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Illinois Initiates Importation Plan

Donna Young

In a move that bypasses a federal ban on prescription drug importation, Illinois Gov. Rod R. Blagojevich today announced that his administration has established an Internet-based program to help residents buy medications from Canada, Ireland, and the United Kingdom.

The state is negotiating with a Canadian pharmacy benefits management (PBM) company to act as a clearinghouse for the program, said Abby Ottenhoff, spokesperson for the governor's office.

She declined to identify the PBM because a contract has yet to be signed.

Importing prescription drug products by anyone other than the manufacturer is illegal, according to the Food and Drug Administration (FDA).

The agency has contended that people who import drugs are at risk for being exposed to counterfeit, misbranded, or adulterated drugs.

FDA has admonished state governors and city officials who have established importation programs or who have included links to Canadian pharmacies on their Web sites.

Ottenhoff argued that Illinois is "doing nothing worse than other states have done that FDA has tolerated."

"FDA has yet to prosecute anyone" for importing drugs, she said.

Indeed, agency officials have sent mixed signals about what actions regulators would take against states that import drugs from Canada or promote the practice.

Acting FDA Commissioner Lester M. Crawford recently told the Associated Press that as long as drugs are imported from Canada from "drugstores that we have some experience with, then we would have a lighter touch probably."

But the agency's associate commissioner for policy and planning, William Hubbard, told Reuters that the agency may seek resolution of the issue from a court.

In the meantime, Illinois is proceeding with its plan, Ottenhoff said.

In exchange for placing the PBM's link and toll-free telephone number on Illinois' Web site, state officials and investigators would have access to inspect pharmacies in the PBM's network that dispense drug products to Illinois residents, she said.

Inspection costs will be paid for by the PBM at no expense to the state, she maintained.

Pharmacies used by the PBM must be in Canada, Ireland, or the United Kingdom, Ottenhoff said. The state selected those countries because English is the dominant language used, she added.

Medication orders must be refillsnot the first time a patient has taken the productand will be limited to therapies used for chronic conditions, according to the state's plan.

Products that need refrigeration are excluded from the program. The program also prohibits any orders for controlled substances.

Illinois' pharmacy-network-based plan provides greater protections for its residents than the programs designed by Minnesota, Wisconsin, North Dakota, and New Hampshire, whose Web sites feature links to Canadian pharmacies, according to a report released today by Blagojevich's office.

By using a PBM-network approach, the report stated, Illinois will, without jeopardizing the viability of the entire program, be able to drop any pharmacy from the program that defaults on agreed-upon standards.

The state has estimated that residents who order medications through its program will save 25 to 50 percent off the prices they normally pay for drugs in the United States.

Illinois' approach of using a PBM to aid residents in ordering medications from foreign pharmacies is "acknowledging and addressing" the "reality of unregulated reimportation," the report's authors stated, "thereby ensuring the safetyand improving the health outcomesof Illinoisans from all walks of life."