Saturday, August 9, 2003

LIVONIA, Mich. — Diane Dewar, weary of federal promises to combat the rising cost of prescription drugs, last week ordered hers from an organization that helps import the goods from Canada and delivers them for about half of what she would pay in the United States.

“For years, starting with Hillary Clinton, we’ve heard about cutting the cost of prescription drugs,” said the 60-year-old retiree, one of thousands in the United States who are unable to pay for their prescribed medications because of a lack of insurance. “They could get something passed in Washington immediately, if they really cared.”

So Miss Dewar and hundreds of others head for the American Drug Club in this working-class Detroit suburb, where a sign on the window advertises “Discount Drugs from Canada. … Save up to 80 percent.”

A 32-year-old former pro golfer named Patrick Slater opened a branch of the American Drug Club here on Monday to a receptive gaggle of the aged and infirm.

They jammed his unadorned storefront, sitting in a circle of chairs while C-SPAN flickered away on a 13-inch television in a corner.

“I don’t want to put myself out of business,” Mr. Slater said between answering two demanding phone lines and a cell phone. “But the government is forcing people to find an alternative to paying those drug prices.”

He is a concessionaire for one of several companies that have opened U.S. storefronts in the last six months to sell prescription drugs to Americans at the substantial savings of rates in Canada.

The Food and Drug Administration has promised to shutter any storefront establishment that sells prescription drugs at cut rates, noting that law forbids U.S. importation of drugs for individuals.

The department has sent letters to the groups, asking that they shut down or the agency will do it for them.

“We have no real enforcement hammer in these cases,” said William Hubbard, the FDA’s associate commissioner for policy and planning. “We have been in touch with the Canadians several times with the hope that they can help us out there.”

Similarly toothless are the efforts of the drug companies, which have vowed since early this year to cut the supply of drugs to Canadian pharmacies that are believed to be selling to American patients.

Congress has wrangled with promises of subsidized prescription drugs for years but has yet to find a consensus on how this can be accomplished.

For example, a bill passed on July 25 by the House would allow pharmacies, wholesalers and individuals to import prescription drugs from 25 countries, including Canada.

Last week, though, 53 senators signed a letter vowing to oppose the bill, citing a possible danger to patients, making it more likely that thrifty patients will have to rely on groups like the Winnipeg, Manitoba-based American Drug Club to keep them in medicine.

It is exactly that bureaucratic juggling of politics as usual in Washington, though, that has exacerbated the opportunity for these drug-sale storefronts in states like Michigan, Arkansas, Florida and Alabama.

“Congress has to address the underlying problem,” said Susan Winckler, a spokeswoman for the American Pharmacists Association. “It is just silly that Medicare will pay for you to find out you have diabetes and won’t pay for you to treat it.”

The storefronts offer no guarantee of the quality of the medications, although they pledge that patients are receiving the exact prescription they were given in the United States.

Advocates for the imports point to a U.S. Congressional Research Service study that found in June that Canadian drugs are manufactured and distributed under virtually identical standards.

The storefront operations are simply ordering centers for those who can’t or won’t go through the Internet, which has offered savings via Canada for several years.

Clients bring in their prescriptions, and the staff of the American Drug Club helps them place an order with a local pharmacy.

Included on the four-page questionnaire is a clause that excludes the company from any liability.

The orders are shipped directly to the client two to three weeks later.

Narcotics cannot be shipped and are not accepted, in adherence with U.S. and Canadian law.

American Drug Club President Amy Ku-Ogawa, who says she is a licensed Canadian pharmacist, declined to be interviewed for this article.

The American Drug Club here, tucked on a busy avenue between a gun shop and a martial arts studio, is the third of 360 stores the company hopes to open nationwide. The first opened in Florida in April.

The savings are substantial. For example, the cholesterol drug Lipitor costs $287.97 at a regular pharmacy, but at the American Drug Club it costs $ 196.86.

After filling out a four-page form and plunking down her credit card, Diane Jones, 50, walked out of the American Drug Club satisfied that the diabetes drug for which she once paid $138 for a 30-day supply will be sent to her for $23.50.

“I have had to work an extra job so that I could pay for my pills,” said Miss Jones, who works full time at Northville Downs, the local horse track. “I have no idea why our government wants to force us to buy these drugs from Canada. But that’s what we will do.”

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