U.S. pharmacists not opposed to importing drugs to lower patients' costs

Nov 24 2004

Many community pharmacists are not opposed to importing drugs to lower patients' costs as long as those drugs are channeled through U.S. pharmacies to ensure safety and efficacy, according to a study by pharmacists at the University of Illinois at Chicago and the University of Michigan.

The study will appear in the November/December edition of the Journal of the American Pharmacists Association. "Importation of Prescription Medications: The Experiences, Opinions and Intended Behaviors of U.S. Retail Pharmacists" surveyed 401 pharmacists practicing in Illinois, Michigan, Florida and Minnesota.

The pharmacists surveyed expressed concern about safety, liability and the economic ramifications of prescription drug importation. More favorable opinions were expressed if imported drugs are channeled through U.S. pharmacies.

Authors are A. Simon Pickard, assistant professor of pharmacy practice at the UIC College of Pharmacy; Glen Schumock, director of the UIC Center for Pharmacoeconomic Research; David Nau, assistant professor, Center for Medication Use, Policy, and Economics, UM College of Pharmacy; and Patrick McKercher, director of the UM center.

The researchers found that pharmacists are concerned about the safety of imported medications and about job security if no regulatory changes are made.

Pharmacists generally felt that safety concerns regarding importation would be diminished if U.S. pharmacists oversaw the process of importation. "By having the U.S. pharmacy import the drug, the pharmacist may be able to identify potential counterfeits before the products reach the patient," Nau said.

The study also found that community pharmacists are being hit with frequent inquiries from the public about how to obtain medications from outside the United States.

Many pharmacists in Minnesota, Illinois and Michigan responded that they are not happy with the handling of the issue of drug importation by their state governments. Florida pharmacists, however, seemed more satisfied, possibly because Florida has aggressively addressed the problem of the importation of counterfeit drugs.

The pharmacists' observations can be useful to policy makers, Pickard said. "Because pharmacists are key stakeholders in this debate, our study can inform policy makers about some of the implications of prescription drug reimportation. If such a policy is to be pursued, there will be ramifications for patient care and safety, the domestic work force and the pharmacy profession as a whole."

Results of the study include:

• Approximately 90 percent of pharmacists surveyed agreed that the Medicare drug benefit would not diminish consumer interest in prescription drug importation, and a similar proportion agreed that interest was not limited to the elderly.
• 69 percent agreed that their primary concern about importation was the quality or purity of the drugs.
• 57 percent agreed that drugs purchased through Canada would not pose a greater risk for medication-related problems if U.S. pharmacists oversaw the process and were available to provide patient monitoring and education.
• Pharmacists strongly favored regulatory actions that may decrease counterfeiting. Thirty-two percent felt consumers should be allowed to legally purchase medications from Canada; 44 percent felt pharmacies should be able to legally procure prescription drugs from Canada. If legally permitted, almost 70 percent said they would consider ordering medications from Canada.
• Approximately half were concerned about job security as a result of the trend toward importation. This concern was significantly higher among pharmacy owners.