Illinois, Wisconsin Launch Programs To Help Residents Purchase Medications From Abroad

Illinois Gov. Rod Blagojevich (D) and Wisconsin Gov. Jim Doyle (D) on Monday initiated the first state-sponsored program that will allow residents of both states to purchase about 100 brand-name prescription drugs from Europe and Canada for an estimated 25% to 50% less than U.S. retail prices, AP/Las Vegas Sun reports. Under the I-SaveRx program, which was created by Illinois officials, the states will contract with CanaRx -- a Canadian pharmacy benefit manager that operates a network of online pharmacies -- to connect residents with a clearinghouse of 45 pharmacies and wholesalers in Canada, the United Kingdom and Ireland. The pharmacies have been approved by Illinois health inspectors and verified by Wisconsin. Residents of the states who access the program's Web site or call a toll-free telephone number will be linked to the clearinghouse, which will provide information on prescription drug costs for about 100 of the most common brand-name drugs used to treat chronic or long-term conditions. Consumers must mail or have their doctor fax a completed health profile form and signed prescription to the clearinghouse, which will "conduct an initial scan for appropriateness" using drug interaction software that is currently used in Illinois pharmacies, the AP/Sun reports. Once the prescription is verified, it will be given to a network physician in the country from which the medication will be dispensed. The physician then will rewrite the prescription for a local network pharmacy. The pharmacy will conduct final safety checks "to comply with local laws and regulations" and then distribute the medication, the AP/Sun reports. Residents will be allowed only to purchase refills, and most generic drugs, narcotics and prescriptions that require refrigeration or other special handling will be excluded (Lannan, AP/Las Vegas Sun, 10/4). The process could take up to three weeks; the program will remind users up to one month before their prescription runs out that they should refill (Forster, Milwaukee Journal Sentinel, 10/4).

Larger Scope
I-SaveRx typically requires that consumers order a three-month supply of medication. The fee for shipping is about $15 (Ritter/Sweet, Chicago Sun-Times, 10/5). I-SaveRx "goes beyond programs in other states" because it includes pharmacies in Europe, the AP/Sun reports. FDA opposes the reimportation of prescription drugs from other countries, but the agency has not yet blocked any city or state from establishing a Web site to help consumers buy drugs through Canadian pharmacies (AP/Las Vegas Sun, 10/4). Blagojevich last October asked HHS to allow Illinois to establish a pilot program in which the state could contract with a Canadian PBM to administer the program by mail order or purchase certain medications in bulk from Canadian pharmacies and distribute them from a state-based mail-order center. HHS officials in June denied the request (Kaiser Daily Health Policy Report, 8/18). Blagojevich then sent state officials to Europe "to study the safety and feasibility of importing prescription drugs from Ireland and United Kingdom," the AP/Sun reports. Wisconsin recently joined the program.

States' Response
Blagojevich said in a news release, "Now, the nearly 13 million people who live in Illinois and the more than five million people who live in Wisconsin will have the opportunity to save hundreds -- and in some cases even thousands -- of dollars each year on the high cost of their medicine. It means our seniors will no longer have to spend more money than they have just to afford the medicine they need" (AP/Las Vegas Sun, 10/4). Doyle said, "At some point, American pharmaceutical companies are going to have to face up to the fact that people are really angry that they're paying exorbitant prices." He added, "Tens of thousands of people are going to Canada outside of any state Web site. They're going physically across the border, or they're going by the Internet, and in those instances there hasn't been any checking going on." Doyle said if FDA "were really on our side, they'd go to these pharmacies and make the same determination that these are safe, reliable and reputable pharmacies, and they would approve them" (Milwaukee Journal Sentinel, 10/4). Doyle at a news conference in Chicago challenged the FDA "to come to court." He added, "I'm very comfortable with our legal position" (Chicago Sun-Times, 10/5). AARP Illinois Director Ralph Yaniz said, "AARP is keenly aware that millions of our members are now engaged in importation of prescription drugs from abroad. The argument over safety concerns only makes more imperative the need to monitor this activity and establish procedures and protocol." He added, "Governor Blagojevich's importation initiative, along with currently available programs, will give older Illinoisans some relief from the high costs of prescription drugs" (AP/Las Vegas Sun, 10/4).

FDA Response
FDA Director of Pharmacy Affairs Tom McGinnis said the government will review the I-SaveRx Web site, adding that FDA already has sent a warning letter to Wisconsin officials about the federal laws being violated by the program. FDA also is expected to contact regulatory agencies in Ireland and the United Kingdom to determine whether laws in those countries allow exportation of prescription drugs. McGinnis said Blagojevich and Doyle are "putting the consumer in a buyer-beware situation. (Consumers) may be getting something equivalent, but they may not be, and that's a poor position to put consumers in." Tom Engels, vice president of public affairs for the Pharmacy Society of Wisconsin, said Canadian pharmacies in the program have sent drugs that have not been approved or that require refrigeration. According to McGinnis, FDA last September sent CanaRx a warning letter that cited concerns about safety and violations of U.S. law (Milwaukee Journal Sentinel, 10/4). FDA Chief of Policy and Planning William Hubbard said he hopes the issue does not go to court, but he added, "[W]e may have to go to a judge at some point" (Chicago Sun-Times, 10/5).