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MEDICINE | HEALTH MATTERS

Boycott campaign calls attention to the high cost of drugs

March 17, 2003|Trudy Lieberman | Special to The Times

If Pedro Rodriguez has his way, millions of Americans will boycott Aquafresh toothpaste, Tums tablets and other consumer products sold by Glaxo- SmithKline. Rodriguez, a community organizer with Action Alliance of Senior Citizens in Philadelphia, is coordinating what the group hopes will be a national boycott of Glaxo products in protest of the pharmaceutical company's decision to curtail shipments of its drugs to Canada.

Glaxo announced that action in January, saying it was worried about the safety of drugs bought by U.S. citizens through Canadian Internet pharmacies, as well as assuring adequate supplies of products for Canadian patients. Glaxo said it would sell only enough medicine in Canada to meet market demand.

During the last few years, Canadian-based Internet companies have done a brisk business in sales of drugs to U.S. consumers seeking to buy less-costly medications.

By some estimates, drugs can cost up to 80% less in Canada than in this country.

While Canadian pharmacies have provided lower-cost medicines, some of these Internet sites are loosely regulated, and there are concerns about consumers getting tainted or counterfeit drugs.

The U.S. government actually forbids sales of foreign drugs directly to patients in the United States, but the law is not often enforced.

"For Glaxo to tell seniors where and at what price they should buy their prescriptions is extremely offensive," Rodriguez says.

He adds that his organization wants the boycott to be a political catalyst that sends a message to Washington to pass a drug benefit for Medicare recipients.

The boycott is a very public reaction to U.S. drug prices that are among the highest in the world.

It also reflects a growing frustration, acutely felt by older Americans and those who lack health insurance, about unaffordable drug costs.

Medicines, of course, consume a much larger share of the incomes of chronically ill people than grapes or lettuce -- the targets of well-publicized consumer boycotts years ago. You can live without lettuce and grapes, but if you need Avandia to control your diabetes, you can't get along without it.

Manny Morry, a pharmacist and owner of the Internet pharmacy Canadameds.com, says a 90-day supply of Glaxo's Avandia costs about $252 in Canada and about $374 in the United States. It's no wonder that many Americans have done what savvy consumers do: find ways to buy what they want or need at the lowest price.

"Allowing people to buy drugs in Canada is a safety valve," says Alan Sager, a professor of health services at Boston University and an expert on the pharmaceutical industry. He believes that drug makers' interests might be better served by permitting the sales through Internet pharmacies. Without such outlets, consumers would have even more reason to pressure Congress to address the issue of Medicare drug benefits and soaring drug costs -- and that maylead to government price controls, which drug makers oppose.

It's hard, however, to make a boycott succeed. Glaxo spokeswoman Nancy Pekarek said the company has not felt the financial effects of the boycott.

"Glaxo's primary motive for restricting supplies is not financial," Pekarek said. "It's a question of legality and patient safety." When asked for examples of U.S. consumers being harmed by tainted or counterfeit drugs from Canada, Pekarek said that "official evidence is somewhat lacking."

To transform the boycott into a significant economic force, supporters will have to get many people, including doctors, pharmacists and wholesalers, to agree not to sell or prescribe Glaxo products, says Marshall Ganz, a lecturer at Harvard University's Kennedy School of Government who has studied consumer boycotts. There are a few small signs of such support. Doctors at the Access Medical Group in Marina del Rey recently vowed to support the boycott against Glaxo by prescribing, for example, antidepressants other than Glaxo's Paxil.

So far there are plenty of alternatives to Glaxo products. But if other drug makers follow Glaxo and restrict Canadian supplies, that could make it hard for the boycott to work. It's not clear whether they will do that. A lot depends on drug company lawyers' interpretation of antitrust laws.

Drug maker Merck's Canadian subsidiary sent a letter to its wholesalers last summer reminding them that products made in Canada were not intended for the U.S. market, but the company has not cut off supplies. Merck spokesman Chris Loder says the company is monitoring the issue.

Ultimately, the boycott may help raise awareness of the struggles of millions of Americans in affording the medications they need.

Canada tackled that problem years ago. Canada's Patented Medicine Prices Review Board sets the prices of all government-approved medicines as they leave the factory gate, although it does not regulate wholesale or retail prices.

The process has resulted in drug prices that are about 40% to 80% cheaper than in the United States. And that's why Americans keep looking north to buy their drugs.

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Trudy Lieberman can be reached by e-mail at trudyal530@aol.com.

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