photo by Charles Williams
There are quite a few pharmacies in Yarmouth, Nova Scotia. Google lists nine in or near the center of town, which is a lot for the approximately 6,800 people who live there.
I have no immediate plans to visit the pharmacies in Yarmouth, where I am traveling on business this week. But I have shopped there in the past, as have many of the American visitors who often passed through Yarmouth before the ferry connecting it to the U.S. was suspended in 2009.
Americans facing high costs for medication have turned to other countries, including Canada, for years. Though it is illegal to bring pharmaceutical products over the border, the rules are seldom enforced at an individual level.
Now, however, a state has raised the stakes surrounding this issue. Last week The Wall Street Journal reported that Maine has passed a law purportedly allowing its residents to buy prescription drugs from certain foreign mail-order pharmacies.
It makes sense that Maine would be a leader in encouraging the importation of cheaper prescription drugs. Maine borders the Canadian provinces of Quebec and New Brunswick, and the aforementioned ferry used to regularly carry travelers from Portland and Bar Harbor to Nova Scotia. Buying medicine in Canada is old hat to a lot of Mainers.
It makes no sense that Americans are asked to pay the highest prescription prices in the developed world and thereby subsidize patients in places like Canada, Australia and Britain. The United States is alone among industrialized nations in lacking some form of price controls on patented medications. Pharmaceutical companies argue that price limits or government-organized central purchasing would hinder research and innovation.
Part of the political price for getting drug companies to support the Affordable Care Act was that the Obama administration did not push for legalized importation to upset this expensive status quo. Instead, it seems the administration now intends to ignore the violation of a federal law that is still in effect.
A coalition of pharmacy owners and pharmaceutical companies has filed a lawsuit against Maine’s new law, pointing out that it circumvents the federal regulatory structure and claiming that importing drugs from abroad poses “serious health risks” for patients. While critics are quick to point out in turn that drug makers and distributors are more likely worried about their own profits than the public welfare, the fact that the plaintiffs have a monetary stake in the outcome does not mean the federal law they cite is any less real or relevant.
I support importation, but I also support the consistent and fair application of the law. Customs stations in Maine are staffed by federal officials, not state employees. Maine does not get to set its own foreign policy, even if that policy is more sensible than the federal government’s.
State-level efforts to create more consumer-friendly importation laws ought to prompt Washington to revisit its own policy, much as with state-level marijuana legalization. For now, however, the law prohibiting importation of pharmaceuticals is still in place. The Obama administration does nobody any favors by avoiding the question of when or whether it might choose to enforce what is on the books.
As for the pharmacies in Yarmouth, good news: Ferry service is due to resume next year. The Americans will return soon, no doubt with fresh prescriptions in hand.
October 18, 2013 - 10:02 am
I could not agree more with Mr. Elkin’s positions, except his concluding one, which from a public health perspective is incorrect. He writes: “The Obama administration does nobody any favors by avoiding the question of when or whether it might choose to enforce what is on the books.” According to the CDC about 5 million Americans buy medication from other countries to at lower prices. If the federal government decided to enforce federal laws by prosecuting people for doing so then many, perhaps millions would not get medication they need because the prices here are too high, as Mr. Elkin points out. So not only does the Obama administration do the right thing by not fully enforcing a bad law, it acts ethically and in the interests of the public health.