FAIRMONT — Mary Ellen Nottingham was running an errand earlier
this month when she spotted a photographer taking pictures of Fairmont's
Discount Prescription Center. "I thought: Oh no, it's happening." She told her
"I told myself, if he's trying to put them out of business,
maybe I can do something," she
She'd seen on television that the West Virginia Board of
Pharmacy is trying to shut the place down. She feared the photographer was a
The 5-foot-1 woman didn't calm down until the newspaper
photographer explained that he was just taking pictures for a story. "I was
ready to make a stand," she
Nottingham believes her health is at stake. She orders seven
prescriptions from Canada through Discount Pharmacy Center, including Lipitor,
Plavix, Glucophage and Tricor. "I'm on 18 different pills a day now," she
"Medicine keeps me alive," she
these people who run this business."
She buys a three-month supply, the maximum anyone can import at
one time. "I'm saving around $400 a month," she
right. When you don't have money, you eat a lot of macaroni and potatoes."
Catching her breath inside the store, Nottingham said that,
after 33 years of making a decent living — 28 at Fairmont's Electronic Control
Systems — she developed near-fatal heart disease and couldn't work anymore.
"Boom, the paycheck was gone," she
put it mildly."
Now she lives on her pension and Social Security, minus her
Medicare B payment. She gets about $1,200 a month total. "It's gone practically
before I get it," she
Medicare does not cover her prescription
drugs. "I'm so thankful this place opened up."
Not everybody is as thankful
In May, the state Board of Pharmacy ordered Discount
Prescription Center to shut its doors or face legal action. The pharmacy board
contends that the center is a pharmacy without a pharmacist.
Pharmacy boards in at least 19 other states are defending their
turf, trying to shut down buy-from-Canada storefronts. Hundreds of these little
businesses have sprung up in at least 30 states in the past year. The U.S. Food
and Drug Administration is urging state boards to put on the lid on them before
they spread further.
In March, the Arkansas pharmacy board sent the nation's first
Moore told USA Today that he would appeal to the U.S. Supreme Court if
going to fight like a wild animal."
To the dismay of pharmaceutical companies and local pharmacies,
Canadian Internet firms have developed a new marketing tool. Each week,
busloads of prescription-filling Americans cross the Canadian border. At least
a million Americans order by computer. Now Canadians are partnering with
American entrepreneurs to attract customers like Nottingham who feel most
comfortable in a U.S. store, where someone can help them.
West Virginia University law professor Bob Bastress represents
owner Carole Becker and her husband, Steve, who manages the store. He has filed
a motion asking the Kanawha Circuit Court to block the state effort to shut the
The case is local, Bastress said, but it involves international
issues: American access to more affordable drugs and access to foreign markets,
pharmaceutical company profits, and senior citizens who can't afford drugs. It
may be the nation's first such hearing. Other states, the FDA and
pharmaceutical companies will be following it.
"The pharmaceutical companies have wanted to shut down the
Canadian outlets for years," said Kevin Outterson, who teaches health law at
WVU. "When people started buying Canadian drugs over the Internet, the
companies didn't know how to stop that buying, because it would mean arresting
Grandma and Grandpa here in the States. That's not going to happen.
"But older people aren't as adept with computers as younger
people are. So these storefront facilitators have developed. Storefronts are a
much easier target, politically."
Meanwhile, the Fairmont store — located in a rehabbed gas
Like storefronts in other states, it isn't fancy and doesn't require much
overhead. American and Canadian flags fly from the building. Signs are modest.
One small, tidy room holds some bookshelves, a few chairs and a table with a
laptop computer, phone and fax machine.
When Mary Ellen Nottingham first came in, Steve Becker showed
her what her prescriptions would cost in Canada. "I couldn't believe I can sit
in Fairmont, W.Va., and get prices like that," she
She found she could get a month of Lipitor for $55.50, a month
of Plavix for $69.30 and a month of the generic of Glucophage for $9.72. It
would cost her about twice as much in Fairmont.
Nottingham showed Becker her prescriptions, and he faxed the
forms, her medical information and her credit card number to his Manitoba-based
.com. A Canadian doctor reviewed Nottingham's form and
prescriptions for accuracy and validity, as required by Canadian law, Becker
Critics say this is exactly the problem. There is no pharmacist
at the Fairmont store to make sure Nottingham isn't ordering two conflicting
medicines, for instance. Nottingham says her doctors — and the Canadian doctor —
She got her medications in the mail at her Fairmont home within
two weeks after she ordered them, she
She didn't pay Becker anything.
Discount Prescription Center gets a 10 percent fee from his Canadian partner
for every prescription they process. "That's how I make money," he
There's a processing fee no matter how you order, he
The store prices are in the ballpark for Canadian Internet
pharmacies: 30 percent to 80 percent lower.
Prices, not patient safety, are the driving force behind all
this, said Outterson. "A huge proportion of the industry's global profits
depend on maintaining the U.S. prices. If U.S. prices went down to the level of
Canadian prices, the pharmaceutical industry would lose tens of millions of
But health care costs — and therefore health insurance rates —
would go down. "Health insurance rates would decrease and stabilize somewhat,
which means more small business owners would be able to offer health insurance
to their employees," said Sally Richardson, who directs WVU's Institute for
Health Care Policy.
Not just a West Virginia story
Steve Becker says he and his wife are fighting the shutdown
order on principle. "This is something that changes people's lives," he
people get packages ready for the post office."
He is not for a drug-ordering free-for-all. He believes the
Canadian market is safe, for instance, but the Mexican market is not. "Anybody
who trusts the Mexican drug market obviously hasn't been to Mexico," he
William Douglass, director of the West Virginia Board of
Pharmacy, says he stands on principle, too. He is protecting the public well-
being. "We don't want to stop people from finding cheaper sources for their
prescription drugs," he
believe this source is either safe or legal."
"Those kinds of statements really tick off Canadian officials,"
Bastress contends that the FDA is responding to pressure from
the pharmaceutical industry on the Bush administration. The FDA denies
it. "Because the medications are not subject to FDA's safety oversight, they
could be outdated, contaminated, counterfeit or contain too much or too little
of the active ingredient."
"Canada has their own equivalent of the FDA and, if anything,
they've got a better record than we do." Becker said, recalling that fake
Lipitor recently turned up in the U.S. drug stream, and a Missouri pharmacist
was convicted of diluting people's cancer prescriptions.
"I can't speak for how their regulatory bodies are up there.
I'm not really familiar with them," Douglass
coming from as far away as across the border of a foreign country allows the
criminal element to have more of a success."
"There are no drugs on my clients' premises," Bastress
ordering the drugs. They process orders. How can anyone call that a
Shift in how drugs
are bought and sold