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Dean's plan contains six major initiatives:
1) Permitting Reimportation of Prescription Drugs from Canada
"Today U.S. citizens spend approximately $750 million on prescription drugs from Canada. In some cases, they travel to Canada, but more commonly they purchase Canadian drugs through the internet. Canadian drug prices are often 30% - 80% less than the U.S. prices. These drugs are made by the same companies with the same ingredients as drugs sold in the U.S., and there is no evidence that Canadian drugs are inferior in any way. Just as U.S. citizens may today purchase prescription drugs from U.S. pharmacies by mail order (after supplying a prescription from a U.S. physician), our citizens should be permitted to realize the substantial savings of purchasing drugs by mail order from Canadian pharmacies. In contrast to the Bush Administration, which has been cracking down on Canadian drug importers, I would direct the Food and Drug Administration to facilitate this proven strategy for achieving significant savings on prescription drugs.
2) Closing Loopholes That Allow Brand Drug Companies to Extend Their Monopolies
"I recognize the importance of the patent system as an incentive for drug manufacturers to undertake research that in recent years has led to important discoveries in the pharmaceutical field. Some of the most innovative research by pharmaceutical companies, however, has been in the field of law, as companies have exploited legal loopholes to block generic competition. This is wrong: once legitimate patents have expired, the field should be open to generic drug competition. I was a founder of Business for Affordable Medicine (BAM), a coalition of Governors, major national employers (Wal-Mart, GM, Kellogg, etc.) and labor organizations. Prior to efforts of BAM, all efforts to close those loopholes had failed, but this year the reform amendment to the Medicare drug benefit legislation sponsored by BAM passed the U.S. Senate by a vote of 94-1 and has also been included in the House's version of the Medicare drug benefit legislation. If enacted, this legislation would make cost-effective generic drugs available earlier."
3) Using Preferred Drug Lists to Save Prescription Drug Dollars
"In treating particular medical conditions, physicians often have a choice of several drugs with a broad price range. For example, a pediatrician treating an ear infection may use a generic antibiotic costing a few cents a pill or an expensive brand antibiotic costing several dollars. For many patients, the two choices are medically equivalent. Not surprisingly, drug companies spend billions of dollars in advertising directed at physicians to convince them to prescribe the brand product. Vermont and other states have successfully used Preferred Drug Lists (PDLs) to steer physicians to less expensive, equally effective medicines The federal government and many health care plans use a form of PDLs to save unnecessary medical expenses. I support expanding the use of PDLs so that senior citizens and other consumers can get the same prices for prescription drugs as big institutional purchasers.
4) Allowing States Wide Latitude to Experiment in Ways of Controlling Drug Costs
"This year the United States Supreme Court rejected a challenge by pharmaceutical companies to a bold program initiated by Maine and Vermont to control prescription drug prices. Under a 1990 federal law, pharmaceutical companies must pay states rebates on their Medicaid purchases, which have the effect of lowering the price of prescription drugs to the states. In recent years some states have required additional rebates. Maine and Vermont have taken the additional step of making these savings available to citizens who are not covered by Medicaid (which is limited to citizens whose income is below a certain level). Under the Maine/Vermont program, drug companies were required to make lower-cost drugs available to all citizens in order to obtain preferred treatment under the state Medicaid program. I support federal initiatives that would give states wide latitude in experimenting with innovative approaches to cutting prescription drug prices.
5) Limitations on Direct-to-Consumer Advertising of Drugs
"Since 1991, drug companies have increased their advertising to consumers from $55 million to approximately $2 billion per year. Occasionally, this advertising has a legitimate purpose of informing consumers about a new product that can benefit them. More commonly, it simply increases the demand for these products, dramatically increasing the nation's prescription drug bill. I support a ban on direct advertising of prescription drugs to consumers (television advertising was banned until 1997) except for situations where there is a compelling public health justification for the advertising.
6) Disclosure of Gifts to Physicians
"One way that pharmaceutical manufacturers persuade physicians to prescribe their more expensive products is to give doctors expensive gifts, free meals, and trips or to pay physicians to undertake simple research. Last June, I signed a bill which made Vermont the first state in the nation to require pharmaceutical manufacturers to disclose the value, nature, and purpose of any gift or other economic benefit provided to any physician, hospital, or other healthcare provider in Vermont. As president, I would propose a national gift disclosure requirement.
"As governor of Vermont, I sought creative solutions to help senior citizens and other Vermonters obtain affordable prescription drugs. If I am elected president, I will work on behalf of the American people, and particularly seniors who have the greatest need for prescription drugs and who pay the highest prices, to reduce drug costs and to make health care more affordable," Governor Dean said.
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