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Tuesday, November 8, 2005

Congress and reimportation

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House and Senate conferees recently stripped a provision from the fiscal 2006 agriculture appropriations bill authorizing the importation of prescription drugs, meaning Congress once again came close to approving "reimportation," but in the end had second thoughts. Interestingly, lawmakers' actions seem to track public opinion, which also supports reimportation at first blush, but softens as more details emerge.

Long a hot-button issue on the Capitol Hill, some argue that importing drugs from foreign countries offers a way to reduce the price of prescription medicines. Indeed, polls focusing on reimportation exclusively as a price-reducing mechanism receive overwhelming support. When asked in this context, many polls show support between 70 percent and 80 percent. Yet when the issue is framed a little differently, mentioning imports from non-Western countries or prescriptions purchased over the Internet, support erodes quickly. For example, one poll last year found 66 percent think Congress should allow importation only from Western nations, while just 20 percent favor allowing it "from any country, like Pakistan, Greece or India" (The Winston Group, June 2004). And 71 percent in a 2004 Pew poll thought "people should not be allowed to purchase prescription drugs online." Questions about the government's ability to ensure safety underlie the public's anxiety about drug reimportation. For example, in the most recent American Survey, (September 26-October 2, 800 registered voters) we asked voters if they believed the federal government "could ensure the safety of prescription drugs imported from other countries." 55 percent said the government "could not," while 43 percent thought it "could." Concerns about the government's ability to ensure safety are particularly strong within certain voter segments. For example, 62 percent of women had questions about the government's capacity to guarantee safety, while less than half of men (47 percent) shared these concerns. Democrats were almost equally divided on the question (48 percent said government could ensure safety, while 49 percent said it could not). Republicans were much more skeptical (36 percent said government could ensure safety. 63 percent said it could not).

Drug reimportation remains a perennial issue on Capitol Hill, promising a quick fix to voters' unquenchable desire for cheaper prescription medicines. Americans, however, also remain cautious about these imports, and particularly skeptical of the government's ability to guarantee safety. These nagging concerns help explain why reimportation supporters often get close, but in the end find it difficult convincing Congress to adopt final action on this measure. As with voters, support among lawmakers wanes as some of the thorny details are raised.

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