Under current law, it is illegal to bring in these drugs from abroad, forcing cash-strapped Americans to become criminals. For example, the drug Tamoxifen, which is used to combat breast cancer, is available in Canada for a 10th of what it costs in this country.
Missouri Republican Jo Ann Emerson engineered the stunning rebuke to the drug industry and its mighty benefactors. “She’s the woman who brought the House to a standstill, and she kicked their a–,” says an admiring lobbyist. Back home in her rural Missouri district, everybody is talking about Emerson’s surprise victory and how thrilled they are that relief is in sight. “Don’t thank me yet,” she says. “The war is yet to be won.” The bill to legalize drug reimportation passed by 57 votes as dozens of Republicans opposed their leadership to vote yes. Now the bill moves to a conference committee where it is part of a broader Medicare reform bill and where differences between the House and Senate must be reconciled. The Senate is on record opposing reimportation with 53 senators, including Democrat Ted Kennedy, signing a letter stating their concern that cheap drugs could flood the American market and compromise safety.
The conference committee is appointed by the leadership in both the House and Senate and dominated by friends of the pharmaceutical industry. The betting is that they will find a way to kill the provision. “That’s where the pros go to work,” says a lobbyist. The wild card is public opinion, and whether Emerson and the bipartisan coalition she helped forge can keep the drug issue front and center. Emerson arrived at her activism through personal experience. After her husband, former representative Bill Emerson, died in 1996 and she took over his seat, she had the responsibility of looking after his aged mother, who was in assisted living and on a fixed income.
Her mother-in-law’s prescription drugs cost a $1,000 a month. Through generics and wise shopping, Emerson pared that down to $600. But she was shocked to learn that prescription-drug prices are increasing at the rate of 10 percent to 15 percent a year, even for drugs that have been on the market for years. “You would think the opposite would occur,” she says. “People are getting angry, and that’s a good thing if they understand they can make a difference by contacting their legislator.”
Emerson voted against her party’s Medicare reform bill because she thought $400 billion for prescription drug expenses over 10 years fell far short of the $1.8 trillion seniors are projected to spend on their medication during that period, and the bill did nothing to curb rising drug prices. The night of the vote in late June, GOP leaders discovered they were one vote short and Emerson traded her support for a promise to bring drug reimportation to the floor for a vote and to strip so-called “poison pill” language from the Medicare bill that would block drug reimportation if it passed. “There’s nothing worse than having people heckle you as you walk down the aisle to vote,” Emerson recalls. With her colleagues chanting “Don’t do it,” Emerson filled out her green card for yes, reversing her earlier no vote. New York Democrat Nita Lowey, an advocate of drug reimportation, hugged Emerson in a display of emotion that erased party lines.
It was 3:30 in the morning when Emerson got home, heady with success and determined to hold the big boys to their promises. She took a nap, got up at 7 a.m. and typed up her understanding of the deal they’d struck. She sent an e-mail to each of the House leaders and committee chairmen involved asking for their commitment in writing. The floor vote that took place before dawn on Friday, June 25, would never have happened if she had not pressed the case. Now she’s watching the conference committee to see if the promise is kept to remove six lines requiring the secretary of Health and Human Services to certify the absolute safety of reimported drugs, the language that is the poison pill.
Emerson believes there are ways to write safety standards that are reasonable, and the bill as written requires drug companies to use anticounterfeit packaging. In fact, 40 percent of drugs on the market are already imported from FDA-approved plants in foreign countries, including Nive, a small island nation off the coast of New Zealand. “We had to look it up in the [CIA’s] World Fact Book,” says Emerson’s press secretary, Jeffrey Connor.
Emerson’s slogan is, “Putting people before politics.” She represents the ninth-poorest district in the nation, and has a reputation for working across partisan lines and being willing to stand up to the Republican leadership. “I was sent to Washington by the people I represent and not the drug companies,” she says. “The night of the vote, drug lobbyists were everywhere. I never saw so many suits in the halls of Congress.” According to Public Citizen’s Congress Watch, the pharmaceutical industry has 623 hired guns, more than one for every member of Congress. Twenty-three former members of Congress with special access to their colleagues lobby for the industry.
Betting on the little guy, or gal, against a massive industry is risky. But heavy-handed tactics have a way of backfiring. When the Coalition for Traditional Values, allied with the pharmaceuticals, blitzed two dozen conservative members saying drug reimportation would allow women to get the anti-abortion pill RU-486 over the Internet, which is not true, Emerson’s coalition picked up two or three votes from members who were offended. “I don’t mind a fair fight, but lying and distorting the truth is not a fair fight,” says Emerson. Neither is what happens behind closed doors–but that’s where this issue will be resolved.
