[Congressional Record Volume 146, Number 56 (Tuesday, May 9, 2000)]
[Senate]
[Pages S3693-S3695]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. JEFFORDS (for himself, Mr. Wellstone, Ms. Snowe, and Ms. 
        Collins):
  S. 2520. A bill to amend the Federal Food, Drug, and Cosmetic Act to 
allow for the importation of certain covered products, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.


              MEDICINE EQUITY AND DRUG SAFETY ACT OF 2000

  Mr. JEFFORDS. Mr. President, as we work to address the problems of 
health care in the new millennium, we are blessed and we are cursed: 
blessed with the promise of new research capabilities and the knowledge 
gleaned from the human genome, and cursed with the high costs of all 
medicines, new and old. Today, I come to the floor to introduce a bill 
that will help address the curse of out-of-control drug prices, the 
Medicine Equity and Drug Safety Act of 2000, or MEDS Act.
  There is no question that prescription drugs cost too much in this 
nation.
  During a time when we are experiencing unprecedented economic growth, 
it is not uncommon to hear of patients who cut pills in half, or skip 
dosages in order to make prescriptions last longer, because they can't 
afford the refill. The question that we should ask is, can we put 
politics aside and work in a bipartisan manner to deal with this 
national crisis? I say we must. And I am hopeful we can.
  Prescription medicines have revolutionized the treatment of certain 
diseases, but they are only effective if patients have access to the 
medicines that their doctors prescribe.
  The best medicines in the world will not help a person who cannot 
afford them. And they can actually do more harm than good if taken with 
the improper dosage.
  Mr. President, it is well documented that the average price of 
prescription medicines is much lower in Canada than in the United 
States, with the price of some drugs in Vermont being twice that of the 
same drug available only a few miles away in a Canadian pharmacy. This 
is true even though many of the drugs sold in Canada are actually 
manufactured, packed, and distributed by American companies that sell 
the same FDA-approved products in both markets, but at drastically 
different prices.
  This pricing disparity unfairly places the heaviest burden on the 
most vulnerable Americans--hardworking, but uninsured Americans who 
make too much money to qualify for Medicaid, yet still cannot afford 
the high cost of lifesaving drugs.
  The legislation I am introducing today will allow pharmacists and 
wholesalers to get the same FDA-approved drugs sold at lower prices in 
other countries, and pass the savings on to consumers in the U.S.
  This bipartisan proposal builds on legislation I introduced last 
year, S. 1462, that would allow imports from Canada for personal use, 
and borrows from another bill cosponsored by Senator Wellstone, S. 
1191, that would allow reimportation of prescription drugs that were 
made in U.S. facilities.
  The most important aspect of this bill, Mr. President, is safety. We 
all want to find ways to bring drug costs down for all Americans, but 
the concept of reimportation has been criticized as compromising the 
Food and Drug Administration's (FDA) world-renowned gold standard for 
safety by opening the American market to foreign counterfeiters who 
will attempt to flood the market with fake drugs.
  This bill is simple in its approach. It would empower pharmacists and 
wholesalers to purchase FDA-approved medicines in Canada and pass the 
discounts along to American patients, and would let the experts at 
Health and Human Services (HHS) determine the best mechanism for 
allowing such imports while preserving the gold standard for safety.
  The discretionary authority granted to the Secretary of HHS would be 
subject to a few important requirements,

[[Page S3694]]

such as identification of the importer and the product, but would 
require the Secretary to promulgate regulations setting up a safe 
system for allowing the reimportation of prescription drugs as long as 
the importer has demonstrated, to the satisfaction of HHS, that the 
product being reimported is safe, and is the same product that is being 
sold in the United States at a higher price.
  Mr. President, I have said before and I will say again, this is not 
the only solution, and it may not be the best solution to this problem.
  I strongly believe we need to enact a broad prescription drug 
benefit, and I believe we need to find ways to encourage more insurance 
coverage for more Americans that covers the cost of drugs. But this is 
a positive, bipartisan measure that we can implement now that will 
bring prescription drug prices down for all Americans, and I encourage 
your support.
  Mr. WELLSTONE. Mr. President, I am very pleased to join Senator 
Jeffords, Senator Collins, and Senator Snowe as a cosponsor of the 
Medicine Equity and Drug Safety Act of 2000. As this bill demonstrates, 
concern about the high price of prescription drugs in this country is a 
bipartisan issue. Republicans, Democrats, and independents alike suffer 
from the unconscionable behavior of American drug companies who 
overcharge American consumers day in and day out, compared to prices 
they charge in every other country of the world. Americans regardless 
of party have a fundamental belief in fairness--and know a rip-off when 
they see one. This bill aims to end the rip-off, to end the choke hold 
that the pharmaceutical industry has on America's seniors.
  The Jeffords-Wellstone Medicine Equity and Drug Safety Act will make 
prescription drugs affordable for millions of Americans by applying the 
principles of free trade and competition to the prescription drug 
industry--without sacrificing safety. Senator Jeffords, Senator Snowe, 
Senator Collins and I have heard the first-hand stories from our 
constituents--in Minnesota, in Maine and in Vermont--constituents who 
are justifiably frustrated and discouraged when they can't afford to 
buy prescription drugs that are made in the United States--unless they 
go across the border to Canada where those same drugs, manufactured in 
the same facilities here in the U.S. are available for about half the 
price.
  This legislation provides relief from the price gouging of American 
consumers by our own pharmaceutical industry. This price gouging 
affects all Americans, but especially our senior citizens who feel the 
brunt of this problem more than any other age group because of the 
increasing number of prescription drugs we all will take as the years 
pass. Senior citizens have lost their patience in waiting for answers--
-and so have I. That is why I have joined Senator Jeffords in this 
bipartisan effort to allow all Americans to have access to prescription 
drugs at prices they can afford.
  While we can be proud of both American scientific research that 
produces new miracle cures and the high standards of safety and 
efficacy that we expect to be followed at the FDA, it is shameful that 
America's most vulnerable citizens--the chronically ill and the 
elderly--are being asked to pay the highest prices in the world here in 
the U.S. for the exact same medications manufactured here but sold more 
cheaply overseas.
  Pharmacists could sell prescription drugs for less here in the United 
States, if they could buy and import these same drugs from Canada or 
Europe. Now, however, Federal law allows only the manufacturer of a 
drug to import it into the U.S. Thus American pharmacists and 
wholesalers must pay the exorbitant prices charged by the 
pharmaceutical industry in the U.S. market and pass along those high 
prices to consumers.
  The legislative solution is simple. The bipartisan Medicine Equity 
and Drug Safety Act does two things: first, it allows Americans to 
legally import prescription drugs for personal use (which currently is 
allowed by FDA discretion), and more importantly, in the long run, it 
allows American pharmacists and wholesalers to import FDA approved 
prescription drugs into the United States for resale. Only drugs which 
have already been approved by the FDA for use in the United States 
could be imported for resale. Thus, the existing strict safety 
standards of the FDA will be maintained.
  Pharmacists and wholesalers will be able to purchase drugs at lower 
prices and then pass the savings along to American consumers. To assure 
safety, the bill requires the FDA to develop regulations to precisely 
track imported drugs and to issue any other safety requirements the FDA 
deems necessary. It is time to tell the pharmaceutical industry: 
Enough! It is an industry that controls competition to keep prices so 
high that prescription drugs become unaffordable for the average 
American. It is an industry that puts profits first and leaves patients 
to fend for themselves.
  What this bill does is to address the absurd situation by which 
American consumers are paying substantially higher prices for their 
prescription drugs than are the citizens of Canada, Mexico, and other 
countries. This bill does not create any new federal programs. Instead 
it uses principles of free trade and competition to help make it 
possible for American consumers to purchase the prescription drugs they 
need.
  In summary, this bill brings competition into the price of 
pharmaceuticals and extends the promise of America's medical and 
pharmaceutical research to every American. It deserves bipartisan 
support, and I am glad to say it has it.
  Ms. SNOWE. Mr. President, I am pleased to join Senators Jeffords, 
Wellstone, and Collins today as an original cosponsor of the Medicine 
Equity and Drug Safety Act of 2000.
  There is no doubt that providing access to affordable prescription 
drugs for American consumers is a very important policy issue. It seems 
that everywhere we turn--from ``60 Minutes'' to Newsweek--we are 
hearing stories that our nation's patients face dramatically higher 
prices for their prescription medication than do our neighbors to the 
North.
  In my view, a solution to the pressing problem of prescription drug 
coverage can't come soon enough. In 1998, drug costs grew more than any 
other category of health care--skyrocketing by 15.4 percent in a single 
year. And that's a special burden for seniors, who pay half the cost 
associated with their prescriptions as opposed to those under 65 who 
pay just a third.
  Seniors are reeling from the burden of their prescription drug 
expenses. The March/April 2000 edition of Health Affairs reports that 
the average senior now spends $1,100 every year on medications. And 
with the latest HCFA estimates putting the number of seniors without 
drug coverage at around 31 percent of all Medicare beneficiaries--or 
about 13 out of nearly 40 million Americans--it's not hard to see why 
we can no longer wait to provide a solution. In fact, nearly 86 percent 
of Medicare beneficiaries must use at least one prescription drug every 
day.
  Who are these seniors who don't have prescription drug coverage? Who 
are the ones traveling by the busload to Canada to buy their 
prescription drugs? They are people caught in the middle--most of whom 
are neither wealthy enough to afford their own coverage nor poor enough 
to qualify for Medicaid. In fact, we know that seniors between 100 
percent and 200 percent of the federal poverty have the lowest levels 
of prescription drug coverage. And these seniors who are just over the 
poverty level are the least likely to have access to either employer-
based coverage or Medicaid.
  But even Medicaid is not the answer. According to the Urban 
Institute, in 1996, 63 percent of beneficiaries eligible for QMB 
(Qualified Medicare Beneficiary) protections--that is, those under the 
federal poverty level--actually receive those protections, while only 
10 percent of those between 100 and 120 percent of the poverty level--
those eligible for SLMB (Specified Low-Income Medicare Beneficiary) 
protections--are receiving that coverage. And only 16 states--including 
my home state of Maine--have their own drug assistance programs.
  The high cost of prescription medications in the United States is 
forcing many of our nation's seniors to make unthinkable decisions that 
are harmful to their health and well-being. It is simply unacceptable 
that any person should have to choose between filling a prescription or 
buying groceries.

[[Page S3695]]

  It is fundamentally unfair that a senior in Maine, Vermont, or 
Minnesota must drive across the Canadian border to be able to afford to 
buy his or her prescription medications. And while it is illegal for 
Americans to go to Canada and purchase drugs to be brought back to the 
United States, we know that this happens on a daily basis.
  Mr. President, we are in a time of unparalleled prosperity. Almost 
daily, it seems, we learn of astounding new breakthroughs in biomedical 
research and in new prescription medications. And there is no question 
in anyone's mind that we have the best--the very best--health care in 
the entire world. But yet what does it say when our seniors are forced 
to go to Canada to purchase their prescription medications?
  Mr. President, the legislation introduced today by Senator Jeffords 
will allow Americans to legally purchase in Canada a limited amount of 
their medication for personal use. This will enable American patients 
to purchase their medications at the lower prices. In addition, 
pharmacists and wholesalers will be allowed to reimport prescription 
drugs that were made in the U.S. or in FDA-approved facilities.
  Mr. President, I support this bill and believe that Senator Jeffords 
has written a sound piece of legislation. But the fact of the matter is 
that addressing the issue of seniors crossing the border to purchase 
drugs is really only an interim approach--the real issue for America's 
seniors is the lack of comprehensive prescription drug coverage for 
Medicare beneficiaries.
  This is why last August I introduced the Seniors Prescription 
Insurance Coverage Equity (SPICE) Act, S. 1480, with Senator Ron Wyden 
of Oregon. Our plan will give seniors coverage options similar to those 
enjoyed by Members of Congress and other federal employees, through a 
choice of competing comprehensive drug plans. SPICE will prescribe 
prescription drug coverage for all Medicare-eligible seniors, with the 
federal government covering all or part of the premiums on a sliding 
scale.
  SPICE has the advantage of working with or without Medicare reform--
something I've heard time and again is important to seniors, because it 
means that they don't have to wait for meaningful prescription drug 
coverage. The SPICE gives us the best of all possible worlds--a system 
that can exist outside of Medicare reform, co-exist with a new Medicare 
regime when it comes, and actually serve as a downpayment on 
comprehensive reform.
  Mr. President, I am pleased to join Senator Jeffords as an original 
cosponsor of this bill. He has written a bill with the needs of 
American consumers in mind, and he is ensuring that Americans will have 
access to safe and affordable prescription medications while Congress 
works to devise a long-term solution to this very serious problem.
  Thank you, I yield the floor.
                                 ______