To the editor:

Across the country, including Nevada, there continue to be efforts by state officials to encourage the importation of drugs from Canada as a way to reduce health care costs for America's seniors. Just last month, the Nevada State Board of Pharmacy voted to allow residents to purchase drugs from Canadian mail-order pharmacies. With all due respect to these officials, I would argue that importation has largely become a solution in search of a problem. The more effective approach to ensure access to safe and affordable prescription drugs is the new Medicare prescription drug benefit, Part D.

While there have been some initial stumbles getting out of the blocks, there is clear evidence that the new Medicare benefit is providing our seniors, including Nevada's, with access to needed prescription drugs at lower rates than they previously paid, all without looking beyond our borders. In fact, 75 percent of Nevada's Medicare beneficiaries have drug coverage under Part D -- the sixth-highest in the nation. Overall, enrollment -- and beneficiary satisfaction -- is exceeding expectations, both nationally and at the state level, with more than 30 million currently receiving coverage. Simply put, the debate on importation should now be moot.

According to the AARP, the new prescription drug benefit provides seniors with a cheaper alternative to drugs advertised as "Canadian," noting that "for many Americans, Medicare drug plans that cover all of a beneficiary's drugs can cost less than buying the same drugs across the border." Even considering that seniors are paying premiums, deductibles and co-payments under the new drug benefit, they will likely pay less than they would in paying the full cost of drugs from Canada or elsewhere. According to a recent survey, two-thirds of enrolled beneficiaries indicated that they have saved money on their prescriptions since enrolling in Part D.

Importation is about more than just price -- there are also safety concerns. Simply because the return address says Canada does not mean the drugs are safe -- or even that they are in fact from Canada. Reviews by the U.S. Food and Drug Administration have shown that few drugs advertised as "Canadian" have been inspected under the Canadian drug regulatory process. Consistent with inspections that occurred under my watch at the U.S. Department of Health and Human Services, on Dec. 16, the FDA announced that an investigation, aptly named "Bait and Switch," found that 85 percent of the drugs advertised as Canadian in fact originated in 27 other countries.

As FDA Chief Dr. Andrew von Eschenbach has stated, these drugs are "of dubious origin, safety and efficacy." Consequently, customs officials should be commended for diligently performing their job of confiscating illegal shipments of drugs. Enforcement of long-standing safety laws helps to reduce the risks associated with drugs of uncertain origin and safety.

As Nevada officials contemplate ways to help people have access to affordable drugs, they should keep in mind the recent series of developments in neighboring California.

In early January, Gov. Arnold Schwarzenegger strongly advocated for drug importation from Canada. A mere four months later, California now leads the country in the number of Medicare beneficiaries with drug coverage, and the calls for importation have died down. Nevada should take note of the success of the Part D benefit and take advantage of this significant opportunity afforded its seniors. Instead of promoting risky drug importation schemes, I hope that Nevada will instead leave prescription drug coverage to the program that has provided America's seniors with health care coverage for more than 40 years: Medicare.

Nevada residents would be better served if its officials encouraged enrollment in the benefit before the approaching May 15 deadline.

Tommy Thompson

WASHINGTON, D.C.

THE WRITER IS FORMER SECRETARY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES.