SAN DIEGO -- Safety needs to move to the center of the debate about drug re-importation, said Mark Polli, director of pharmacy professional services, Hannaford Bros., Scarborough, Maine.
Public debate about the importation of medications from foreign sources has focused almost exclusively on the price difference, Polli said, ignoring the critical safety facet of the issue. Polli spoke during the National Association of Chain Drug Stores Pharmacy & Technology Conference here late last month. Hannaford is a unit of Delhaize America.
"It's about the money, not about the safety. The only time we ever hear about safety is from this crowd," he told the NACDS meeting.
In many cases, politicians' priorities on the issue of drug imports have been to save money with no regard for other consequences, Polli said. He cited a quote from a Maine public official who said her office was looking to "save anything, anytime, anywhere" on prescription costs.
Given that approach, Polli asked, where is the concern for public protection? With imported drugs, there is no guarantee that they are not counterfeit, or even that the information accompanying the prescriptions will be in English, he pointed out.
In Maine, where Hannaford is based, the state Senate has a Web site with links to online pharmacies selling drugs from Canada. However, it provides no guidance on which companies are reputable or any warnings about potential safety issues with imported drugs that are not overseen by official U.S. government bodies, Polli said. Maine is not alone in that approach.
In its current form, drug importation will not work, Polli said. "It is viable for us to move forward with re-importation, but safety has to be central," he said.
In addition to safety concerns, attention should be paid to potential supply side consequences, said Jeff May, vice president pharmacy, professional affairs, Shoppers Drug Mart, Toronto, a Canadian drug store chain, speaking on the same panel.
"To think that Canada can supply the United States is absurd," he said. The impact on Canada's health care system in trying to supply individuals in the U.S., particularly in terms of diverting pharmacist resources, would be very negative, he said.
Drug importation is nothing new, said Marv Shepherd, director, Center for Pharmacoeconomic Studies in the College of Pharmacy at the University of Texas, Austin, who also spoke on the panel. What has complicated and changed the issue is that the price differential has become much larger in recent years, he said. Current estimates are that 1% to 2% of Americans are meeting their prescription drug needs from foreign sources, he said.
In spite of the large number of unanswered questions regarding the effect of importation on community pharmacies, some sort of policy is likely relatively soon with Congress going back into session this month, Shepherd said.
