centers for Medicare and Medicaid Services (search). President Bush nominated McClellan last week.
"I believe it is appropriate to hold up Dr. McClellan's nomination for a time and ask some hard questions," said Sen. Byron Dorgan, D-N.D.
A new poll by The Associated Press says two-thirds of those surveyed think the government should make it easier to buy cheaper drugs from other countries, including Canada.
The FDA has said that won't happen until the practice is proven safe.
Fox News' Caroline Shively contributed to this report.