To: Lane3 who wrote (15696 ) 11/9/2003 5:34:10 AM From: LindyBill Respond to of 793625 Drug discount maze By Alan Reynolds THE WASHINGTON TIMES Alan Reynolds is a senior fellow at the Cato Institute and a nationally syndicated columnist. When something valuable sells for two different prices, how do you stop people from paying the lowest price? And why would you want to do that? Congress is debating whether to allow Americans to buy prescription drugs from other countries, notably Canada. Many Americans already do that, of course, so the issue is really about making it either easier or more difficult to do what is already being done. Several governors want to make it easier. I recently received an e-mail asking me to add my name to a letter signed by some prominent economists. It says allowing U.S. citizens to buy drugs from Canada or Europe amounts to adopting their price controls. But one could just as well say that it amounts to taking advantage of the discounts pharmaceutical companies choose to offer to some big buyers — including the U.S. government and HMOs. Unfortunately, deep discounts create powerful incentives for arbitrage. To sustain the wide gap between U.S. and Canadian drug prices therefore requires high enforcement expenses. There is no reason U.S. federal and state governments should bear those expenses just to give Canadians a bargain. The complaint about "importing price controls" assumes that the actual effect of greater drug imports would be to drop U.S. drug prices to the Canadian level. But that could happen only if drug companies were willing to ship tons of drugs to Canada. In reality, several major drug companies have already moved to restrict sales to Canada to limit that country's ability to re-export. If that does not work, the Canadian government will have to step in and try to restrict re-exports to the United States. If the drug companies or Canadians manage to keep cheaper drugs from being arbitraged back into the U.S. market, then officially sanctioning reimportation would have little impact. But if U.S. shoppers instead contribute to critical drug shortages in Canada, the Canadian government would have no practical choice but to ease up on price controls. To presume the adjustment can only take the form of lower U.S. prices seems presumptuous. Another overblown rationale for prohibiting U.S. citizens from bargain-hunting is that there is supposedly a much greater danger of being sold counterfeit drugs. Here is what the Food and Drug Administration (FDA) Web site says about that: "Counterfeits may enter the U.S. distribution system from within the U.S. or from other countries.... The FDA has seen two highly publicized examples of counterfeit Lipitor and Procrit within the U.S. distribution system." Health Canada warns that Lipitor drugs "are counterfeit if they contain packaging or labeling that states: 'Repackaged by: Med-Pro Inc., Lexington, Neb 68850.'" The largest U.S. drug wholesaler, Amerisource Health Corp, is also under FDA and FBI investigation for allegedly being involved with counterfeit domestic drugs. REST AT dynamic.washtimes.com