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Will Congress Legalize Prescription Drug Smuggling?

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When Alice fell down the rabbit hole into Wonderland, reality was turned upside down. Watches ran backwards and people had to run as fast as they could just to stay in one place.

A lot of senior citizens are wondering whether they too have somehow landed in Wonderland. For one thing, they are running as fast as they can to pay for expensive prescriptions but many are losing the race. For another, the rules keep changing and rarely make any sense.

The FDA says that buying prescription medicines in Canada is against the law. The agency says it is just trying to protect Americans from unsafe medicines. The feds maintain that they cannot guarantee the quality of drugs coming from Canada or other countries.

But the House of Representatives recently passed a bill permitting citizens to purchase their prescription drugs across the border to save money. Expressing their anger at the high cost of medicines, Congressmen voted overwhelmingly to allow pharmacies, wholesalers and individuals to import pharmaceuticals from 25 other countries.

The catch is that the Senate, the Bush administration and the FDA are not likely to go along. The pharmaceutical industry is vehemently opposed to any law that would undercut its right to charge whatever it pleases for its drugs. And pharmacist organizations have also expressed opposition.

Critics of the House drug-import bill claim that unsafe or counterfeit drugs might pour into the country, endangering people's health. But Canadian pharmacists selling medicines over the Internet counter that Canada actually has more controls to discourage counterfeiting than the U.S.

Repackaging, in which large lots of pills are distributed into smaller bottles, opens the door for mischief. While common in the U.S., this practice is not permitted in Canada.

Counterfeiting has recently become a problem in America. A large quantity of the cholesterol-lowering drug Lipitor was recently found to be substandard. In other cases, cancer patients received injections that had been diluted.

There is little if any evidence that these counterfeiting problems are linked to Canadian drugstores. Purchasing medicines from third world countries could put consumers at risk, but Canada and many European countries have stringent safeguards.

The current controversy is so confusing partly because neither the FDA nor Customs is enforcing existing laws against drug importation. Arresting 80-year-old grannies for smuggling their blood pressure pills in their handbags would be a public relations fiasco.

The impasse between the House, the Senate, the FDA and the White House is creating confusion and consternation for consumers. Older people who wouldn't dream of exceeding the speed limit may be concerned about breaking the law by importing drugs. But they are equally distressed when they can't pay the bill for a life-saving medication.

Sorting through the topsy-turvy logic of legislation driven by the crisis in pharmaceutical drug prices is a challenge. Will Congress find the leadership to solve this puzzle, or must senior citizens live in fear that the Queen will shout, "Off with their heads"?

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