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March 14, 2004
60 Minutes - Morley Safer
It may come as no surprise that the pharmaceutical industry is the most
profitable business in the country. Americans pay far more for their
prescription drugs than citizens of any place on Earth.
It will also come as no surprise that as a political issue, the high price of
drugs has united both Republicans and Democrats. More than a million Americans
now buy their medications in Canada.
And it's no longer just older people taking buses across the border. Mayors and
governors from Minnesota to Alabama are helping Americans get Canadian drugs by
mail.
Such purchases are technically illegal. So far, the government has declined to
prosecute individual customers or the cities and states involved. But the FDA -
The Food and Drug Administration - has raised the specter of safety.
For more than a year, the FDA Commissioner, Dr. Mark McClellan, has been waging
a campaign against Canadian importation. The FDA has also issued a serious
warning that using Canadian drugs could be unsafe. Correspondent Morley Safer
reports.
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How unsafe? How common are the problems for drugs that people are buying in
Canada?
“Well, that's the problem. We don’t know,” says Dr. McClellan. “Because we don't
have the authority to tell where these drugs have come from, or to monitor
closely how they're getting into the United States. And to make sure that the
drugs that come in are safe, it could be a widespread problem.”
“That's a lot of hooey. There is no reason that buying drugs in Canada is any
less safe than buying them in the United States,” says Dr. Marcia Angell, who
was executive editor of The New England Journal of Medicine for 11 years. She’s
currently writing a book on the secrets of the drug industry.
“The people who say you have to worry about the safety of drugs from Canada are
imagining the way it was in the old days. That there's a moat around the United
States that drugs that are sold in the United States are made by only American
companies. And made in this country,” says Angell.
“It's not that way anymore. Pfizer, for example, has 60 manufacturing sites in
32 countries. So the drugs are made all over the world. They're sold all over
the world.”
Most of Pfizer's anti-cholesterol drug Lipitor is made in Ireland. The same
Lipitor that's sold in both U.S. and Canadian pharmacies. Other familiar drugs
like Zocor, Nexium, and Prevacid are the same as the ones sold in Canada.
They're much cheaper there because the drug companies must abide by Canadian
government price controls.
Do the drug companies still make a profit?
“Oh, sure. Why else would they sell them in Canada? They're not charities. Of
course they make a profit,” says Angell.
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The United States is the only industrialized country without some form of
control on the prices of drugs. The U.S. also accounts for more than half of the
industry's profits.
In order to keep those profits up, the drug companies have joined the FDA in
trying to shut down imports from Canada, and Canadian pharmacies are feeling the
pressure. In one pharmacy just over the border, Americans account for 30 percent
of its business. They were nervous about having 60 Minutes mention the actual
name of the pharmacy.
“We've had several letters from the big multi-nationals, certainly threatening
to cut off the drug supply very explicitly if you are supplying medications to
U.S. patients,” says the pharmacist.
This pharmacy supplies drugs to municipal workers in the city of Springfield,
Mass., through a program set up by former Springfield Mayor Michael Albano.
“Major pharmaceutical companies are saying, ‘We're going to limit our supply.’
What does that tell you? It tells you that they want to keep the artificially
high prices in America,” says Albano. “How brazen is that? It just boggles my
mind that they can get away with this.”
When Albano was faced with a budget crunch last year, he had to lay off
firefighters, police officers, and teachers. By arranging for 3,000 city
employees, retirees, and family members to buy Canadian drugs, the city can make
substantial savings.
“We can save anywhere from $4 to $9 million on an annual basis if I get
everybody enrolled and everybody goes to Canada. And that's a huge amount of
money right now,” says Albano. “If I can save $9 million for my city and put it
back, redirect it back into police and fire and to public education, it'll make
a world of difference. So it's a huge savings.”
Does he do it himself?
“I do it for my family's use. My son Mikey is diabetic. And we get his insulin
and related products for diabetes from Canada,” says Albano, who saves that
saves his family $250 a year because there is no co-payment. “And it’ll save the
taxpayers who front 76 percent of the payment about $850 a year. So it's a
rather substantial savings for my family and for the taxpayers of Springfield.”
The FDA says importing drugs from Canada or buying drugs from Canada is unsafe.
Does Albano agree?
“The American public is not buying that safety issue. The fact is that it is
getting insulting for the FDA to say that. I view myself as a responsible
father,” says Albano. “And I could tell you that I would not let my son inject
insulin into his body three times a day if I thought there was a safety factor
here.”
Mayor Albano concedes that casually buying drugs on the Internet could be risky,
but says it was quite simple for him to check out his Canadian supplier, and
challenges the FDA to do the same thing.
“The FDA has become a pawn of the pharmaceutical industry, that they are
protecting those high profit margins. If the FDA wanted to put a plan together
similar to what we're doing in Springfield, that would be good for all
Americans, they can do it in 15 minutes, relative to safety,” says Albano.
“We get all our medications from certified, regulated pharmacies in Canada. It's
no different than going to your neighborhood pharmacy. And it's the exact same
medication.”
So why can’t the FDA insure the safety of products from Canadian pharmaceutical
exporters – and make sure that it’s as safe as any product leaving an American
company?
“Under current law, we don't have the authority to insure the safety of foreign
produced, foreign distributed drugs,” says McClellan.
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So what would motivate the FDA, which is not in the business of profiting from
drugs, to put out an alarm about Canadian drugs?
“The influence of the pharmaceutical industry on our government is huge. And the
FDA is a part of the executive branch of the government. And this is just the
propaganda that's put out to do the drug company's bidding, to make sure that
Americans don't have access to cheaper drugs,” says Angell.
“Because then they'll come to know what's going on. And what's going on is that
these drugs, while they're made by global companies all over the world, are sold
in this country for about double what they're sold for everywhere else. And that
they wanna keep secret.”
“Our interest is in protecting and promoting the health of the public,” says
McClellan.
Of course, the whole controversy over Canadian drugs would be moot if Republican
Congressman Dan Burton of Indiana had his way. During the recent debate over the
Medicare bill, he co-sponsored a provision that would have legalized bringing in
Canadian drugs with safeguards.
But Burton says he ran into two brick walls: the drug industry and the U.S.
government: “This is a perfect example, in my opinion, of where a special
interest, the pharmaceutical industry, has been able to manipulate the Congress
and the government of the United States to their benefit, and to the detriment
of the American taxpayer and the American people.”
Since 1999, the drug industry has given more than 45 million dollars in
political contributions, and it's spent hundreds of millions more on an army of
more than 600 lobbyists to work its will on Capitol Hill.
Congressman Burton says the new Medicare act makes it clear the industry got its
money's worth. He says billions of dollars are in it for drug companies in this
new Medicare Prescription Drug Benefit.
“In the new Medicare Act, the federal government is specifically prohibited from
negotiating prices with drug companies,” says Safer.
“That is unconscionable. The government of the United States negotiates prices
in the Defense Department, in every area of government,” says Burton. “And here
we are, going to spend billions and billions and billions and probably trillions
of dollars on pharmaceutical products. And we cannot negotiate the prices with
the pharmaceutical industry. That's just not right.”
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In December, surrounded by members of Congress, President Bush signed the new
Medicare act. Since 1999, these legislators have accepted more than a million
and a half dollars in campaign contributions from people working in the
pharmaceutical industry. President Bush alone has received more than half a
million dollars.
But now, the new Medicare prescription drug benefit is being billed as a big
victory for America’s seniors.
“You gotta be kidding me,” says Burton. “Seniors, when they find out what's in
that bill, are gonna be very angry. The problem is, they're not gonna find out
about it until after this next election.”
The plan doesn’t start until 2006. Does Burton think that will reduce the
attraction of importing drugs from Canada?
“Oh, I don't think so,” says Burton. “Because even when you talk about the
discount cards and the other things, you're gonna find that seniors are gonna be
paying, in many cases, more than they are paying for Canadian imports right
now.”
60 Minutes contacted Bristol-Myers Squibb, Pfizer, Merck, Wyeth, Glaxo
SmithKline, and Eli Lilly. None of them would agree to be interviewed. Safer
asked Dr. Angell about the case the industry invariably makes to justify drug
prices.
“This is a kind of blackmail. What they're saying is, ‘Don't mess with us. Let
us charge whatever we want for our drugs. Otherwise, you won't get the
miracles,’” says Angell. “And the truth is that they spend less in R&D then they
make in profits. And far less then they spend on marketing. And they don't make
that many miracles in the first place … The problem is, is that we're no longer
getting our money's worth.”
Adds Albano: “The pharmaceutical industry is gouging the American consumer.
There's no other conclusion one can draw. And why should we, in this country,
have to pay the highest prices in the world? Why isn't the president doing
something? Why isn't Congress doing something? Someone has to wage this battle.
So we're prepared to do it here.”
Political pressure is building. Congress now plans to reconsider legislation
that would legalize Canadian drugs. As for Dr. Mark McClellan, he is leaving the
FDA and becoming President Bush's new head of Medicare and Medicaid.
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