US Pharm. 2009;34(3):2. 

Perhaps you've heard the expression that something keeps coming back "like a bad penny"? If you haven't, it basically means that something distasteful keeps recurring. The expression is purported to be derived from an early 19th-century novel by the Scottish author Sir Walter Scott when he wrote, "The bad shilling is sure enough to come back again." In this case, I am referring to the importation of Canadian drugs as a way of saving U.S. patients money on their prescription medications. It was a bad idea five years ago when the FDA closed stores in this country that claimed to be selling drugs from Canada, and it is bad idea today. That's why I can't understand why the Obama White House is actually thinking of reversing the FDA's decision. While there is no question that our health care system needs an overhaul, importing drugs from Canada is not the answer.

Although there are hundreds of Canadian pharmacies selling legitimate prescription drugs at lower prices to U.S. citizens, due in large part to government price controls initiated as part of Canada's system of socialized medicine, legal U.S. importation of those drugs will once again open Pandora's box to let out the thousands of illegal Web sites and other brick-and-mortar outlets that claim to be selling Canadian drugs but, in reality, are not. It will only perpetuate the problem of counterfeit drugs, which continue to be a growing worldwide health care threat. In fact, a report by the American Council on Science and Health (ACSH) documents how increasingly sophisticated counterfeiting rings, some with connections to organized crime and even terrorist groups, have improved upon their methods of evading international police and investigative forces, slipping potentially dangerous counterfeit, substandard, and adulterated drugs into legitimate drug supplies, including those of the United States. Some of these drugs make big headlines, as with the episode of tainted heparin imported from China that killed nearly 100 people. Commenting on the legalization of drug importation, ACSH President Dr. Elizabeth Whelan said that it "represents an unjustifiable breaching of our domestic drug supply that has the potential to erase even the minimal gains we have made in the fight against counterfeit drugs." I agree. Prescription drugs approved by the FDA and purchased at state-licensed pharmacies in the U.S. are still the safest source for patients here purchasing medications.

As I write this column, President Obama is focused almost exclusively on getting our sick economy off its death bed, while uninsured sick people continue to die. By the time this column gets published, the wrangling over what will be in the stimulus bill will almost certainly be over. My hope is that the final version of the bill did not water down the amount of money earmarked to help fix our health care system.

Whatever form it takes, the U.S. needs major health care reform. At least two U.S. senators are hard at work to find a solution. Senators Baucus of Montana and Kennedy of Massachusetts have vowed to work hard to make comprehensive health care reform a reality this year. I encourage them and their committees to propose health care reform that includes access to affordable health care for every American. What we don't need is another bad penny. 

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