N.H. to obtain drugs via Canada
Governor Craig Benson of New Hampshire will set up a program to import prescription drugs from Canada, declaring yesterday that he plans to reduce state prescription drug costs even if it means defying the Food and Drug Administration.
In an interview, Benson brushed aside the FDA's repeated warnings about the safety of drugs shipped from Canada. He also dismissed the FDA's caution that importation would expose states to civil lawsuits if someone dies or is injured by an illegally imported drug.
"The FDA and drug companies have been spreading this notion that it is unsafe, but I have a different take," Benson said. "We have a lot of people who are not taking prescription drugs because they can't afford them. I think there's a liability for sitting still."
Importing drugs from Canada is illegal under US law. The FDA said it wants to talk to Benson about his program but does not plan to take any action before New Hampshire begins importing drugs.
Thus far, the only government entity to operate a program is the City of Springfield. But Boston Mayor Thomas M. Menino appeared before the City Council yesterday and said he would set up a pilot program for city workers and retirees in July that could save $1 million a year.
Benson's plan, part of which could be up and running in 10 days, could make New Hampshire the first state to formally adopt a Canadian drug plan. Minnesota's governor, Tim Pawlenty, has said he plans to move aggressively to set up a program. Illinois, Iowa, and Michigan have been studying the idea.
Though Massachusetts officials have rejected the idea of importing drugs for state employees, New England is emerging as an epicenter of interest in Canadian drug importation. The decision by Benson, a Republican, also emphasizes the bipartisan appeal of Canadian importation.
In addition to Boston and Springfield, Burlington, Vt., said it plans to import drugs early next year, and Cambridge is studying the issue. As Democratic contenders for president furiously criss-cross New Hampshire in advance of January's party primary vote, Benson's action promises to increase the amount of attention on the Canadian option.
Cost savings from Canadian imports are difficult to calculate. Mayor Michael Albano of Springfield has estimated that his city will save $4 million to $9 million a year, but in its first year the program is on pace to save less than $2 million.
Benson said he did not have any estimates on how much New Hampshire might save. He plans to establish a state-sponsored website within 10 days that will provide any New Hampshire resident with access to Canadian Internet pharmacies that are certified as safe by the state Department of Health and Human Services.
That will be followed by a program to import drugs for the state Department of Corrections, which he said will save "millions of dollars" every year. New Hampshire will also give retired state workers the option to buy Canadian drugs. The state will purchase drugs for Medicaid patients as well.
But because of contractual obligations, the only drugs for Medicaid patients that New Hampshire can purchase from Canada will be for the treatment of mental illness, Benson said.
The FDA said yesterday it was unhappy with Benson's decision.
"On principle it seems unwise and unsound and not prudent, and we would like to talk to him and tell him there are serious problems with moving in that direction," said Peter Pitts, the agency's associate director for external relations.
Asked if the agency would seek to block the plan, Pitts said: "The FDA wants to keep all our options open. You don't take enforcement action against someone until they do something."
The FDA won a federal court injunction last month shutting down RxDepot, a chain of sales agents for Canadian Internet pharmacies. The FDA has said it reserves the right to pursue action against city or state governments that import drugs, but so far it has declined to go after Springfield.
Tom McGinnis, the agency's director of pharmacy affairs, said the FDA's strategy has been to meet with government officials and give them specific warnings about safety and legal liability. He said the strategy is working thus far in the case of Iowa and other Midwestern states that have studied the issue but have not established programs.
"Pretty much the majority have told us they are not interested in breaking the law," McGinnis said.
The Medicare bill signed by President Bush this week contains a provision, similar to measures approved over the last five years, that would allow importation from Canada if the practice is certified as safe by the FDA and the secretary of Health and Human Services.
Stephen Schondelmeyer, director of the University of Minnesota pharmacy economics program, said New Hampshire's move puts increased pressure on the federal government to come up with a way to certify Canadian imports as safe.
"Each state that continues to move in this direction sends a signal to Congress and the FDA to have a bonafide assessment of the issues, not just a knee-jerk reaction of `We've never done it, we're never going to do it,' " he said.
In Boston, quality and safety concerns moved to the forefront of discussions last night about Menino's proposed pilot program. Pharmacists and representatives of the biotech industry voiced their own concerns about safety, urging the City Council to be circumspect before embarking on importation. But city councilors appeared eager to begin importing drugs.
"I urge you not to be afraid to move forward, to be bold," said City Councilor Michael Ross.
Christopher Rowland can be reached at crowland@globe.com. Stephen Smith of the Globe staff contributed to this report. 