Buying Prescriptions Online (cont.)

He's not alone. By September 2004, one-third of American adults who use prescription drugs said they already buy or intend to buy drugs from online Canadian pharmacies, according to a survey by the Results for America (RFA), a project of the nonprofit and nonpartisan Civil Society Institute.

The reason is simple economics. According to the Congressional Budget Office, brand-name drugs on average cost from 35% to 55% less in other industrialized nations than they do in the U.S. The CBO also estimates that if Americans in 2001 could have bought brand-name drugs at Canadian pharmacies, they would have saved more than $38 billion (under the new Medicare prescription-drug benefit, the government is expressly forbidden from negotiating lower drug prices on the behalf of beneficiaries).

As for Springfield, Mass., the city saved more than $3 million in the start-up year, and is on track to save $6 million this fiscal year, Albano says.

Next: The Global Prescription Drug Business

Pharmaceutical Outsourcing

In an interview with CBS's 60 Minutes earlier this year, former FDA commissioner Mark McClellan said that "under current law we don't have the authority to ensure the safety of foreign-produced, foreign-distributed drugs." He warned that the practice of "drug reimportation," as it's called, violates federal law and puts patients at risk because they can't be sure about the source of the drugs they receive.

But advocates for cross-border drug buying point out that most medications purchased from reputable Canadian or European pharmacies are the identical medications -- brand names as well as generics -- that are available at your local drugstore. In addition, those medicines, including some of the blockbuster drugs advertised on the network evening news programs, may be made not just in North America but also in Europe, South America, the Middle East, or Asia.

"There are about 60 locations where the pharmaceutical industry manufactures all across the world," Albano tells WebMD. "Lipitor, for example, comes from Ireland, is manufactured and shipped to the United States and then shipped to Canada. And some Lipitor goes right from Ireland to Canada, so this whole notion that Canadian medications are not safe is simply ludicrous."

Barry Power, PharmD., director of practice development for the Ottawa-based Canadian Pharmacists Association tells WebMD that "most drugs are made in one or two global locations and then exported to all the countries, so even the term 'reimportation' is technically incorrect. And there are actually quite a few drugs that are made in Canada, so it's all just a matter of spin-doctoring in a lot of cases."

Mayor Albano had confidence in the source of the lower-cost drugs his city offered to municipal employees and retirees because he had done his homework, he says. "Before we started the program officially in Springfield, I went to Canada and went to the pharmacies. I spoke to the pharmacists, and then we started my son on his insulin and related products three months prior to the official beginning of the program. The idea was that it's a medication that you have to take precautions with, and I thought my public employees would realize that 'if it's good enough for the mayor's family, then it would be good enough for me.'"