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Bill Would Allow Mainers to Get Discount Drugs from Canadian Program
03/13/2013   Reported By: Patty B. Wight

Until recently, nearly 1,200 Maine households had access to steeply discounted prescription drugs through a program called CanaRx. The only problem was the Canadian mail order company is not licensed to distribute in Maine. Last summer, the Maine attorney general pulled the plug on the program. But some lawmakers vowed to bring it back. And today, legislators considered a bill that would do just that. But, as Patty Wight reports, opponents say importing drugs from other countries poses safety risks.

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Everybody likes a good deal, and that's what you get with CanaRx, according to businesses like Hardwood Products Company of Guilford. CFO Scott Wellman says in the six years the company used the service, its health care costs decreased significantly. Now that it's gone, Wellman says some employees pay as much as $3,000 more per year to buy medication.

"We don't want them to have to start making the choice of, 'Do I take my medicine, or do I heat my home?' We don't want them making the choice about their medicine or paying for food," he says.

CanaRx also supplied discount prescriptions to state workers and city of Portland employees. Estimates are that the service saved at least $3 million a year. Portland Mayor Michael Brennan says CanaRx filled nearly 17,000 prescriptions for city employees with no incidents.

"In Portland, we've had this program since 2004 that we've had in place that has been simultaneously cost effective and it's been safe," Brennan told lawmakers. "There's absolutely no reason, other than a quirk in the statute and a quirk in the law, that has us standing here today."

That quirk in the law is that CanaRx is not licensed to distribute in Maine. It's not even a licensed pharmacy in Canada. It's more like a coordinator that negotiates prices to buy brand-name medications from so-called Tier One countries - those that regulate their pharmaceutical industry at a level at least equivalent to U.S. standards.

And while CanaRx officials say they haven't had a single counterfeit medication in their supply chain in over 10 years of operation, drug safety advocates say just because no incidents were reported doesn't mean they didn't happen, or couldn't.

"Lives are at stake," says Shabbir Safdar, of the national group Partnership for Safe Medicines. Safdar says there are no quality inspections being done on medications that come from CanaRx.

"If one of those patients got a fake medication, assuming it didn't have a toxin in it, which has been known - heavy metals and so forth - then all their doctor would think is that they were unresponsive and might try switching them to another formula. They would never know it was fake."

There have been issues with counterfeit drugs in the U.S. Over the past year, a fake, ineffective version of the cancer drug Avastin circulated in the U.S. three different times, though it was not linked to CanaRx. Still, pharmacist Amelia Arnold is concerned about trusting a company on the honor system.

"As someone who spent six years working hard in school and passing licensing exams in both pharmacy content and law, I question how this happens, and I feel it completely undermines our health care system," Arnold said. "If this legislation passes, I say, why license anyone?"

Despite potential risks, lawmakers like Democratic Rep. Andrew Mason of Topsham say the benefits of CanaRx are hard to ignore. "I understand your position on safety and licensure....It's a dramatic savings." Arnold says there are other options for cheaper drugs, either through generics or federal programs.

Pharmacist Amelia Arnold agrees. "You've heard a lot of prices quoted here today, but let me just give you this one: To buy Nexium at a pharmacy here in the United States, you're looking at $700 plus for a 90-day supply. My understanding is the CanaRx price is approximately $200. Well, the federally qualified health center price is less than $50," she said. "So there are alternatives out there to get these medications. I think that we just have blinders on in thinking that the only answer is Canada, and it's not. "

But plenty of people do see Canada as the answer. The bill has bipartisan support from a dozen legislators. Gov. Paul LePage supported resuming the CanaRx operation last fall, but his spokeswoman, Adrienne Bennett, says he is not taking a position on this bill.



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