In July 2003
the city of Springfield, Mass., began the United States' first
voluntary program to import cheaper prescription drugs from Canada
as part of the city's employee health insurance.
in the program submit a prescription from a U.S. doctor to Ontario-based
CanaRx, which has a physician review the script. CanaRx then fills
the order and ships the drugs back to the United States.
the 20,000 city employees, retirees and dependents eligible for
Springfield's program, the city reported that 1,600 people had
enrolled as of mid-October 2003. The city waives prescription
co-payments for those participating in the program, which has
filled some 2,600 prescriptions in its first three months. According
to the city's calculations it saved $600,000 on those prescriptions,
which translates into $2.4 million in annual savings.
program has attracted nationwide attention as governors and mayors
throughout the United States grappled with the rising cost of
providing drug coverage to local government employees. Along with
this interest, Springfield's program also provoked criticism from
the Food and Drug Administration. The agency cites safety concerns
as the main reason behind its vocal opposition to importing prescription
drugs from other countries.
initial criticism of Springfield's program did not lead to any
changes, the FDA left open the possibility of pursuing legal action
against the city and other local governments importing Canadian
drug safety laws that Congress has charged FDA to enforce require
that drugs be proven to be safe and effective to be legal,"
said FDA Commissioner Mark McClellan in November 2003.
FDA will continue to do all it can to make safe and affordable
drugs available, we are also committed to enforcing the law against
those, whether governmental or private, who endanger Americans
by profiting from 'buyer beware' schemes to import illegal, unapproved
and potentially risky medicines," McClellan continued.
made this statement as the FDA also informed CanaRx that its operations
were illegal and that the drug importation "circumvents measures
designed to protect U.S. citizens." The letter stated that
the agency was "reviewing [its] enforcement options"
and was forwarding information about CanaRx to the Canadian government.
to the FDA's complaints against CanaRx, a statement on the company's
Web site maintains that "we at CanaRx share FDA's interest
in the health and safety of U.S. consumers. Contrary to the agency's
assumptions and assertions, we take numerous steps to safeguard
our customers' health and safety, and what we do creates no risk
beyond that faced by U.S. consumers conducting similar transactions
been reluctant to crack down on Internet pharmacies shipping drugs
to the United States, arguing that it is the United States' problem.
Canada's Assistant Deputy Minister of Health Diane Gorman told
reporters in November, "My responsibility is to make sure
that Canadian law ... is respected. The U.S. FDA is sharing some
information with us. We are investigating a number of issues that
they've brought to our attention.
At this point in time
we don't have evidence of Canadian law being broken."
Gorman's remark's, Canadian Health Minister A. Anne McLellan issued
a press release in November stating that McClellan may have "left
the impression that unsafe Canadian drugs are going across the
border to the United States." She went on to say she wished
to assure all Canadians that drugs approved for use in Canada
are safe. "We have one of the most rigorous drug approval
systems in the world to assure safety, quality and efficacy,"
she said, adding that no drug shortages have been reported due
to Internet drug sales.
opposition to the importation of Canadian drugs did not seem to
have fazed former Springfield Mayor Michael Albano, who instituted
the program. "If they are willing to prosecute Michael
Albano ... then they better be prepared to prosecute 2 million
Americans, many of them senior citizens, who are going to Canada
to get their prescriptions filled," he said in November 2003,
according to the Associated Press.
not going to be intimidated," he continued. "If the
FDA is prepared to prosecute the mayor for doing what's right
for his constituents, then so be it."
emerged as a national spokesman for municipal frustration over
high drug prices. In October 2003, government officials from Boston
and New York joined him when he met with members of Congress to
explore ways of lowering prescription costs.
as mayor ended in January 2004, but Springfield's stance on drug
importation is unlikely to change. Calling U.S. drug prices ''unconscionable,''
current Mayor Charles Ryan pledged to continue the program.
By Karyn Schwartz, Online NewsHour