I read an article today about "reimportation" of drugs. When I looked up "reimportation," it said to "import again" (duh!). What exactly would it mean when talking about medicinal agents? Is this a common term that I have just missed? Is there a "reexportation?"

I assume the content of the article was medical. When I read the first few words the only meaning that occuurred to me was for illegal drugs. I was thinking drugs produced, drugs exported, drugs find their way back to the originating country.
It sounds from your question as if that's not the context here though.

This was an article in the newspaper about bringing in legal prescription drugs from other countries at a discounted price. I am just not sure why they are called "reimported."

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Originally posted by Kalleh:
This was an article in the newspaper about bringing in legal prescription drugs from other countries at a discounted price. I am just not sure why they are called "reimported."

Perhaps the term refers to drugs that are manufactured in the US, exported to foreign countries, then brought back into the US, as opposed to imported drugs which are manufactured outside the country.

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Originally posted by neveu:

Perhaps the term refers to drugs that are manufactured in the US, exported to foreign countries, then brought back into the US, as opposed to imported drugs which are manufactured outside the country.

That's how I'd understand it from the context.

I agree to this interpretation. What I do NOT get is how they can cost LESS when brought back here from Canada or elsewhere when they originated in the USA. Somebody's got a financial officer who studied "new math!"

ANNNNND furthermore, why not call it "de- exported?"

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Originally posted by Asa Lovejoy:
I agree to this interpretation. What I do NOT get is how they can cost LESS when brought back here from Canada or elsewhere when they originated in the USA.

Hey, someone's gotta pay for those massive television ad campaigns.

What I do NOT get is how they can cost LESS when brought back here from Canada or elsewhere when they originated in the USA.

It's the research that is done here on drugs. My understanding is that other countries let us do the research (that is really expensive), and then they manufacture the drugs based on our research.

My gut feeling is that reimportation doesn't mean the drugs were manufactured here, exported, and then reimported. My reasoning is that other countries are quite capable of developing the drugs; it is the research that takes so much time and money.

However, I just don't know what is meant by it.

It's perfectly possible for tax laws to be set up in such a way that goods manufactured in a country for export are exempt and imported goods subject to separate taxation so that to export and reimport goods ends up cheaper than to manufacture and sell them. I'm not saying that this is the case here, just that it provides an explanation of how it mighthappen.

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It's the research that is done here on drugs. My understanding is that other countries let us do the research (that is really expensive), and then they manufacture the drugs based on our research.

That's the Standard Explanation, but I think there's more to it. Going to the movies in Mexico is a fraction of the cost it is here; they just can't charge a day's wages for a movie, so they don't. I suspect they charge whatever the market will bear in each country.

Neveu, you are probably right.

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It's perfectly possible for tax laws to be set up in such a way that goods manufactured in a country for export are exempt and imported goods subject to separate taxation so that to export and reimport goods ends up cheaper than to manufacture and sell them.

Is that why I found Italian leather and name brands more expensive in Italy than in the U.S.? When I was in Italy, I was looking forward to buying my daughters some of the coveted name brands here, such as Gucci, Prada, and Armani...at cheaper prices. Lo and behold, the items were more expensive in Italy than in the U.S.! How annoying!

Hard to imagine Gucci, Prada and Armani being more expensive. Amazing. I understand the import/export thing . . . but honestly!

Remember, selling prices have only a passing connection with costs. Prices are part of the marketing mix; costs are an overhead.

One of the main drivers affecting prices is customer expectation. Which is why bottled water, exactly the same as the stuff that comes from the tap (faucet), costs about 10,000 times as much; people expect to pay that stupid amount. If they stopped doing so then the price would drop; after all, it costs as near to nothing to produce as makes no difference.

The USA is a "low-price" economy; there is much price competition and customer expectations are for low prices - which the Americans seek. In other countries the expectation of price is different and often higher. Ironically, in spite of being a "low price" economy the USA is actually quite a high cost economy since wages, rents, etc., are high.

In a market-based economy producers and sellers will seek to maximise their profits - which means charging what the market will bear. Generally speaking the US market will not bear the same price levels and thus profit margins as will many European countries' markets.

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Asa: What I do NOT get is how they can cost LESS when brought back here from Canada or elsewhere when they originated in the USA.
Kalleh: It's the research that is done here on drugs. My understanding is that other countries let us do the research (that is really expensive), and then they manufacture the drugs based on our research.
neveu: That's the Standard Explanation, but I think there's more to it. Going to the movies in Mexico is a fraction of the cost it is here; they just can't charge a day's wages for a movie, so they don't. I suspect they charge whatever the market will bear in each country.

Not quite, neveu. I believe that in Canada, the goverment limits the price that may be charged for drugs.

Which is why bottled water, exactly the same as the stuff that comes from the tap (faucet), costs about 10,000 times as much; people expect to pay that stupid amount.

Boy, do I agree with that, Richard. How in the world can people pay so much for bottled water?

The OED Online defines reimport as "To bring back; spec. to import again to the country exporting, and cites it from 1742.

Sheldon Richman, in an article titled "Reimporting Drugs Is OK, But It Misses the Point," (July 30, 2003) argues that "Congress [is]doing something right for the wrong reason." Here's a quote from that article. The bolding is mine.

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There’s a simple reason that some, though not all, drugs are cheaper in Canada. The Canadian government sets maximum drug prices, which is what many members of Congress would like to do here. Anyone familiar with basic economics knows that price ceilings discourage suppliers from bringing products to market. This would be especially true with pharmaceuticals, which are so expensive to develop. Why would anyone make that investment if the law deliberately kept prices below what the market would set? The result would be a halt in the creation of life-saving drugs.

If that’s so, why do American companies export drugs to the price-controlled Canadian market? They do so because the government there sets prices enough above marginal cost to make exports worthwhile. In America the companies can freely set prices (inflated by patents) and recover the immense development costs. Then they can produce additional pills and sell them for a bit more than it costs to produce them. The slight profit in Canada is sufficient only because America does not have price controls.

Note the last sentence. In this article (September 29, 2000), Robert Goldberg of the National Center for Policy Analysis, says that the lack of price controls in the US that are responsible for the low prices in Canada are also responsible for the ability of US Companies to develop and manufacture new drugs.

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Physicians and patients in the United States have better access to innovative treatments than do those in any other developed country. And the U.S. has become the world leader in biotechnology, including the development and manufacture of new drugs. The main reason is the lack of price controls. In almost every other industrialized country, choice of and access to the most effective new drugs are limited by drug price controls and other government restrictions.

Tinman

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Not quite, neveu. I believe that in Canada, the goverment limits the price that may be charged for drugs.

Interesting. If they do they they are in a minority in the "free" world. In many countries price control is not only uncommon but in many cases illegal.

In the UK any form of price-fixing, now matter by whom, is now illegal. Drugs (along with books) were one of the last bastions of price control but even they can now be sold at whatever price the retailer chooses to sell them at. Of course, the drugs companies don't like that at all since it means they can't charge high prices to help recoup their research costs more quickly.

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Not quite, neveu. I believe that in Canada, the goverment limits the price that may be charged for drugs.

Drugs are also cheaper in Mexico, which does not have price controls.

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How in the world can people pay so much for bottled water?

Because tap water in my area tastes disgusting. When I was a child I never drank water because I didn't like the taste, and every adult to whom I said this would patronisingly reply 'but water doesn't have a taste'. It was only years later that I found out that there are in fact many people who can taste - and dislike - the added chemicals in tap water (some areas have better-tasting tap water, but I don't live in one). Add to this the fact that the Nanny State has approved the addition of even more superfluous goodies (such as fluoride, which some studies have suggested can cause health problems if too much is ingested rather than just brushed onto one's teeth), and it's no wonder people are turning to overpriced mineral water - which is far cheaper in France, btw. No-one should add anything other than what is hygenically necessary to our drinking water, because most of us have no choice other than to drink it - how dare they force potentially dangerous (woefully undertested at least) chemicals on us under the guise of 'improved' public (in this case dental) health?

I go to Malvern when I can and get my water straight from the spring

And yes, I've had several 'taste tests' foisted on me by non-believers. And yes, I've identified the tap water every time

Having sampled the water in the mid-continent, I now know why so many people are pouring into Oregon and Washington: water that doesn't clink and clatter when it hits the glass! Aquifer, WHAT aquifer - it comes right off the mountains!

Well, we have an interesting conflict here. Tinman quotes a Cooper article saying that most of the industrialized world (except the US) has price controls on drugs ...
but RE says that they are "not only uncommon but in many cases illegal."

I'd suggest you're talking about different things: "price controls" are not "price fixing". The latter means collusion amoung business competitors colluding to agree upon a price -- it is indeed generally illegal. The former, however, refers to goverment imposing a price, or a price ceiling, different from what the seller could otherwise get.

This matters to a manufacturer who has patent protection. By definition he can't price-fix with competitive manufacturers of the product (simply because, due to the patent, there are no such competitors). But if government price control limit him to charging (say) $2, when the market would be willing to pay $5, then it has in effect limited his patent.

Richard, if I interpret your second paragraph aright, you're saying that price-fixing (among retailers) is forbidden, which I don't doubt. But does UK law restrict ('control') the manufacturer's right to set the price he will charge as the sole manufacturer of his patented drug?

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But does UK law restrict ('control') the manufacturer's right to set the price he will charge as the sole manufacturer of his patented drug?

Yes. It is now illegal for manufacturers to set prices (although they can set recommended prices which most retailers will adhere to). However, they are not allowed to impose sanctions (by restricting supplies, for example) on retailers who decide to sell for other than the recommended price.

There were a number of exemptions, drugs being one, but I believe they have all been withdrawn, in spite of the protestations of manufacturers and retailers alike.

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But does UK law restrict ('control') the manufacturer's right to set the price he will charge as the sole manufacturer of his patented drug?

Richard, allow me to clarify my question.

You're saying when the drug manufacturer sells to the retailer or wholesaler, he may not set the price the retailer must charge when reselling to the consuming public. I wouldn't have thought otherwise. The retail remains free.

But my question is, "Do the British govenment and law restrict the price which a drug manufacturer may charge when making his own sales (whether to retailers or wholesalers) of a patented drug?" That's the type of price control I was asking about.

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Add to this the fact that the Nanny State has approved the addition of even more superfluous goodies (such as fluoride, which some studies have suggested can cause health problems if too much is ingested rather than just brushed onto one's teeth)

I, too, have read these studies - and those studies that prove exactly the opposite. Flouride is added to some tap water to bring its level of flouridation to the same levels that appertain in some natural sources. The only research I have seen that has been properly validated is that which shows that tooth decay in regions where the water has high levels of natural flouride is less than that in areas where the flouride level is less.

Water companies have been adding substances to water for many years - and taking them out, too. Many brands of French mineral water have levels of nitrates (from the synthetic fertiliser that the French farmers use in large quantities) that would exceed permitted levels for UK tapwater.

I am prepared to accept that your tap water might not taste all that good - I have never drunk it. However, proper blind tests (where all the water is served chilled and in disguised bottles) have been undertaken in my part of Surrey many times. On each and every such occasion the East Surrey Water Company's tap water has been found to have the best taste by those who can detect a difference.

Some tap water can have its taste affected by dissolved solids (not always from the company's supply - some people's plumbing is itself a source of contamination) and those who feel that their own water tastes poor for this reason should consider using a water filter - a much cheaper option than buying bottled water. Incidentally, some brands of bottled water are simply ordinary tap water, bottled (and maybe filtered). Coca Cola's is one such.

Most people who claim to be able to detect tap water have never tried it when it has been treated in the same way as bottled water - filtered and chilled.

Quote "...But my question is, "Do the British govenment and law restrict the price which a drug manufacturer may change when making his own sales (whether to retailers or wholesalers?" That's the type of price control I was asking about..."

Not as far as I am aware. Free market competition has been the mantra of our various Governments for many years.

Most of the non-prescription drugs available in this country have generic alternatives that cost far less (Disprin/soluble aspirin; Panadol/paracetemol).

So far as prescription drugs are concerned I don't know. We do not have to pay for them in the UK - we only pay a flat-rate precription fee - and so most of us have no idea what they cost. I imagine it must be a lot since I get masses of spam offering me discounted drugs from places like Canada and the cost of some of them horrifies me!

There's another possible confusion. When someone speaks of the government limiting the prices of prescription drugs, are we talking about the government limiting the price the manufacturer can sell the drug for, or are they limiting the price the government-run health system will pay for the drug? Tinman's editorial quote implies it's the former, but I suspect it is the latter.

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Originally posted by shufitz:
Tinman quotes a Cooper article ...

Uh, that was Goldberg, not Cooper.

Tinman

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Incidentally, some brands of bottled water are simply ordinary tap water, bottled (and maybe filtered). Coca Cola's is one such.

That Dasani episode did make me laugh. The first I saw of it was when my brother showed me a free sample he'd got at a local cinema or something. I looked at it, read the blurb on reverse osmosis etc, had a sip, gave it back and said "that's tap water". I actually didn't even need to try it, but I did anyway. He almost didn't believe me until I explained what I knew of various purification treatments, and then of course it all came out that the stuff was indeed purified tap water being sold at an outrageous price.

So no, RE, if and when I buy bottled, I buy mineral water - I've checked labels on every foodstuff I buy for years and know most of the tricks (ooh! New thread idea!). I do also have a filter which, as you say, is far cheaper and does make the water more palatable and indeed more difficult (but still possible - I can usually do it) to tell the difference.

I wish we had East Surrey's water if it's that good! I tried some in France once that tasted as good as mineral water - although it might have been sourced from a local spring, come to think of it.

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Add to this the fact that the Nanny State has approved the addition of even more superfluous goodies (such as fluoride, which some studies have suggested can cause health problems if too much is ingested rather than just brushed onto one's teeth),

I do hate to disagree with dear Cat, but in this I must. When put into the water in appropriate amounts, there are no side effects of fluoride, and the benefits are quite significant. The research has shown a significant decrease in dental caries with fluoridated water, and dental disease can not only be painful and expensive, but can cause other physical problems as well. In fact, one unanticipated effect in the U.S. of so many people drinking bottled water (especially children) is a surge in dental caries. I always ask my kids to buy bottled water with fluoride, if they must have bottled water. However, there is nothing wrong with tap water here; it's just that bottled water is a fad right now.

Neveu, I tried to get the facts on a comparison of what the U.S. spends on developing new drugs, versus what other countries spend. I haven't been able to find those statistics (yet), but I feel very confident that the U.S. spends significantly more money developing drugs than the rest of the world and that is one reason for our increased drug prices. I did read that China and India are beginning to develop more drugs. I also found that it takes an average of 10 years before a drug has been adequately tested to be marketed.

On the other hand, I don't want to sound like I think the drug companies are poor. I know they aren't. They remind me of the malpractice insurance companies, always whining about their situation, while their executives and stockholders are making big bucks. The drug companies literally bribe physicians to prescribe drugs by donating to conferences, funding research, providing lunches for residents, etc. I will say that physicians are finally beginning to deal with this and are refusing to take these freebies.

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I haven't been able to find those statistics (yet), but I feel very confident that the U.S. spends significantly more money developing drugs than the rest of the world and that is one reason for our increased drug prices. I did read that China and India are beginning to develop more drugs. I also found that it takes an average of 10 years before a drug has been adequately tested to be marketed.

I know this is the standard explanation, but it doesn't make any sense. The costs of R&D are divided among the total market, not shouldered by the citizens of the country that happened to develop it. If a drug were developed in Sweden and sold internationally, no one would argue that the Swedes should pay for the R&D and everyone else should get it cheap. It's just pharmaceutial company propaganda. I'll stick with my model: it's capitalism and they charge what the market will bear.

And I am not taking one model because I think the problem (as with malpractice lawsuits) is far too complex for that.

It is a fact that the large American drug companies spend billions of dollars on the development of new drugs, and part of this is drugs for very rare diseases. (Likewise, our own government spends millions of dollars on drug development throught NIH funding.) The companies have to recoup that money some way, and they do it by patents on their trade name drugs. Then they keep those patents active for as long as possible, often through dubious methods, so that generic drugs (much cheaper) cannot be marketed. My point is that it just isn't all pharmaceutical company propaganda, though some of it is. There has to be a better way, I think we all agree with that.

As I said, it is quite similar to the perceived malpractice "crisis" in the U.S. Again...there is insurance company (and political) propaganda there, and I have seen their outlandish misuse of and misstated facts and statistics. The malpractice problem is far too complex for there to be one, and only one, cause too. Yet, there are many who blame the problem soley on the lawyers. Those same people forget about the 98,000 people killed every year in the U.S. because of medical errors. This is a very complex issue, as well.

BTW, I was at an international conference in Washington DC recently, and some physicians from Denmark said they had 1 (I may be wrong, but it was definitely a single-digit number) lawsuit in 5 years! The American physicians there were just stunned!

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Yet, there are many who blame the problem soley on the lawyers.

Ambulance chasers ARE a problem, but, as you say, just one of several. I note that the present administration is attempting to move all class-action lawsuits to federal courts, where such suits are less likely to succeed than in the states. But does it address the complex problems of patients who fail to accept responsibility for themselves, or ambulance chasers, or incompetent doctors? Not that I can see.

The principle behind insurance is indemnification, or "making whole" a loss. The problem arises when someone tries to make an inflated estimate of the loss of one's health or quality of life. Punishment and indemnification are not the sme, yet insurance companies are faced with paying for both when the loss is an intangible one.

In the UK, for some years, we have adopted the US model whereby people can sue for a specific sum, not just for damages. This means that "ambulance-chasing" has started here and we now get advertisements from lawyers advertising "no-win, no-fee" deals.

Previously damages were assessed by a special panel and lawyers were not allowed to advertise their services, except by means of a brass plate outside their doors.

I think it's a very bad change and hope that the new Government looks very hard at the whole situation.

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yet insurance companies are faced with paying for both when the loss is an intangible one.

I urge you to look at the dividends paid to the insurance stockholders, the compensation (including their hidden golden parachutes) paid to their executives, their luxurious offices and expenses, etc. I also suggest that many of their "current headaches" are due to their very poor business decisions during the 90s when stock pricse were rising. I don't feel one bit sorry for them.

I suppose I should comment on water, since I drink little else. I have a well, and the water is hard and smelly (sulfur). I run all my water through a whole-house filter, and I filter my drinking water a second time (through a Brita pitcher). I need a water softener, but I hate the things.

I seldom see any of my co-workers drink the water from the water cooler, which is all I drink at work. They drink, variously, Coke, Pepsi, bottled water, coffee, etc. I don't understand why no one likes plain water! I don't like unfiltered "city" tap water, but the water from our cooler at work must be filtered, since I find it very tasty. I would love to be a participant in a water-tasting test.

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I would love to be a participant in a water-tasting test.

Me, too, Sunflower. Heck, I even like unfiltered tap water and have never drunk anything else no matter where I have lived.

Sunflower, what do you think of Portland tap water? I agree, your water REALLY stinks!!! How about you, Kalleh? How's Portland water?

Mmmmmmmm!!!!! Give me more!

I like Portland's filtered tap water, but I actually prefer my own hard water - maybe just because I'm so used to it. I've been drinking rural well water for 20 years. Part of the problem with my current well, I believe, is that it should have been dug deeper, but I have no way of knowing for sure.