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City looks to get drugs via Canada

Menino to tout pilot program as cost-saving

Beginning next July, Boston plans to import prescription drugs from Canada for thousands of city workers and retirees, under a cost-saving proposal Mayor Thomas M. Menino will announce today.

The pilot program, outlined in remarks scheduled to be delivered at a City Council hearing, would probably shave about $1 million a year off the city's $61 million prescription drug bill, according to city estimates. The savings are expected to be relatively small at first, because the program would be voluntary and cover a limited selection of medicines.

Menino asserts in his comments, which were obtained by the Globe, that importing medications is safe, although the federal Food and Drug Administration has repeatedly cautioned that it cannot ensure the safety of drugs brought in from Canada and importation remains illegal.

The agency, however, has not tried to stop Springfield, the first and only US city to turn to Canadian pharmacies to fill the drug orders of its employees. Mayor Michael Albano figures the five-month-old policy has already cut by $750,000 the $18 million the city spends on prescription drugs for its workers, retirees, and their dependents.

Menino's move comes as US pharmaceutical companies find themselves increasingly under fire because their drugs cost more in the United States,, and as thousands of Americans look to pharmacies north of the border to fill prescriptions for everything from asthma to heart disease.

Much like Albano, Menino intends his initiative to be as much political as financial, hoping to embarrass regulators and the drug industry into lowering prices.

"The pharmaceutical manufacturers should be more sensitive to consumers' needs," Menino will say in his address to the City Council this afternoon. "If they are not, then the federal government needs to take responsibility for making sure that all Americans can afford to fill their prescriptions and take the medicines prescribed by their doctors."

Boston's approximately 15,000 workers and retirees have their health-care costs covered through one of two mechanisms: either they belong to an outside health plan, the choice of most current employees, or their bills are paid directly by the city. It's the latter group, numbering about 7,000 and constituting mostly retirees, that would initially have the option of getting drugs from Canadian pharmacies. About half of the $61 million total spent annually on prescriptions goes toward members of that plan.

Calculating how much could be saved by buying drugs through Canada is tricky, because not all drugs are available from the Canadian suppliers and the medicines that are stocked typically treat chronic conditions such as high blood pressure rather than acute illnesses, city officials said.

Drugs that are available from Canada would probably cost the city 20 percent to 40 percent less than what it currently pays for those medications from US pharmacies, a city official estimated last night. That official, who requested anonymity because the mayor's plan has not yet been made public, said conservative projections show an initial savings of $1 million. If the pilot program proves safe and cuts drug spending, it could be expanded to all city workers and retirees, but that would require approval by the private health plans that cover most city workers.

"This isn't a panacea for the City of Boston, and it isn't a panacea for citizens at large," the city official said. "The real issue is overall pricing, and this is a mechanism for shining a light on the issue of pricing."

Cost is at the heart of the growing movement by both public entities and private citizens to circumvent federal law and import drugs from Canada.

That practice remains illegal, although Congress has instructed the Department of Health and Human Services to review whether drugs can be safely imported from Canada. For now, the FDA continues to voice fears about the ability to ensure quality when medicines come from outside the country.

"The unknown concerns us -- where these things are being made, how they're being shipped, how they're being stored," said Tom McGinnis, director of pharmacy affairs for the FDA.

"In the United States, we have authority over all of those things. Outside the United States, we don't have authority."

The pharmaceutical industry has assailed campaigns to bring Canadian drugs into the United States, citing safety concerns that it says have been validated by US health agencies under both the Clinton and Bush administrations.

Wanda Moebius, a spokeswoman for the leading industry trade association, the Pharmaceutical Research and Manufacturers of America, said last night that Menino would better serve his constituents by alerting them to alternative methods for getting medication such as programs run by pharmaceutical companies to aid patients who can't afford their drugs.

"There are people who have problems paying for prescription drugs, and we understand that," Moebius said. "But there are more responsible ways to help those people than to flout the law and flout safety and encourage people to get their prescription drugs from what purports to be Canada."

Albanohailed Menino's plan yesterday.

"Not only is it good for Boston, but this will send shockwaves around the country," Albano said. "There's a little bit of a difference when a city like Springfield, Mass., does something and when Boston, Mass., does it."

Stephen Smith can be reached at stsmith@globe.com.

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