Drug importation is "not going away," said Abby Ottenhof, a spokesman for Illinois Gov. Rod Blagojevich,whose I-SaveRx program has filled 14,000 prescriptions through pharmacies in Canada and Ireland since itwas launched a year ago."If anything," Ottenhof said, "demand continues to build."
To limit the amount of drugs being imported to the United States, drug companies have tried limiting sales topharmacy chains and wholesalers in Canada. In response, Internet operators have turned to countries suchas Australia, New Zealand, Ireland, India and China for supplies.The FDA has sent warning letters to a variety of unlicensed Internet suppliers that it says are circumventingits safety guidelines and putting consumers at risk. It has also warned various states that federal laws pre-empt any state efforts to legalize drug importation.When it comes to enforcement, however, it is performing triage. In 2003, a federal judge issued aninjunction, based on FDA regulations, that shut down RxDepot. The Oklahoma business was setting upstorefronts in the United States that took prescriptions locally and faxed them to a Canadian pharmacy to befilled.But for every site the FDA shuts down, a new one -- or several -- pops up.The FDA has yet to move against state programs such as the one set up by Illinois. And from an operationalperspective, Hamilton said I-SaveRx is doing the same thing as ProgressiveRx, running a Web site thatallows Americans to buy prescription drugs abroad.Hamilton said safety and quality control are his first concerns. ProgressiveRx fill prescriptions through ApolloHospital Group and Pill and Powder, two Indian pharmacy chains that source their drugs directly through thesame FDA-approved factories that the big drug companies use, or through Indian pharmaceuticalcompanies that produce generic versions.Hamilton said his employees check every order three times for accuracy before shipping. All medicationsare shipped in original manufacturers' packaging with instructions on use.Thus far, he said, among thousands of orders, the only mistake encountered was the substitution of a nasalinhaler for an oral inhaler of the same product.Richard Palais, a former dentist and pharmaceutical representative for a drug company who is now onSocial Security disability in Hernando Beach, Fla., said he found ProgressiveRx about a year ago and hasnever looked back. A 14-day supply of the antibiotic he uses regularly, Levaquin, goes for $300 at hisneighborhood pharmacy and $20 at ProgressiveRx, he said. The prescription for Prevacid that he takes foracid reflux would cost $130 or $140 locally, but he gets it for $40 on ProgressiveRx."My transactions have always gone smoothly," he said. "You place the order, you e-mail or fax a copy ofyour prescription, and eight days later, you get your medicine with an explanation sheet -- everything youwould get from a pharmacy in the U.S. It's all here, and you save a pile of money."
State sees a violation
But Gary Schnabel, executive director of the Oregon Board of Pharmacy, said ProgressiveRx isn't a licensedpharmacy and appears to be in violation of Oregon pharmaceutical laws. The Web site, he said, lookssimilar to those of prescription brokers who argue that they're exempt from regulation because they sendprescriptions to Canada and never handle the drugs themselves.