Las Vegas Sun, May 12, 2005

By ELIZABETH WHITE (ASSOCIATED PRESS)

CARSON CITY, Nev. (AP) - Supporters and opponents squared off Thursday over a controversial bill to let Nevadans buy lower-priced drugs from Canada through a state-run Web site.

After hours of testimony for and against, there was still no conclusion over many lawmakers' biggest concern about the measure: whether the practice is legal.

"I don't think we got a clear answer," said Sen. Warren Hardy, R-Las Vegas, vice chairman of the Senate Commerce and Labor Committee, which heard AB195. "And there may not be a clear answer."

"The governor doesn't want to pass something that's not legal, I don't want to pass something that's not legal," he added.

Proponents of the measure say a "personal use exemption" lets Americans bring a 90-day supply of FDA-approved drugs into the country.

Assembly Majority Leader Barbara Buckley, the bill's sponsor, said eight other states have similar programs, and that Nevada's would ensure the safety of the drugs purchased because the state's Board of Pharmacy would inspect and license those linked to on the Web site.

"AB195 is not designed to be a long-term fix for the problem of unaffordable prescription drugs," said Buckley, D-Las Vegas. "Our country must do better. ... At the state level we must act today."

Buckley brought in Minnesota's commissioner of employee relations, Cal Ludeman, to testify on his state's Web sites, which have been running for 16 months for public access and 13 months for state employees.

Ludeman said the only problem with Minnesota's program is an occasional confiscation at the U.S.-Canada border, an inconvenience that can be corrected with a simple phone call.

Sen. Sandra Tiffany, R-Henderson, said the number of orders, about 17,000 total in the state of about 5 million people, doesn't make the program a cure-all.

"It's a modest baby step," she said.

Tiffany also asked Ludeman if he could say whether his state's practice is legal. Ludeman said that he believed it is, despite admonitions from the FDA not to run the program.

"The personal use policy began to evolve more clearly," Ludeman said, adding, "We're making (the sites) available with full disclosure."

Dr. John Ellerton, a cancer specialist in Las Vegas, and several others who testified for the bill, including AARP Nevada and the Nevada Alliance for Retired Americans, said it doesn't matter if the FDA condones the Internet sales because people will do it anyway, and it's better that they buy safely.

But Peter Pitts, a former associate commissioner for the FDA who was involved in the fight over Minnesota's program, said in a telephone interview that there's no such thing as a personal exemption law on the books.

"It might exist in a de facto way," said Pitts, now a senior fellow at the Pacific Research Institute in San Francisco. "The FDA doesn't prosecute individuals who buy drugs because it's not the best use of the regulatory dollar."

Pitts, who was not at the hearing, said Web sites like the one proposed here are "absolutely illegal. Any type of legislation that the Nevada Legislature would choose to pass would be pre-empted by federal law."

Pitts called the proposal dishonest because he says U.S. consumers will not get the same drugs Canadians do.

"Licensed Canadian pharmacists are getting drugs from all over the world that are not even legal for sale in Canada," he said. "At the end of the day, just because a politician says foreign drugs are safe doesn't make them safe."

Chris Ward, a former Canadian lawmaker who worked for Canada's equivalent of a U.S.-based industry group, Pharmaceutical Research and Manufacturers of America, or PhRMA, told legislators that the program would put U.S. consumers at risk and would create disincentives for searching for new medicines.

He also said that when adjusted for income levels, Canadians pay no less than Americans for their prescription drugs and that these programs are not a substitute for reforming the health care system.

Other opponents of the bill listed a litany of possible problems including unfair competition, lack of compliance with other federal regulations and drug interaction problems.

"If you go to a Canadian pharmacy you walk away from a lot of that safety infrastructure," said Washington, D.C., lawyer Matthew Van Hook, the former deputy general counsel of PhRMA, adding, "With the advent of the Internet people are going online and buying drugs from God knows where and there's a real problem with that. ... If you want to allow people to go on the Internet and take chances they can do that today but to have the state get involved in that is a very serious matter."

Buckley urged supporters not to be put off by "scare tactics that have been attempted in the other eight states."

"I believe we can very clearly set forth laws being relied upon by the eight other states," she said after the hearing, adding that she's working with Gov. Kenny Guinn and his staff to make the language in the bill, which may be voted on by the committee next week, specific.

Asked about the discussions with Buckley, Guinn said he's feeling better about the bill. "I'm not negative on it at this point."