Why 'we get it' about personal importation

 In a news story about the launch of the Center for Safe Internet Pharmacies (CSIP), the lead in Fierce Pharma Manufacturing, a well-respected news email about the pharmaceutical industry, noted that  “An organization set up lastyear by some of the largest Internet and credit card companies to fight the  scourge of illegal pharmacies selling counterfeit drugs thinks consumers just don't get it.”

Having had more than five decades of experience in communications, and having worked for 12 years on behalf of the right of Americans to engage in personal importation of safe, affordable brand-name medicine from Tier One countries, whose standards of safety and efficacy meet or exceed those of the U.S, I had a sense of, as Yogi Berra used to say , “Dejavu all over again” as I read the statement.

The comment is one that I have heard many times from smug Beltway personalities who believe that Americans outside the Beltway simply lack the intelligence, common-sense and ability to act in a responsible manner to understand what policy-makers don’t, i.e., that personal importation is still the best option available to curtail Pharma (the industry) and PhRMA (its trade association) from making the U.S. even more of a safe haven for the highest prescription medicine prices in the world.

My favorite example was some time ago at a meeting of Former Speaker of the House (and later failed GOP Presidential candidate) Newt Gingrich’s ambitious Center for Health Transformation start-up in Missouri.

After the meeting, I asked his Chief of Staff about the role of personal importation and why the group did not support it as a means of deterring the major price driver of health care costs in the U.S.—rising, unaffordable prescription medicine costs. 

She smiled at me and answered, very condescendingly:  “We don’t want our poor seniors dying like all those pets whose food was contaminated by tainted ingredients from Chinese plants.”

My response: “Do I look like I fell off the turnip truck yesterday?  I asked you a legitimate question about healthcare policy and you talk to me about dog food—which, by the way, many seniors have eaten because they couldn’t afford their medicines!”

She walked away, never to be seen again (at least by me).

But, her spirit, like Marley's ghost , still wanders the earth.  The opening paragraph from the Fierce Pharma Manufacturing article was its latest incarnation.

I must point out that I am not critical of FPM since I am sure its comment merely reflected the fallacy of Pharma’s claims about the ability of Americans to act in a responsible manner when it comes to distinguishing clearly bogus sources of medicines from legitimate sources.

And, despite what the source of the comment about Americans “not getting it,”  I want to assure CISP that, yes we do:

• ·         We get it that prescription drug prices in the U.S. are the highest in the world, as much as 60 percent more than the same drug in Tier One Countries;

• ·         We get it that the medicines that PhRMA would deny access to are the very samemedicines manufactured in FDA-approved facilities, usually in plants outside the U.S.  and then given a different label to meet U.S. requirements (language, etc.) to be sold at tremendous markups to U.S. citizens;

• ·         We get it that PhRMA has an undue and troubling influence in healthcare policy, to the extent of dictating policy behind closed-doors to even the President of the United States;

• ·         We get it that dozens of members of the House of Representatives and the U.S. Senate receive millions of dollars from the pharmaceutical industry;

• ·         We get it that it was the necessity of untold numbers of Americans not being able to afford their prescription medicines more than 12 years ago that led to bustrips into Canada where suddenly Grandma became a ‘drug smuggler’ bringing back safe, affordable medicines from Canadian pharmacies, a situation that led to the rise of Canadian pharmacies establishing the online pharmacy business;

• ·         We get it that the answer was a flawed Part D Prescription Drug program in which seniors had to pay for insurance, pay high deductibles, and then after receiving their benefit, were forced into the so-called ‘Doughnut Hole’ in which they had to pay again for their medicines PLUS paying for their insurance ‘coverage,’ all thanks to the last-second efforts of Rep. Billy Tauzin (D-LA 3) to insertprovisions favorable to and dictated by PhRMA and its members (His reward?  He resigned from Congress and accepted the role of the head of PhRMA at a salary of $2 million per year.  Now, what do you think he ever did that made him worth that much to the industry?);

• ·         We get it the Pharmaceutical industry is considered by many the most corrupt inthe U.S.

• ·         We get it that as the industry claims to tout safety, many of its leading members continue to be found guilty of unsafe practices.  The most recent notable example is the travails of GlaxoSmithKline (GSK), which settled a Department of Justice action for  $3 BILLION!  (For the sake of transparency, at the above referred-to meeting of Newt Gingrich, I met with a director of state legislation for GSK who expressed an interest in outreach to seniors and establishing communications on the role of personal importation. We exchanged several emails regarding how that might be accomplished, since I believed that expanded personal importation could actually be of benefit to Americans by lowering prices, with the expanded use of affordable medicines by Americans actually being beneficial to the industry itself.  Needless to say, the conversations went nowhere, because, as my contact noted, ‘I had said some pretty rough things’ about industry practices. Based on the recent DOJ experience, perhaps GSK should have listened to me.)

• ·         We get it that the FDA has been charged by many as being instrumental in the shortage of vital medicines that has led to opening new opportunities for gaps in the worldwide supply chain to be exploited by counterfeiters.  (Ironically, the latest example of this, the entry of counterfeit Avastin, a cancer-treating drug, into the American supply, actually was detected and uncovered.  The leakage did not involve an internet pharmacy, although the wholesale operations of Canada Drugs, a leading Canadian internet pharmacy, were involved, and opponents have attempted to seize the situation to disparage the ability to guarantee the safety and efficacy of personally imported medicines.)

• ·         Weget it that safety is of primary importance, and that geography does notguarantee safety for those such as the Kansas City pharmacist, who was licensedby his state Board of Pharmacy, diluted vital cancer medicines for years beforebeing discovered in 2001;

• ·         Weget it that  Pharma’s hands are not ‘clean’in such matters.  In 2011, the offending pharmacist had a $2.2 billion judgment against him, and, significantly, EliLilly and Bristol-Myers Squibb, settled charges that they were negligent out of court;

• ·         We get it that the FDA has for years worked to scare Americans either by the use of the intimidation of seniors such as was done in the infamous use of Customs to seize medicines and then demand that the elderly sign letters admitting totheir ‘guilt’ and pledging to not engage in personal importation again, and now, with the launch of CSIP, a ‘public service announcement’ in which a youthful caregiver is concerned that prescription medicines ordered on the internet might kill Grandfather unless they are from a pharmacy ‘approved’ by CSIP;

• ·         We get it that responsible legislators from both political parties including but notlimited to Senators McCain, Vitter and Snowe on the GOP side and Dorgan, Nelson of Florida, Brown of Ohio, Franken and Klobuchar of Minnesota, and even that lovable old Socialist Bernie Sanders have long supported personal importation legislation,only to have it denied by secret deals of the Obama administration with PhRMA,or Poison Pill ‘certification’ requirements.

• ·         We get it that in 2008, then-candidate Obama pledged that he would support personal importation, and then as President Obama, switched his position to prevent PhRMA from mounting a Harry and Louis-type campaign of the type that killed HillaryCare and that the President feared would deal a death-blow to ObamaCare;

• ·         We get it that U.S. prescription medicine prices continue to increase at a rate greater than inflation and are a major driver of the health-care cost crisisthe country faces;

• ·         We get it that Pharma supporters in Congress have tried repeatedly to co-opt legislation regarding intellectual property rights with the insertion of Pharma-driven (and written or directed) sections that would have claimed infringement of copyrights and intellectual property of Pharma, with the unintended consequence of damage to the health and well-being of untold numbers of Americans who wouldlose their access to vital medicines, a factor in the flawed bills that led totheir overwhelming defeat;

• ·         We get it that untold numbers of Americans have safely purchased their medicines viapersonal importation, and their communities and families have benefitted fromtheir enhanced health and well-being;

• ·         We get it that even with a host of governmental programs, millions of Americans are still not able to afford their medicines;

So to our new-found ‘friends’ at CSIP, welcome to the fold.  IF you stick to farrowing out the truly bogus pharmacies, we applaud you.  IF you try to confuse the issue with attacks upon the concept of personal importation, we urge you to be truthful about your real goals.  But don’t think that we don’t get it or that we won't get it..  As I said, we didn’t fall off the turnip truck yesterday.