July 15, 2011Dear Sir,The announcement that the Ministry of Health is going to allow the importation of generic prescription drugs from countries not hitherto permitted has raised questions, hackles and fears for the safety of the patients who will take these medications.The thrust of most of the objections to the Minister's proposal is in the area of quality control: the source countries nominated have a muddied reputation when it comes to the manufacture and distribution of low-grade or downright phoney pharmaceuticals. This may be true, although I expect that most of the bloggers and screamers commenting, privately and publicly, don't really know a lot more about the subject than I do, which isn't very much. However, there is no question in my mind that the Minister should have consulted the relevant professionals in Bermuda's pharmacy arena, who do know more than I, the bloggers and the Minister combined about the chemistry involved. Be that as it may, the safety issue will hopefully be sorted out.But what has been missing, at least from what I have heard and read, is debate about the true bottom line, the possible saving to the patient that generic drugs can and will realise, which I believe is what the Minister set out to sell to us at the beginning. Here's my first question: how much cheaper is the drug (presuming it's of good quality) made in Brazil than the (chemically) same cheapest Canadian equivalent? Maybe quite a bit, but what will the retail price to the consumer be? Who will be importing the drug — pharmacy, agency, Government, NGO — and will the markup be controlled? The wholesale cost might be $10 from Brazil, $20 from Canada, and we find the cost to us is $80, the generic price, against $100 for Big Pharma's version. That, I submit, is where the controls should come in, every bit as important as those of quality.You think, I'm sure, that the numbers I have suggested are a gross exaggeration. They are not. Here's a link to an article written six or seven years ago in the US, about the disparity in generics prices within the US (in fact within the confines of just one city):http://web.archive.org/web/20050316092358/http://www.wxyz.com/wxyz/ys_investigations/article/0,2132,WXYZ_15949_2635151,00.htmlThis is where the real savings can happen and, conversely, where the rip-offs and big profits will be found. So my suggestion is: buy the cheapest generics from the US, Canada et al where we know them to be safe. And make sure the importer is marking up to the minimum required by the overheads. That should make everybody happy (except perhaps someone who had expected to strike it rich on the new generic gold coast.)Now let's see who gripes and growls about this suggestion.MOONMANWarwick