State Rep. Frank LaGrotta – 11/8/04

This page was last updated on November 16, 2004.

LaGrotta: Pa. should allow residents to buy prescription drugs from Canada or U.K.; State Rep. Frank LaGrotta (D-10); November 8, 2004.

No one wants to pay more for anything than they have to, including me. That said, I believe some of our legislators are trying to use the price of prescription drugs for no more than personal political gain.

When you read my comments below you may conclude I oppose allowing PA residents to purchase prescription drugs from wherever they please. That would be incorrect. Indeed, I even investigated purchasing my own prescription from Canada. In the case of my prescription, I found the small price difference didn’t justify the hassle. Of course, that’s not true for all prescription drugs. If any PA laws prohibit PA residents from buying prescription drugs from wherever they please, H.B. 2971 would make sense. That said, any benefits might be short-lived given that a movement is already underway in Canada by groups representing Canadian seniors, pharmacies, and patients to ban prescription drug exports.

The point of this piece is to expose the bill and its simplistic view of a more complex problem.

Below you will find the following:

· Critiques of a recent news release from Mr. LaGrotta’s office, an e-mail reply from Mr. LaGrotta’s office, and a Beaver County Times article on this topic.

· An e-mail trail of communications I had with Mr. LaGrotta’s office.

“HARRISBURG, Nov. 8 – State Rep. Frank LaGrotta, D-Lawrence/Beaver/Butler, is co-sponsoring legislation (H.B. 2971) that would allow Pennsylvania residents to purchase prescription drugs from pharmacies in Canada or the United Kingdom.”

[RWC] Unless there is a Pennsylvania law prohibiting PA residents from purchasing prescription drugs from wherever they please, I believe H.B. 2971 is no more than a political stunt. When I asked Mr. LaGrotta’s office to identify the PA law to be repealed by H.B. 2971, I received talking points and Bush bashing instead (see below). I interpret that to mean no PA law prohibits PA residents from purchasing prescription drugs from wherever they please. There are FDA regulations, but I don’t believe state laws can override them.

On a side note, I don’t know what “co-sponsoring” a bill means. Mr. LaGrotta is not listed as one of the legislators who introduced the bill. If bill sponsors exist, the General Assembly legislation web site doesn’t appear to identify them.

“‘Prescription drug prices have become so inflated over the past few years; Pennsylvanians really should have the opportunity to shop around for the best prices,’ said LaGrotta. ‘As far as safety concerns go, the FDA has never given proof that prescription drugs from Canada or the U.K. are more dangerous than those purchased in the U.S.’

[RWC] Anyone care to guess who would be one of the first to attack the FDA if a PA resident were to be harmed by an unapproved imported prescription drug?

“According to LaGrotta, other states have already taken steps to allow residents to buy their medications from other countries. Last month Illinois, Missouri and Wisconsin enacted a collaborative program that saves residents thousands of dollars a year by allowing them to order from prescreened, approved pharmacies in Canada and the U.K.

“‘The fact of the matter is that patients in these countries haven’t been hit with an epidemic of tainted medications,’ said LaGrotta. ‘Prescription drugs are often in manufacturer-sealed containers, essentially eliminating the possibility of tampering or counterfeiting.’”

[RWC] Consider this. Because of demand from U.S. customers, Canadian pharmacies are now turning to wholesalers around the world to fill prescriptions. In July 2004, Customs seized prescriptions ordered from Canadian pharmacies but shipped from the Bahamas.¹

The comment about little possibility of tampering or counterfeiting is naïve. One of the things that makes distributing pirated movies, software, et cetera so easy is that packaging is easily duplicated. There’s no way for the consumer to tell the difference between authentic containers and counterfeit containers.

“‘If Pennsylvanians can get safe medications at a lower cost in Canada or Europe, I think it’s only fair that they be allowed to. Perhaps that will discourage pharmaceutical companies from overpricing the medicines they market in the U.S.’”

[RWC] What is “overpricing?” Any company has a responsibility to seek a price that maximizes the company’s profit. In my mind, overpricing is when you charge so much the decreased demand more than offsets the higher unit price. I suspect Mr. LaGrotta’s definition differs from mine.

1. Drugs from Canada seized; Julie Appleby; USA Today; September 17, 2004.

Following is a critique of a newspaper article on this topic.

LaGrotta: Let people get prescription drugs from Canada, U.K.; Amanda Gillooly; Beaver County Times; November 11, 2004.

“ELLWOOD CITY - Six years ago, state Rep. Frank LaGrotta’s parents paid $7 a month for health insurance with prescription coverage. Now, they pay $1,100 every other month for the same thing.

“‘You do the math,’ he said.”

[RWC] Because we don’t know the circumstances of Mr. LaGrotta’s parents, we don’t know if the alleged premium difference is an apples-to-apples comparison. For example, were the parents covered by an employer’s program six years ago but now must purchase coverage on their own? Is the coverage the same? Also, how much of the premium is dedicated to prescription drug coverage? The article doesn’t say.

“LaGrotta, D-10, Ellwood City, said the single-biggest complaint he hears from his constituents is the high cost of prescription drugs.

“The complaints - and his own personal experience - led him to co-sponsor a bill introduced Monday that would allow Pennsylvanians to buy drugs from Canada and the United Kingdom by mail, telephone or from the Internet.

“The bill was referred to the Health and Human Services Committee Tuesday where it will be reviewed, according to LaGrotta’s office. A spokeswoman for his office said LaGrotta is also asking for a public hearing.”

I don’t know what “co-sponsoring” a bill means. Mr. LaGrotta is not listed as one of the legislators who introduced the bill. If bill sponsors exist, the General Assembly legislation web site doesn’t appear to identify them.

“‘It’s absolutely sinful that this country doesn’t allow that,’ he said. ‘It’s the same medicine sold in this country, but it’s just so much cheaper.’”

[RWC] This is a very sweeping claim with no supporting evidence mentioned in the article. If Mr. LaGrotta has that proof, it should have been presented. Otherwise, Mr. LaGrotta’s comment is opinion, not fact. Without proof, I believe it’s not in the best interest of PA residents to make safety claims about imported prescription drugs.

“LaGrotta said other states have already taken steps to allow residents to buy their medications from other countries. Last month, he said, Illinois, Missouri and Wisconsin enacted a collaborative program that saves its residents thousands of dollars a year by allowing them to order from prescreened, approved pharmacies in Canada and the United Kingdom.”

[RWC] The alleged collaboration program would help – but not fully – address safety concerns, but there’s nothing like this mentioned in the bill. H.B. 2971 simply states, “A resident of this Commonwealth shall have the right to purchase pharmaceutical drugs directly or through mail order from a pharmacy in Canada and the United Kingdom, provided that the resident has a valid prescription and uses the prescription drugs solely for personal use.”

“The Food and Drug Administration and the Pharmaceutical Research and Manufacturers of America have protested such legislation, saying drugs imported from other countries may be unsafe.

“‘We have serious safety concerns,’ PhRMA spokeswoman Wanda Moebius said, adding that the FDA has yet to certify drugs that are imported.

“She said that because of that, the group also has liability concerns, considering that many such programs require prescription-seekers to sign waivers disallowing them from pursuing civil or criminal action if something goes wrong.

“LaGrotta, however, disagreed.

“‘No one has shown me that these drugs are unsafe or counterfeit,’ he said, adding that most drugs come in manufacturer-sealed containers. ‘The only difference between drugs here and drugs there is that it is cheaper.’”

[RWC] Mr. LaGrotta appears to believe “manufacturer-sealed containers” provide protection against unsafe or counterfeit drugs. One of the things that makes distributing pirated movies, software, et cetera so easy is that counterfeiters can easily duplicate legitimate packaging. There’s no way for the consumer to tell the difference between authentic containers and counterfeit containers.

Indeed, counterfeit drugs received in counterfeit containers fool even pharmacists. That’s why the FDA is working with drug manufacturers to employ RFID tags to track authentic drugs from the manufacturer to the pharmacy.² Theoretically, RFID tags will make it more difficult for counterfeiters to fool wholesalers and pharmacies. Even if it works, though, it only provides assurance to the pharmacist. There’s no way for the consumer to know if the pharmacy filled a prescription with counterfeit drugs.

Anyone care to guess who would be one of the first to attack the FDA if a PA resident were to be harmed by an unapproved imported prescription drug? Finally, we have the same sweeping claim about safety Mr. LaGrotta made above.

2. Radio tags to vouch for drugs’ legitimacy; Julie Appleby; USA Today; November 15, 2004.

Below is the e-mail trail from when I asked for clarification about Mr. LaGrotta’s news release.

From: Robin Cox

Sent: Tuesday, November 09, 2004 3:53 PM

To: Goldberg, Laura [Ms. Goldberg was listed as the contact person on the news release.]

Subject: LaGrotta: Pa. should allow residents to buy prescription drugs from Canada or U.K.

Dear Ms. Goldberg,

Regarding the subject news release, the implication is that there is a PA law prohibiting PA residents from purchasing prescription drugs from Canada or the U.K. Can you point me to that law? If there is no such law, HB 2971 would appear to be no more than a political stunt. Please correct me if I’m wrong.

Yours truly,

Robert (Robin) Cox

Center Township, Beaver County

PS: Why is the bill limited to Canada and the U.K.? That is, what is wrong with prescription drugs from Australia, France, Ireland, Italy, Sweden, et cetera?

=====

Ms. Goldberg replied that Mr. LaGrotta requested me to send my request for clarification directly to him and I forwarded him the note above. I received two replies from Mr. LaGrotta.

From: LaGrotta, Frank [mailto:FLaGrott@pahouse.net]

Sent: Thursday, November 11, 2004 8:29 AM

To: Robin Cox

Subject: RE: LaGrotta: Pa. should allow residents to buy prescription drugs from Canada or U.K.

Sent you a letter to respond.

Here is emailed copy.

Thank you for your email inquiring about a recent press release that detailed my support for House Bill 2971, a measure designed to give Pennsylvania residents the right to purchase prescription drugs from pharmacies in Canada and the Untied [sic] Kingdom.

As you know, the importation of drugs from other countries by consumers or companies other than drug manufacturers is prohibited by the U.S. Food, Drug, and Cosmetic Act. The Bush Administration has shown no interest in making prescription drugs more affordable in this country, choosing instead to expand the already-exorbitant profits of the drug companies. However, in the wake of sky-rocketing prescription drug costs, seniors organizing bus trips to Canada to purchase prescription drugs has blossomed into several U.S. cities and states exploring and implementing programs that permit importation through their employee-provided health benefits. The pharmaceutical products purchase [sic] out of this country are costing, on average, 50 percent less than the same products sold here.

[RWC] The FDA doesn’t prohibit the importation of all prescription drugs. The FDA prohibits importation of unapproved prescription drugs. According to the FDA, “Unapproved new drugs are any drugs, including foreign-made versions of U.S. approved drugs, that have not been manufactured in accordance with and pursuant to an FDA approval.” That said, there might be little practical difference between prohibiting importation of all prescription drugs vs. only unapproved drugs depending on the breadth of the FDA’s approval of foreign sources.

Regarding the Bush administration comment about “no interest in making prescription drugs more affordable in this country,” the only way the U.S government can do anything to help is to get foreign countries to refrain from placing price controls on prescription drugs and/or subsidizing their price via taxes. These tactics, plus the unspoken threat to ignore patents unless the manufacturer agrees to a “reasonable” price, are the primary reasons prescription drugs are frequently priced lower outside the United States. Assuring there are no impediments to fair competition would be another action. More government involvement or applying our own price controls would eventually result in fewer drugs from fewer manufacturers in lower volume with lower quality. That is always the eventual result of price controls.

Regarding the “choosing instead to expand the already-exorbitant profits of the drug companies” comment, Mr. LaGrotta appears to accept a figure – generated by Bush administration critics – John Kerry threw around during the election campaign. A review by the Pacific Research Institute concluded the effect of the Medicare prescription drug benefit on drug company profits would range from –1% to 3.2%.

In any case, who decides what constitutes “already-exorbitant profits?” If a local steel company could generate the same profit, would Mr. LaGrotta complain? Every business has a moral obligation to its owners to maximize profit within the law. We also need to remember that drug company profits contribute to retirement income via pension and 401(k) funds and increased profits also mean more income taxes paid by the company and its owners.

Mr. LaGrotta doesn’t provide a source for his statement that “pharmaceutical products purchase [sic] out of this country are costing, on average, 50 percent less than the same products sold here.” It might be true, but I’ve learned to question “facts” without backup.

Furthermore, states with programs that import drugs from other countries predominately deal with Canada and the United Kingdom because of established standards and the absence of a language barrier. At present, European countries permit their residents to purchase prescription drugs from other European countries, hence the United Kingdom is an obvious choice. Canada, a close neighbor to the United States and a country with established drug regulations and previous evaluation by states who have implemented programs, is another perfect fit for prescription drug importation. While other countries are being explored and considered by states that have programs, Canada and the United Kingdom are, at this writing, an informed choice for the residents of our Commonwealth.

[RWC] Just because you order drugs from a Canadian pharmacy doesn’t guarantee the drugs come from Canada. Because of demand from U.S. customers, Canadian pharmacies are now turning to wholesalers around the world to fill prescriptions. In July 2004, Customs seized prescriptions ordered from Canadian pharmacies but shipped from the Bahamas.¹

It is with this in mind and more that my support of House Bill 2971 is intended to encourage Pennsylvanians to individually reduce the price of their prescription drugs and, moreover, establish precedent in state law.

[RWC] What is the precedent and what does it accomplish? Under PA law, PA residents already have the right to purchase prescription drugs from foreign sources and Mr. LaGrotta doesn’t allege H.B. 2971 would override FDA regulations.

If you have additional questions regarding this or any other state-related matter, please feel free to contact Rep. Vince Biancucci, your representative in the State House.

=====

Mr. LaGrotta immediately followed the above reply with the following note.

From: LaGrotta, Frank [mailto:FLaGrott@pahouse.net]

Sent: Thursday, November 11, 2004 8:30 AM

To: Robin Cox

Subject: RE: LaGrotta: Pa. should allow residents to buy prescription drugs from Canada or U.K.

By the way….when you accuse me of a political stunt, you must be thinking of the president’s Medicare Prescription Plan. Or his “Health Savings Accounts,” or “War on Terror” fought in the wrong place against the wrong enemy.

Sorry. Wrong guy here. I try to help people, not lie to them

=====

You can draw your own conclusions about Mr. LaGrotta’s demeanor and the underlying reason. Changing subjects and Bush bashing appear to be standard operating procedure. Unfortunately for Mr. LaGrotta, so far he hasn’t picked positions he could successfully defend against my positions.

I replied to Mr. LaGrotta as shown below. As of November 13^th I received no response.

From: Robin Cox

Sent: Thursday, November 09, 2004 11:33 AM

To: LaGrotta, Frank

Subject: RE: LaGrotta: Pa. should allow residents to buy prescription drugs from Canada or U.K.

Perhaps you should read my original note more carefully and note its history. I did not accuse you of a political stunt. I addressed my original note to the House Democrat Communications Office (HDCO) as directed in the news release. Other than referring to the news release title in my note’s subject line, I never mentioned your name in my note and you’re not listed on the bill as one of the legislators who introduced HB 2971. I eventually addressed my note to your office only because Ms. Laura Goldberg of the HDCO informed me that was your request. Had the news release been on Mr. Biancucci’s web site, I suspect I would have been directed to his office.

In my note I opined that HB 2971 -- not you or any other individual -- would appear to be no more than a political stunt if there were no PA laws already on the books preventing PA residents from purchasing prescription drugs from wherever they please. Given your replies, and the fact that HB 2971 doesn’t include language to repeal any laws, I have to assume no such PA laws exist. If this assumption is incorrect, please point me to the PA laws preventing PA residents from purchasing prescription drugs from wherever they please.

Apparently you believe I oppose allowing PA residents to purchase prescription drugs from wherever they please. That’s incorrect. Indeed, I even investigated purchasing my own prescription from Canada. In the case of my prescription, I found the small price difference didn’t justify the hassle. Of course, that’s not true for all prescription drugs. If any PA laws prohibit PA residents from buying prescription drugs from wherever they please, HB 2971 would make sense. That said, any benefits may be short-lived given that a movement is already underway in Canada by groups representing Canadian seniors, pharmacies, and patients to ban prescription drug exports.

Yours truly,

Robin Cox