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February 21, 2005

General Assembly Journal 2005 Part 6

Richard B. Weldon Jr.

Last Tuesday was "drug day" in the Health and Government Operations Committee. The bill-hearing schedule for that day included six bills related directly to prescription drugs, including three bills on re-importation.

Re-importation is the catch phrase for purchasing pharmaceuticals from Canada for ultimate use in this country.

Currently, federal law prohibits the re-importation of prescription drugs. The federal Food and Drug Administration has been fairly specific in their objections, even while some states and lesser subdivisions enact laws designed to circumvent the FDA position.

Here's my "balanced" policy analysis:

In favor of re-importation Boston, San Francisco, Minnesota, Wisconsin, and the District of Columbia have already embarked on a similar program. Some of these jurisdictions believe they'll have savings that could result in a substantial percentage of their total program, although none have seen the scope of savings that they had projected. Proponents have argued that many of the drugs are already manufactured overseas anyway. They also argue the savings could be significant, comparing several specific drugs:

DrugCommon DosageUS CostCanadian Cost
LIPITOR20mg/30 tablets$107.99$73.38
PLAVIX75mg/60 tablets$227.98 $151.16
PRILOSEC20mg/30 pills$134.99$85.51
ZOCOR20mg/30 tablets $129.99 $57.42
TOPROL XL100mg/90 tablets $110.99$36.58

So there would be savings! Even if the savings were inflated, lower drug costs WOULD result. Lower drug costs translate into either more drugs purchased or more health care services for those without health coverage. Labor unions, religious groups, the AARP, and health care providers for low income Marylanders have all testified in favor of this legislation. If we spend hundreds of millions in prescription drugs, and the savings represents 20-30%, we're talking about enough in savings to bring thousands into drug coverage who are currently not covered.

Opposed to re-importation There are several arguments against re-importing drugs, and they can be broken down into three groups.

  1. Safety Re-importing drugs from Canada removes the safeguards throughout the drug distribution chain. Using the Internet or the protections of another government bypasses the built-in protections created by the federal FDA.

  2. Research and Development Part of the cost paid by the American drug consumer covers the cost of research and development (R&D), which is then re-invested into R&D on new drugs. By comparison, Canadian consumers pay almost no R&D cost, and hence see almost no benefit from new products coming into the marketplace (unless they come from R&D investment paid by an American consumer). Removing that R&D price recovery would have a chilling impact on new R&D, jeopardizing emergence of new drug breakthroughs.

  3. Violation of federal law Currently these individual jurisdictional agreements violates federal law. The fundamental argument goes back to the safety issues outlined above. This matters because every state depends on federal healthcare spending, particularly through the Medicare/Medicaid program. No state can afford to jeopardize these dollars.

That's as fair as I can make it, and it hopefully demonstrates to you the policy complexities and differences.

I gave you the straight policy debate, but it's never that simple. Now you need to get the political perspective.

The Maryland Chamber of Commerce views these bills as very bad. They have taken a position in opposition, and have made it clear that a vote in favor of re-importation will be considered a vote against the interests of business in Maryland.

Remember a few months back when I wrote about Gov. Robert Ehrlich and business "getting dangerous?" The Governor had challenged the business community to keep track of how legislators vote on issues important to the business community.

On the other hand, advocates for low-income citizens, union workers, and the active elderly have made it very clear that they will make an issue of a legislator who votes against their interests.

Their members vote and they'll use their influence to impact those members.

So, where am I? Good question! I am struggling with the idea that a state, any state, would take a legislative action that conflicts with federal law.

I see two really big problems with this approach. One, I'm concerned about the impact of this legislation if pharmaceutical manufacturers decide to reduce or eliminate their research programs.

Canadian citizens, and others around the world, benefit directly from our investment in R&D. Some of that money comes from the "profit" the drug companies receive from the cost of prescription drugs.

Imagine a world where research into new cures for cancer, AIDS, and muscular degenerative diseases, etc., is reduced because drug companies see a drop off in the very funding that pays for these efforts.

Another component of the economic argument is the proliferation of pharmaceutical research investment on the 270 corridor. Local companies like MedImmune, Dynport, and Life Sciences are working in our community, employing our neighbors in the study and testing of long-term solutions to these problems.

I'll keep an open mind, and rest assured that the policy side of the argument will trump the political implications. I don't really care what the groups who threaten political pressure say, as evidenced by many of my votes.

Besides, I'm on a special workgroup that will be working on this, so keeping an open mind is essential. More will be forthcoming in the weeks ahead. Stay tuned!

* * * * * * * * * *

Senate President Mike Miller (D., PG/Calvert) and the House and Senate leadership team have found a way to remove partisan politics from state government processes.

Here's the background story: Governor Ehrlich was elected in 2002, in spite of the strong desire of Maryland Democrats to retain their 36-year hold on the Governor's Mansion.

During the course of the last two and a half years, Democrat's longing to see the moving vans pull up in front of Government House (the official name of the mansion) has attacked just about every policy move attempted by the Ehrlich Administration.

The proposed sale of state-owned land in southern Maryland and the attempt to remove State Elections Board Supervisor Linda Lamone are just two examples of perceived diminutions of power previously held by the Democratic Party.

The County Commissioners in St. Mary's County wanted the land sold to a developer in exchange for a school site, which would have saved them the cost of the purchase of the land.

On the Election Board issue, the State Board, with Ehrlich appointees in the majority, had decided to seek the removal of longtime Supervisor Lamone. This wasn't just a casual thing. There was a great deal of dissatisfaction expressed by county elections boards.

Unfortunately (for Ehrlich) Ms. Lamone is a favorite of the Democrat leadership in spite of serious concerns from the locals.

With this backdrop, Senate President Miller and the All Stars of Ehrlich-bashing (names like Speaker Mike Busch, Del. Peter Franchot, Sen. Brian Frosh, and now local Frederick County Delegate Galen Clagett) have proposed the solution to politics impacting state government.

They are now suggesting (through legislation, of course) that the way to remove partisan politics is to INSERT THE MARYLAND GENERAL ASSEMBLY INTO THE PROCESS!

Wait just a minute. Have we completely lost our collective minds? How in the world does inserting General Assembly oversight into the process remove partisan politics?

The way they propose doing this is interesting in itself. In the case of the land sales, General Assembly committees would be involved in assessing the public disclosure and assuring an open process.

No one could EVER doubt the integrity of a General Assembly Committee, right? These are the same committees that regularly, routinely violate the intent of the State Open Meetings Act by holding secret meetings to determine which bills the chairmen want passed or killed. The same committees that hold weekly voting sessions behind closed doors, so members don't have to be held to account for their comments.

Oh, wait a minute. That last statement wasn't fair or accurate. It isn't fair to hold the General Assembly committees accountable to the Open Meetings Act because the regulations contained therein simply don't apply to the legislature.

That's right, the State Open Meetings Act, intended to make government process open and fair for all, simply doesn't apply to the committee process in the General Assembly.

How's that for fair!

Regarding the State Elections Board, the non-political solution is to pack the new Elections Commission with members that are appointed by Democrats. The new 12-member Commission in the bill being pushed by the Democrats would have ONE member appointed by an Ehrlich ally, Secretary of State Karl Aumann.

Even Common Cause, not an Ehrlich advocacy group by any stretch of the imagination, strongly opposes the change. Their executive director was quoted saying "the cure is worse than the disease."

You know, I wouldn't mind it at all if the Democratic leadership of the House and Senate were to say that they want to change Maryland law to make it harder for Governor Ehrlich to get re-elected.

At least then they'd be intellectually honest.

Yellow Cab
The Morning News Express with Bob Miller
The Covert Letter

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