WASHINGTON – The House approved legislation early Friday to allow the importation of lower-cost prescription drugs (search) from industrialized nations, brushing aside opposition from the Bush administration (search) and a fierce lobbying campaign by the pharmaceutical industry.
The vote was 243-186, and sent the measure to the Senate (search), where it faced an uncertain fate.
"I was not sent here by drug companies and I will not stand here and see American seniors take a back seat to the pharmaceutical industry," said Rep. Jo Ann Emerson, R-Missouri.
"A bottle of tamoxifen, used to fight breast cancer, costs $360 in the United States. It costs $60 in Germany," she added.
But critics argued the bill, while it held out the hope of lower prices, would sacrifice patient safety.
"The country is going to be flooded with unsafe pharmaceutical counterfeits, over-age pharmaceuticals, pharmaceuticals that don't preserve and protect the safety of our citizens," said Rep. John Dingell, a Michigan Democrat who has worked across the decades for patient safety legislation.
The bill was brought to the floor under unusual circumstances. Republican leaders oppose it, but Speaker Dennis Hastert, R-Ill., agreed to allow a vote last month as part of an agreement for Emerson to vote for Medicare prescription drug legislation.
Congress has approved legislation twice before dealing with the drug importation issue, but both times said the secretary of the Department of Health and Human Services would first have to certify that the drugs would be safe. Neither Donna Shalala, who served under former President Clinton, nor Tommy Thompson, who holds office under President Bush, was willing to do so.
The vote was designed to force House and Senate bargainers to accept the legislation as part of a Medicare prescription drug bill.
But even as it was passing, 53 senators declared their opposition to any change in law that would remove deny the secretary of HHS the ability to decide whether importation was safe.
The House bill, backed by Republican Reps. Gil Gutknecht of Minnesota and Emerson, as well as Rep. Rahm Emanuel of Illinois, ordered HHS to set up a system to allow importation of FDA-approved drugs from FDA-approved facilities in Canada, the European Union and seven other nations.
The measure also would require imported medicine to be shipped in anti-tampering and anti-counterfeiting packaging.
But the Bush administration issued a statement calling the bill "dangerous legislation."
And FDA Commissioner Mark McClellan said the measure "creates a wide channel for large volumes of unapproved drugs and other products to enter the United States that are potentially injurious to public health and pose a threat to the security of our nation's drug supply."
The measure had wide appeal to consumers -- thousands of whom have ridden in buses to Canada in recent years to buy lower-cost drugs. And several lawmakers accused the drug industry of merely trying to protect its own profits. Liberal Rep. Bernard Sanders, I-Vt., saying it had spread "lies, lies, and lies again" in an effort to kill the bill, while conservative Rep. Dan Burton, R-Ind., said, "it's not about safety, it's about money."
But the lobbying seemed one-sided.
Rep. Elijah Cummings of Maryland, a liberal Democrat and head of the Congressional Black Caucus, said only one outside group had contacted him, the pharmaceutical industry.
And in Indiana, Eli Lilly & Co. ran newspaper advertisements in GOP Rep. Dan Burton's district attacking the bill that he supporters. Burton, a conservative Republican, ran radio advertisements in response.
"We do believe there is a safety problem," said Mark Grayson, a spokesman for the Pharmaceutical Research and Manufacturers of America, known as PhRMA. He also said the legislation would import the system of price controls that foreign government impose on drugs.
He said he didn't know how much the group was spending the defeat the bill, adding, "We don't discuss that."
The pharmaceutical industry made more than $20 million in political contributions in the past election, with roughly $8 of every $10 going to Republicans, according to an analysis by the Center for Responsive Politics.
PhRMA itself gave more than $3 million and spent more than $14 million lobbying Congress on various issues last year. In addition, the organization gave millions last year to an organization that aired television commercials on behalf of candidates who backed a GOP-written prescription drug bill.
Individuals who rarely agreed on anything worked to defeat the measure.
They included the Traditional Values Coalition and the Rev. Jerry Falwell, both warning that the bill could allow importation of the morning-after abortion drug RU-486; and Rep. Bobby Rush, D-Ill., a liberal Democrat who represents an inner-city Chicago district.
In a letter to all House members, he warned the bill could divide the country into two groups: one, middle class and suburban "will be able to pay higher prices for the medicines they need." The other, he said will be "economically disadvantaged ... including a significant portion of the minority community." Those Americans, he said, won't be able to afford what American drugs cost and will wind up with "cheap, reimported, cut-rate medications sold through knockoff drugstores."
Also opposed to the bill was the National Medical Association, an organization of black physicians, which cited concern about safety issues. The association also receives support from PhRMA, which was a corporate sponsor at the group's 2002 annual convention.
Given the circumstances, the customary party lobbying was suspended.