[Congressional Record (Bound Edition), Volume 147 (2001), Part 10]
[Senate]
[Pages 13609-13610]
[From the U.S. Government Publishing Office, www.gpo.gov]



                           PRESCRIPTION DRUGS

  Mr. DORGAN. Mr. President, in the coming days I suspect there will be 
appropriations bills and we will visit another issue we have visited 
previously in the Senate and also in the House, and that is the price 
of prescription drugs, especially those imported into this country from 
other countries.
  About a week ago, the Secretary of Health and Human Services decided 
that legislation which I and several of my colleagues drafted and was 
passed last year and became law would not be administered. It is a law 
dealing with the reimportation of prescription drugs into this country.
  The provision allows distributors and pharmacists to go to another 
country such as Canada, to access the same prescription drugs made in 
an FDA-approved plant and bring them to this country because it is much 
less expensive in Canada, and pass those savings along to consumers. 
That is what our legislation did.
  The Secretary of Health and Human Services under the previous 
administration and now under this administration said they could not 
certify, A, that it would be lowering costs for prescription drugs and, 
B, that it would be safe; therefore, they would not certify to that and 
would not implement the law.
  We are terribly disappointed by that. We think it was a mistake in 
the past administration to have made that decision, and we think last 
week it was a mistake for the Department of Health and Human Services 
to make that decision.
  We will revisit this issue, and there will be another vote in the 
Senate dealing with it. We will have to do it in a different way, but 
the principles are still the same.
  The same pill put in the same bottle manufactured by the same 
prescription drug company by the same pharmaceutical manufacturer is 
sent to Grand Forks, ND, and to Winnipeg, Canada--the same drug made in 
the same plant put in the same bottle made by the same company. The 
difference? Price, and in many circumstances a very big difference.
  One pays 10 times more for the drug tamoxifen, which is used to treat 
breast cancer, in the United States than in Canada. I happen to have in 
my desk--I have had several of them. These are two empty bottles. I ask 
unanimous consent to show these bottles in the Senate Chamber.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, this drug called Zoloft is used to treat 
depression, a very commonly used drug. The same pill made by the same 
company; one is marketed in Canada, one in the United States; $2.34 per 
tablet sold in the United States; $1.28 per tablet--same drug--sold in 
Canada.
  Let me make it more immediate. Emerson, Canada; Pembina, ND--5 miles 
apart. I took a group of senior citizens to Emerson, Canada. We left 
Pembina, ND, traveled across the border, and went to a little one-room 
drugstore in Emerson, Canada. The prices for the prescription drugs, 
for a whole range of prescription drugs that these senior citizens 
needed for heart disease, diabetes, and a whole series of ailments they 
had, in every circumstance, was much less expensive in Canada.
  Why is that the case? It is not just the case in Canada; it is the 
case in every other country in the world: Mexico, England, Italy, 
France, Sweden, the identical drug, produced in a plant approved by the 
Food and Drug Administration, in many cases produced in the United 
States, is sold for a much higher price here than any other country in 
the world.
  Why is that the case? Because the pharmaceutical industry can do it. 
They can impose whatever price they choose and they choose to do it in 
this country. The result is the American consumer is charged multiples 
of what the same pill is sold for or the same drug is sold for to 
virtually every other citizen in the world.
  We said if this is truly a global economy, there is trade back and 
forth, it is a global economy that ought to benefit everyone, how about 
making this a global economy with respect to the purchase of 
prescription drugs? Why should you not be able, if you are a pharmacist 
in Grand Forks, ND, to go to Winnipeg to access a supply of 
prescription drugs at a fraction of the cost and bring it back and pass 
the savings on to the customers? Why should you not be able to do it?
  At the moment, a law prevents it. The United States has a law that 
says the only entity that can bring a prescription drug into this 
country is the manufacturer itself. What a sweetheart deal that is.
  So we said, provided this is a drug that is approved by the FDA, 
provided for a chain of custody and safety of supply, our distributors 
and pharmacists ought to be able to go to another country to access the 
same prescription drug, made in the same plant, put in the same bottle, 
and come back and pass those savings along to the American consumers.
  So we passed a piece of legislation like that on the floor of the 
Senate with over 70 votes. It went to conference. After some laboring 
in conference, it became law. And then the Health and Human Services 
Secretary in both the last administration and this administration 
refused to administer it because they said they cannot demonstrate 
there will be, A, savings, and, B, they cannot assure the safety.
  Let's take part A, savings, first. This is not rocket science. I am 
happy to give the names of citizens from Fargo who can describe to the 
Secretary of Health and Human Services, either in the previous 
administration or this administration, that there is savings. They have 
gone to the one-room drugstore in Emerson, Canada, and saved the money 
on the prescription drugs. If you are going to pay half the price or a 
third of the price or a tenth of the price for the identical 
prescription drug, how on Earth can a Cabinet Secretary not compute 
that to be a savings? What nonsense is this? Of course there are 
savings, and substantial savings.
  Second, with respect to safety, we import a massive quantity of 
prescription drugs into this country from other countries with the 
pharmaceutical manufacturers doing the importing. What is the 
difference between that and having a licensed pharmacist or a licensed 
distributor access from a licensed pharmacy in Canada the identical 
prescription drug made in the identical plant, approved by the FDA, to 
bring back into this country to sell to American consumers at a reduced 
price? Why on Earth should someone have to go in the first place to a 
foreign country to find a reasonable price for a prescription drug that 
was made in the United States? That doesn't make any sense to me. So we 
passed that legislation and now it has been sidetracked because the HHS 
Secretary has refused to implement it both last year and this year.
  We will be back to revisit that and we will change the construct of 
it some. A group of Senators, including Senator Stabenow, Senator 
Collins, myself, Senator Jeffords, Senator Wellstone, and others, have 
worked very hard on this issue for a long period of time. There is no 
justification for the American consumer paying the highest prices for 
prescription drugs in this country. There is no justification for that.
  I have held hearings across this country as chairman of the 
Democratic Policy Committee in recent years on this subject. It doesn't 
matter where you are--in downtown Manhattan; I have held hearings in 
Dickinson, ND; hearings in Chicago; you hear the same story. The 
stories are from people 70 or 75 years of age. A woman testifies at a 
hearing, saying: I go into a grocery store and I must go to the back of 
the store first where the pharmacy is because when I buy my 
prescription drugs and pay for them, then I will

[[Page 13610]]

know how much money is left for food, if any.
  We hear that all the time. Or the doctor from Dickinson who did a 
mastectomy on a senior citizen and told her: Now, in order to reduce 
the chance of recurrence of breast cancer, you have to take these 
prescription drugs I will prescribe. And she asked how much they would 
cost. He told her, and she said: There isn't any way I can take the 
prescription drugs; I have to take my chances.
  We hear those stories in town after town. It doesn't matter what the 
State is.
  The fact is, prescription drug prices are higher in this country for 
the American consumer than they are anywhere else in the world. It is 
unfair. We ought to do something about it. My feeling is we ought to 
pass a piece of legislation we will offer once again this year and 
expect someone to implement that legislation as we enact it, that gives 
pharmacists and distributors and ultimately the American consumers--not 
just senior citizens, the American consumers--the opportunity in a 
global economy to access prescription drugs that are reasonably priced. 
They are reasonably priced in virtually every other country of the 
world but are overpriced here, often in multiples of prices as 
elsewhere for the exact same drug that was manufactured in this 
country.
  I wanted to offer a preview, again, of this issue to say we won last 
year, passed legislation that became law, and HHS refused to implement 
it. But we are not giving up. This is the right thing to do for the 
right reasons. We say to the American people who struggle to pay the 
prices, there is a way to make the global economy work for you and 
allow, through your pharmacist or distributor, a personal amount of 
prescription drugs, to access those prescription drugs in Canada or 
elsewhere.
  Ultimately, my goal is not to ask someone to go elsewhere to buy 
drugs but to force the pharmaceutical industry to reprice the drugs in 
this country so our consumers get a fair price as well.

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