WASHINGTON - With little hope left for passing legislation this year to provide prescription drug coverage through Medicare, Republican leaders in Congress are uniting behind a short-term alternative: Allow Americans to buy U.S.-made drugs from other countries at cut-rate prices.
Republican negotiators have yet to agree on the final form of a drug re-importation provision that they hope to pass before they adjourn next month. They are trying to blend a House bill that lifts the ban on importing drugs with a Senate-passed version that includes safeguards enforced by the Food and Drug Administration.
"We're trying to work out some language that takes care of everybody's concerns," said House Republican Whip Tom DeLay. "Members are working very hard to work something out, and we probably will get something."
The legislation is intended to address the anomaly that causes Americans to pay up to 70 percent more for U.S.-made drugs than do people in Canada, Mexico and other countries that impose price controls. The bill would let pharmacists and wholesalers re-import American-made drugs from those countries for resale in the United States at discount prices.
"What's needed is a more comprehensive solution, but with time running out, we have to look at fallbacks," said Rep. Bill Thomas of California, who is the leader among House Republicans on health care issues.
Thomas was among only a dozen lawmakers who opposed the House-passed proposal to lift the ban on importing prescription drugs. The ban was passed in 1988 to protect Americans from drugs that the FDA could not guarantee met all its quality standards.
"Some of us were concerned about safety," Thomas said. "But the Senate bill goes a long way in the direction of getting it right."
House Speaker Dennis Hastert, who is fighting desperately to hold onto his slender six-seat Republican majority, appealed for action at a meeting of Republican leaders this week. "We need to do this," he told his colleagues.
Senate Majority Leader Trent Lott has been concerned all year about the potential effect of the drug-price issue on five Republican senators seeking re-election in states along the Canadian border, where many voters are keenly aware of the drug price disparity. Lott is committed to passing a drug re-importation bill as a short-term solution, said his spokesman, John Czwartacki.
In endorsing a proposal that has passed both houses by sizable bipartisan majorities, Republican leaders have bowed to the seemingly inevitable. Nevertheless, the lawmakers who first offered the re-importation bills say they fear that the politically well-connected pharmaceutical industry might yet prevail in its multimillion-dollar campaign to defeat the legislation.
"I challenge the Republican leadership to show the American people that they have the guts to stand up to the pharmaceutical industry," Rep. Bernard Sanders, a Vermont independent, declared on the House floor yesterday.
The Pharmaceutical Research and Manufacturers of America is running television and newspaper ads contending that re-importation would "result in adulterated, spoiled and counterfeit drugs in America's medicine cabinets."
The bill's sponsors sought to counter those claims this week with letters from Health Secretary Donna E. Shalala and former FDA Commissioner David A. Kessler, arguing that the safety of drugs could be assured so long as the agency receives enough money to monitor the handling of pharmaceuticals while overseas.
But an industry spokesman contended that the request for extra money is, in effect, recognition of the greater safety risk.
"Let's not go off half-cocked," said Jeffery Trewitt of the Pharmaceutical Research and Manufacturers, which supports a Medicare drug benefit through private insurers. "Why not wait and deal with this in a responsible way?"
The momentum behind the re-importation bill appears too strong to stop. Even Democrats who fear Republicans will use it as an excuse not to enact a Medicare drug benefit won't stand in its way.
"If we can get nothing done" on comprehensive drug coverage this year, Senate Democratic Leader Tom Daschle said, he and his colleagues would back the re-importation bill because "at least that would be some contribution."