WASHINGTON – Efforts to allow Americans access to cheaper prescription drugs from abroad should blossom once Democrats assume control in Congress, but it won't be a top priority, lawmakers and health care experts said.
Members of the House and Senate are gearing up for a renewed push to change federal law and permit broader imports of prescription drugs from Canada and elsewhere, where certain medicines can cost less than two-thirds what they do in the United States. Their hope is the imports will drive down prices at home.
"The pressure is not to tell people you have to go outside this country to buy prescription drugs. The pressure is to force the pharmaceutical companies to re-price their drugs in the U.S.," said Sen. Byron Dorgan, a North Dakota Democrat who has introduced with Sen. Olympia Snowe, R-Maine, a bill to make importation of prescription drugs legal.
The issue remains overwhelmingly popular with voters, even though the government estimates it would do little to actually cut the prices Americans pay for prescription drugs. And there is continued opposition to imported drugs as well.
Still, Republicans and Democrats alike see the shift in control of Congress as an opportunity to advance previously blocked legislation. The issue generally is called reimportation, since many of the medicines are made in the United States or by U.S. companies.
"Things were headed in the right direction with reimportation to begin with, but the election will speed up that process because it's removed leadership that was opposed to reimportation. I am a Republican and support leadership in general, but on reimportation they were opposed to it," said Sen. David Vitter of Louisiana.
Vitter and Sen. Bill Nelson, D-Fla., recently sponsored legislation to halt the seizures of imported Canadian drugs for personal use — something the government now allows only on a limited basis.
And Vitter continues to block confirmation of Dr. Andrew von Eschenbach, President Bush's nominee to lead the Food and Drug Administration, until federal drug import laws are further relaxed.
As for the FDA, the agency says it can't vouch for the safety or efficacy of imported drugs. This summer, the FDA said testing revealed fake versions of Lipitor and other widely used prescription drugs ordered through Web sites linked to a Canadian pharmacy but shipped from other countries.
Nelson, too, intends to make such legislation a priority. He wants to either bar the use of government funds to enforce the rules or authorize the import of drugs certified as safe from Canada and select other countries on a case-by-case basis, spokesman Dan McLaughlin said.
The drug industry, which generally opposes such legislation, is bracing for an onslaught.
"I don't think there's any question there will be renewed attempts to pass reimportation legislation in the new Congress. It's a fight that's been going on for years now. Given the new leadership and its priorities, we expect it to pop up again," said Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America.
But don't hold your breath, said Drew Altman, president and chief executive officer of the Kaiser Family Foundation, a health care research organization. Imported drug legislation is not at the top of Democratic leadership's list of priorities. And Bush, who's also raised questions about the safety of imported drugs, could veto legislation to make it happen.
Speaker-elect Nancy Pelosi, D-Calif., has made cheaper prescription drugs part of her immediate plans for the House. Yet Pelosi's focus is on negotiating lower prices with drug companies for Medicare beneficiaries. The same goes for Sen. Harry Reid, the next Senate majority leader. Reid spokesman Jim Manley said reimportation was among "a whole host of other issues."
"Timing is another thing," said David Certner, legislative policy director for the AARP. "This would be presumably something we see later in the day."
If and when it does come to the fore, not everyone is taking Democratic support as a given.
"A lot of people say, 'Oh, it's just the Democrats,' but it's not. It depends on where you're from, and who are your constituents," said Rep. Jo Ann Emerson, R-Mo., a key sponsor of previous reimportation legislation.
Still, Emerson says the issue will have a "fighting chance" in the new Congress, even without a veto-proof majority. Others are less sanguine.
"This is one of those things where I think that the conventional wisdom may not be accurate. I personally think reimportation has a much tougher prospect of moving with the Democrats in charge, particularly in the House," said Ira Loss, an analyst at Washington Analysis.
Loss points to the potential opposition of Rep. John Dingell, D-Mich., who will take over as chairman of the House Energy and Commerce Committee that oversees the FDA. Dingell previously has warned of the safety risks posed by imported drugs — as do both the FDA and pharmaceutical industry.
Reimportation advocates believe Canada could provide the U.S. with prescription drugs that are both cheap and safe. Canadians, for instance, pay on average just 62 percent as much for prescription drugs as do Americans, according to the 2005 annual report from that country's Patented Medicine Prices Review Board.
But lower prices overseas wouldn't automatically translate into massive savings for U.S. consumers, according to a 2004 study by the Congressional Budget Office.
The study found that allowing drug imports from a broad set of countries would cut drug spending by $40 billion over 10 years, or by about 1 percent. Limiting it to Canada would produce a "negligible reduction" in drug spending, it found.
Despite such estimates, public support remains strong, according to polls by the Kaiser Family Foundation and others.
"It's an issue whose popularity with the public is out of proportion to its potential benefit in terms of driving down drug costs," Altman said.