Las Vegas Mercury, February 2, 2005

By her own admission, Ethel Nash is a "walking chemical plant." A resident of the Sunrise Senior Village in northern Las Vegas, the spunky 67-year-old takes seven different medications--all of which are paid for by a combination of Senior Dimensions, Medicare and personal savings.

Ostensibly, she seems like the perfect candidate for prescription drug importation--the controversial plan to buy drugs from Canada and Western Europe, where name-brand medications are up to 50 percent cheaper then the American equivalent--but Nash is a staunchly opposed to drugs that come from any further than her local Rite Aid store.

"What if I have a problem with my prescription?" she says. "Do I have to run to Canada to get it resolved?" Still, Nash sympathizes with seniors who might see salvation in mail-order pharmaceuticals. "It's a matter of desperation," she says. "All they see is the few dollars that they might save. That few dollars could mean a loaf of bread or a bag of potatoes. They need drugs. They need food. They can't always consider the potential consequences."

Nash is an unexpected voice in a complex debate that has ensnared legislators, lobbyists and everyday Americans in a tangled web of speculation and fearmongering. In December, a task force headed by Surgeon General Richard Carmona detailed myriad problems with drug importation, concluding that it would be "extremely difficult" to ensure the safety of such drugs and that the potential savings to consumers might be no more than 1 or 2 percent.

"I think that the [Bush] administration has repeatedly proven that it is more concerned with preserving profit levels for pharmaceutical companies than it is with making sure that U.S. citizens have affordable prescription drugs," says Assemblywoman Barbara Buckley, D-Las Vegas, who will sponsor a statewide importation plan when the Legislature convenes next week.

"I think it's time for Nevada to join the increasing number of states that say the status quo is not good enough." Contrary to the federal findings, Buckley says she has contacted the Nevada Board of Pharmacy and that the regulatory body already has "the existing framework to license and monitor Canadian pharmacies."

Not so fast, says Peter Pitts, a former Food and Drug Administration commissioner and current senior fellow in health care studies at the Pacific Research Institute--a conservative California think tank. "A lot of these Canadian Internet pharmacies aren't even really pharmacies," Pitts says. "They're just warehouses--like an Amazon.com for drugs."

Pitts describes the importation programs implemented by other states--most notably, Wisconsin, Illinois and Minnesota--as "snake-oil solutions" that put consumers at risk and "allow politicians to avoid addressing this extraordinarily complicated and crucial problem."

"It's a frustrating issue," says Pitts. "Mark Twain said, `For every complex problem there's usually a simple solution--and it's usually wrong.' That's what drug importation is. It's not safe. It doesn't really save anybody any money. All it's really good for is headlines."

In the middle of the debate sits Dr. Ron Ziance, a professor of pharmaceutical science at the University of Southern Nevada College of Pharmacy. Not specifically opposed to drug importation, he notes that the regulatory infrastructure probably is not adequate to ensure the health and well-being of Nevadans.

"The plan has many attractions, but you really have to pay attention to where Canada is receiving the drugs from," Ziance says. "There are many, many horror stories involving counterfeit drugs purchased from unreliable sources."

According to Ziance, expensive AIDS drugs and high-demand "designer" drugs like Viagra are the most susceptible to counterfeiting. He does, however, note that the Nevada Board of Pharmacy has been vigilant in monitoring in-state drug distributors.

"The Nevada State Board of Pharmacy and the Florida State Board of Pharmacy have been the two most active boards in the country in terms of putting strict controls on drug wholesalers within their state," says Ziance.