Tucson Citizen.com

Mexico pharmacies targeted

by on Jan. 15, 2008, under Edge, Local

Arizona governor among those proposing safety push

Several states have direct links to Canadian pharmacies to ensure their residents have access to less expensive prescription drugs.

Yet no state has such formal ties through Web sites or state-sponsored programs to pharmacies in Mexico.

Still, residents of Arizona and other Southwestern states routinely visit border towns such as Los Algodones near Yuma to buy prescription drugs at large pharmacies catering to tourists.

Gov. Janet Napolitano and her counterparts on both sides of the border are floating an idea that would scrutinize the safety of prescription drugs sold in Mexican border towns. They want to create a cross-border testing and inspection program to ensure drug safety.

Napolitano has initiated talks with Bush administration officials on what it would take to launch such a pilot program with cooperation on both sides of the border.

Some consider it a long shot. U.S. Food and Drug Administration inspectors already are stretched thin. The state agency that oversees pharmacies in Arizona already is stretched thin.

And the proposal, first floated at last fall’s Border Governors Conference, is short on details such as funding and regulations needed to turn the idea into a reality.

Still, Napolitano’s representatives are hopeful that the Southwest can create a level of cooperation similar to programs that other states have with Canadian pharmacies.

“We know that people do this, and we know it is not illegal to purchase for personal use,” said Jeanine L’Ecuyer, Napolitano’s spokeswoman. “The issue is, is it safe?”

State standards
The governors’ proposal urges both the United States and Mexico governments to work with states and local authorities on each side of the border on a program that would promote “testing and inspection of quality of prescription drugs.” The program also calls for bolstering the authority of state agencies to establish standards for pharmacies and drug manufacturers to ensure consumer safety.

The resolution endorsed by governors of Arizona, California, New Mexico and Texas gives no timeline on when such a program may be adopted or who will pay for it.

Other states have sponsored programs that allow their residents to purchase prescription drugs from Canada.

Perhaps the most well-known program is Minnesota’s RxConnect, an initiative launched nearly four years ago that provides residents phone and Internet links to Canadian pharmacies. The state-sponsored program has been popular with Minnesotans who want access to prescription drugs sold in Canada, where government price controls generally keep drug prices lower than in the United States.

Under Minnesota’s program, the state provides consumers with phone and Internet links to Canadian pharmacies. The state dispatches pharmacists to inspect and review participating Canadian pharmacies once each 12 to 18 months.

The inspections verify that the Canadian pharmacies have the appropriate controls and procedures in place to ensure consumer safety, said Brian Osberg, assistant commissioner of health care for the Minnesota Department of Human Services.

“It is a valuable site for people who want to buy brand medications from Canada,” Osberg said.

Despite the program’s initial popularity, factors such Medicare’s prescription drug program and a strong Canadian dollar have curtailed the program’s use in recent months, Osberg said. The Minnesota plan initially processed about 1,000 orders per month. Now, the plan has about 150 orders per month.

‘Like shoe stores’
Some groups are wary of establishing a formal program that monitors the safety of drugs sold in Mexico. Such a program could be costly.

“I think it is real risky,” said Marvin Shepherd, a University of Texas professor who studies drug importation.

Shepherd cited a World Health Organization report that indicated 10 percent of prescription drugs sold in Mexico are counterfeit.

Those drugs sold in pharmacies may have the incorrect potency or the wrong active ingredient, Shepherd said.

“I don’t know how you would inspect these pharmacies,” Shepherd said. “They are not licensed. They are like shoe stores.”

Lyle Bootman, dean of the University of Arizona’s College of Pharmacy, agreed it would be difficult for U.S. inspectors and Arizona regulators to police pharmacies in Mexico.

The Arizona State Board of Pharmacy has five inspectors responsible for scrutinizing the state’s 1,200 pharmacies each year.

With the state facing a budget deficit of $1 billion or more, the board of pharmacy’s executive director doesn’t expect money will be available to pay for more inspectors.

Consumer demand
Despite the warnings from researchers and the pharmaceutical industry, consumers who travel to border towns to purchase prescription drugs are wary of changing the system.

Peoria resident Lou Edmonds said he began purchasing prescription drugs in Los Algodones a few months ago after receiving dental surgery there.

He said the prescription drugs all have been properly sealed, and he is not concerned about the safety or potency of the drugs.

Plus, the drugs are much less expensive.

Edmonds cited asthma medication that costs $50 in Arizona sold for $12 at a Mexico pharmacy.

Mike Hagerman arranges bus trips to Mexico for about 500 people each year through his Phoenix-based Synergy Tours.

He advises customers who are traveling to Mexico for prescription drugs to stick to the larger pharmacies and check expiration dates.


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