Tom Curb, R.Ph.

(When the stakes are high, the rhetoric gets hot, wild and loose. Currently, there are few "public" issues having greater economic and political impact than the flagrantly disproportionate prices Americans pay for prescription drugs. I once read that nothing encourages acceptance of an adverse agenda better than fear - others must have read the same article. However, their invalid fear tactics are rapidly eroding public trust in vital elements of the US healthcare system. Below are some "fear phrases" – and contradictions.)

¦"Looming threat of counterfeits from Canada" - FACT - Numerous reports of increasing counterfeit drugs within the US drug market imply that patients directly importing medications are less likely to receive a counterfeit drug from a Canadian pharmacy than if they obtained them in a US pharmacy. (The US market has reported several recent high-profile cases of counterfeit drugs; Canada has had none.)

(US) investigators admit that…there are growing holes in the U.S. drug safety net…(a US) investigator… says, ''It (counterfeiting) is a nationwide (US) problem.'' As more high-priced prescription medications hit the (US) market, they are proving irresistible to counterfeiters, who have successfully slipped fake, mislabeled and mishandled drugs into U.S. pharmacies (through the internal US distribution system).

¦ "FDA approval needed for safe, effective drugs" - FACT – many developed countries require a new drug to have demonstrable benefits, but FDA’s policy on approval of new drugs is that "delays in approving (new) drugs…could be just as bad as letting a dangerous medication to market." It has been stated that " FDA won't consider the cost or cost-effectiveness of new drugs or devices in assessing them (for US approval) - because that would prompt a furious counterattack from (drug) manufacturers."

¦ "Almost no imported drugs are FDA-approved" - FACT - "Unapproved" is a misleading designation that is routinely quoted to imply that imported drugs may be inferior to those obtained in the US. For example: Even if a specific drug entity may be available and approved by the FDA for use in the US and may come from the same source and may be exact in content, composition, therapeutic effect, and formulation, the imported product could be designated by the FDA as "unapproved" for reasons as insignificant as a difference in the appearance of the drug (color, shape, form); the wording on the container’s label; the type of container the drug is in; or even the way the container is closed.

¦ "Imports/price controls will limit R&D dollars" – FACT – Not at all likely! In reality, of each dollar received by the pharmaceutical industry, approximately 37 percent is spent on administration and marketing – which is almost three times the amount allocated to research and development.

It is estimated that up to 85 percent of (the drug industry’s) research and development funding comes from the National Institutes of Health (NIH), private foundations, academia, and public tax credits. (One {US income} tax credit alone allows a 50 cent {50%} tax credit {refund} for each dollar spent by a pharmaceutical company on R&D.) This gives the pharmaceutical industry the lowest effective tax bracket of any industry – about half that of other corporations and half that of the average US family.