Floor Statements

Mr. Speaker, I rise again tonight to talk about the high cost of prescription drugs, and I am going to be showing a chart and talking about what I think are some pretty stubborn facts. But before I do, I just want to remind the Members of something that Abraham Lincoln said over 100 years ago: You can fool some of the people some of the time, you can even fool all of the people some of the time, but you cannot fool all the people all the time.

Earlier, my colleague, the gentleman from Indiana (Mr. Burton), rose and showed some righteous indignation about some of the kinds of advertising that are going on right now, and they are now saying that somehow if we are in favor of opening up markets to give Americans access to world-class drugs at world-market prices that somehow we are in favor of abortion, which is just a ludicrous argument to make. It says a lot about those groups, and I think my colleague, the gentleman from Indiana (Mr. Burton), raised some of the questions about the ethics of those groups who are sending out those brochures and running those ads.

I think it is fair to ask where the money really comes from, and I think we all know where the money really comes from, but at the end of the day I think we ought to ask ourselves about the ethics of the pharmaceutical companies, the companies who are actually paying for those ads, the companies who actually develop and sell RU-486.

Why is it that they want to change the subject? Why is it they do not want to talk about the real issue? They want to talk about anything they can except this chart.

The reason is simple. They cannot defend this chart. They cannot even explain this chart. I have asked them to explain this chart. Let me go through some of the numbers on this chart.

These are not somebody else's numbers. This is not some goofball group from Florida. This is not some left wing or right wing extremist. These

are my numbers. Because I went to Germany 2 months ago, and we bought 10 of the most commonly prescribed drugs. The total price in the United States for those same drugs, $1,389.65. We paid $373.30 in Munich, Germany. I cannot explain that. They cannot explain that.

We know that, for example, every day Americans consume thousands of tons of imported foods. Last year, we imported 318,000 tons of plantains. We imported $1.1 billion worth of bananas last year.

Americans gladly consume those bananas. About 40 percent of the orange juice that we consume in the United States now comes from other countries. We are an importer. Markets work. The reason we import is because we can buy those products cheaper in those markets than we can produce them here in the United States. But in many cases we are not talking about products that are produced somewhere else. Many of these products are produced here. But we are talking about products produced in FDA-approved facilities, drugs like Coumadin, which my father takes.

We bought Coumadin in Munich, Germany for $21. This same Coumadin package in Washington, D.C. sells for $89.95. Let us talk about ethics. Two years ago this package of drugs in the United States sold for $64. Nothing has changed. This drug was developed in the 1940s at the University of Wisconsin Veterinarian School. How did it go from $64 2 years ago to $89 today? Is that ethical? Is that responsible? Yet they sell it in Germany for $21.

My colleague talked about Tamoxifen. The American taxpayers paid to develop Tamoxifen. We paid hundreds of millions of your taxpayer dollars to develop Tamoxifen. They sell it in Germany for $60. A woman suffering from breast cancer here in the United States will pay $360 for this drug. Is that ethical? Is that responsible? Is that the kind of companies we are dealing with? Go down the list.

We had another example in several of the publications. The drug Taxol, we paid for the development. We took it through phase 2 trials at the NIH, the National Institutes of Health. We paid for all of that, hundreds of millions of dollars; and then the company came along and signed a licensing agreement, and we have gotten royalties back of $35 million, but the company has had sales of $9 billion. We got $35 million for the taxpayers after spending almost $500 million for developing the drug, and they got $9 billion in sales.

Let us talk about ethics and being responsible. We had a big debate last year about Enron and the stock holding companies and insider trading. We said this ethics thing has to change. This is one way we change it. We open up markets and hold people accountable, and things will change.

Mr. Speaker, I rise again tonight to talk about the price that Americans pay for prescription drugs relative to the rest of the world.

As I have often said, I think we as Americans ought to be willing to pay our fair share. But as Members can see, and I apologize for this chart, the numbers are a bit hard to read for Members who are watching on C-SPAN in their offices, but if you cannot read the chart, it is available on my Website. Simply go to gil.house.gov, and Members can review this chart.

This is a chart essentially showing the prices that we paid for prescription drugs, 10 of the most commonly prescribed prescription drugs, when I was in Germany 2 months ago. Then we asked some of the local pharmacies here in Washington how much those same drugs, same dosage and number of tablets, would be here in the United States.

Let us take this drug, Coumadin. This is a drug that was developed originally at the University of Wisconsin veterinarian schools. It was a rat poison. It was designed to help kill rats. It is a blood thinner. When they consume it, they mix it with feed, and the rats eat it, and they go back to their dens and bleed to death internally. It was found that in small dose dosages this was very effective for people with heart conditions. My 86-year-old father takes Coumadin. We bought this drug in Germany for $21 American. This same package here in the United States sells for $89.95.

Glucophage is another drug we bought in Germany. It is an effective drug against diabetes, borderline diabetes. I am not a doctor, and I do not play one here in Congress, but we bought this drug in Germany, 30 tablets, 850 milligrams, for $5. That same drug here in the United States sells for $29.95 for the same package. The report goes on and on.

Prozac, we had a relatively small difference. We bought Prozac for $36.46, but here in the United States it was $49.95.

But then a drug like Pravachol, the price we paid in Germany was $62.96. That same drug and same dosage in the United States is not $62 but $149.95.

My wife takes a drug called Synthroid. She has a problem with goiter. Synthroid in the United States, 50 tablets of 50 milligrams sells for about $21.95. You can buy that exact same drug probably made in the same plant under the same FDA approval in Germany for only $4. So $21.95 in the United States, $4 in Germany.

Then I come to the one that really chaps my hide because we hear about the reason these drugs are so expensive is because it is so expensive to develop them, the research and development costs. And I recognize there are costs, but let us talk about tamoxifen, which was essentially developed by the NIH. So we paid for it. The American taxpayers paid for virtually all of the research and development. We bought 60 tablets, 20 milligrams of tamoxifen in Munich, Germany, for $60. That same drug in the same package sells in the United States for $360.

Now, tamoxifen is a very effective drug against women's breast cancer. We are happy to pay our fair share for the research costs; but as I always say, we ought to be willing to subsidize the poor people in sub-Saharan Africa, we should not be required to subsidize the starving Swiss.

And that is what is happening today because American consumers are being held captive. Some people ask why are prices so much cheaper in Europe. Well, in part they have something called price controls. That is part of the answer, but it is not the whole answer. They also allow in Germany, for example, they allow German pharmacists to do parallel trading. So the German pharmacist can order the drug wherever they can get it the cheapest. That is called competition. That is how markets work.

Mr. Speaker, I have introduced a bill called the Market Access Act, which would allow American pharmacists and American consumers to have that same kind of opportunity to go into the world markets. There are roughly 25 countries that are already recognized as having similar FDA- type regimens as we have in the United States, 25 countries are already recognized in the statute, and the bill I have would allow our pharmacists and our consumers to have access to those markets.

It may not be the perfect answer, but if Members do not like my plan, what is your plan? What is the administration's plan? What are we going to do about this? Because I will tell Members if next year we come back, and if Americans are still required to pay six times the amount for the same anticancer drug, they are not going to say shame on the pharmaceutical industry, they are going to say shame on us.

The time has come to make certain that Americans have access to world-class drugs at world market prices.

Mr. Speaker, will the gentleman yield?

Mr. Speaker, I want to thank the gentleman from Illinois, and I want to make a special point. This is time on the Democrats today. We have Democrats and Republicans that are agreed on this because, as I said in the past, this is not a matter of right versus left. It is a matter of right versus wrong, and it is simply wrong to require that Americans pay the world's highest prices for prescription drugs, even though we are the world's best customers.

In virtually every other area that you can imagine, the best customers get the best prices, but that is not true in prescription drugs, and I began to research this story about 5 years ago, and the more I learned, the more upsetting and compelling this story really is.

The story is that Americans are really held captive, and anytime you have a captive market, it is absolutely predictable that you are going to see the world's highest prices.

I want to give you a few examples from this chart. I apologize, this chart is kind of hard to read, but I will show you some of the examples, and I will give you the total, because I was in Germany 2 months ago, and we bought 10 of the most commonly prescribed prescription drugs. What you see here on the chart is the prices that we paid in Munich, Germany, and what those prices would be for the same drugs, same quantities, same milligrams, here in the United States. Let me give you a few of those examples.

This is a drug called Coumadin. It is a blood thinner, actually developed at the University of Wisconsin veterinarian schools, and actually originally developed as a rat poison, but in the United States, this box of drugs would sell for $89.95. In Germany we bought the drug for $21.

Here is another drug, Glucophage, made by Merck. It is a very effective drug for diabetes. A 30-tablet, 850-milligram package in the United States, $29.95. You can buy that same package, this package of drugs we bought in Munich, Germany, for $5.

The story goes on. Zocor, commonly prescribed drug, a very effective drug, the United States price, $89.95. You can buy that drug in Germany for $41.20.

The grand total of these 10 drugs in Germany was $373.30 American, but if we went down to buy them here in Washington, D.C., or almost any city in America, the price would be $1,039.65.

In fact, in many of the cases, I believe these drugs were made in the same plants, and they are shipped around the world.

All we really are saying in our bill is let us do with prescription drugs essentially what we do with every other product, and that is allow market forces to work to make certain that Americans are not held captive, and as I have said, I think Americans should pay their fair share, but I do not think we should be required to subsidize the starving Swiss.

We also have a colleague with us tonight, my good friend from North Carolina (Mr. Jones) who has joined us tonight, and he has been a strong proponent of opening markets and finding ways to get cheaper prescription drugs not just for senior citizens, but for all Americans. Ultimately we are going to have a prescription drug benefit for the taxpayers as well, and I would yield, if I could, a few minutes to the gentleman from North Carolina.

Mr. Speaker, if the gentleman would continue to yield, I thank the gentleman from Illinois, and I thank my colleague from North Carolina as well.

One of the arguments that they are making is this is not safe, you cannot be reimporting or importing or opening markets to these drugs. And once again, let me say, first of all, we are only talking about FDA-approved drugs from FDA-approved facilities, number one.

Number two, what more and more of the companies are coming out with, and we require in our legislation, and that is, they begin to develop counterfeit-proof packaging, tamper-proof, counterfeit-proof packaging.

The other thing people need to understand is we are not saying people have to do this. This is their option. We want to make certain that they are not treated like common criminals, because right now seniors are doing this. There was a study done by a University of Texas professor. A million Americans right now are crossing the border to buy their prescription drugs, and they have no assurance, no tamper-proof packaging, and worse than that, they are treated like common criminals by their own government.

So we want to make it safer. We actually want to put in a regimen, a plan, so that people can do this and their pharmacists can do this, because my vision is people ought to be able to go to the local pharmacist, and he ought to be able to shop for the best price on the best drugs. It is called parallel trading. That is what they do in Europe, and it is why they get cheaper prices than we do here in the United States.

We are concerned about safety, too. I do not want people dying from taking contaminated drugs, but remember this: Every day we import thousands of tons of food. Last year we imported 318,000 tons of plantains, and so if someone wants to tamper with things that go into people's mouths, they are more likely to do it with food products than they are with something that comes in a tamper-proof, counterfeit-proof package.

We are only talking about FDA drugs, and more importantly than that, you are correct. There are only, as I am told, about 600 facilities in the world that can produce FDA-approved drugs, and so that is the only drugs that we would permit, and we believe that a program can be established very easily using modern technology so that we can be as certain that these drugs are, in fact, Coumadin or Glucophage from an FDA-approved facility.

We can be just as assured of that even if we get the drugs from Geneva, Switzerland, or from right down the street. We want safe drugs. We want seniors to be safe. And I think we have the plan that will do that.

Mr. Speaker, the gentleman is correct. The Congressional Budget Office, which are our official bean counters, if you will, have estimated that seniors in the United States over the next 10 years will spend $1.8 trillion on prescription drugs. We can see by this chart, and I think we were very conservative, we estimate that if we simply open markets, as we do with plantains and with prunes and with pork bellies, if we just open up the markets as we do with everything else, we will see prices in the United States drop by at least 35 percent. Well, 35 percent of $1.8 trillion is $630 billion that we will save American consumers and/or taxpayers.

If I can give just one more example. We had an Inspector General who testified before the Committee on the Budget just yesterday, her name was Dara Corrigan, and she estimated, and these are her numbers not mine, but her numbers were that last year Medicare through the hospitals bought $8.2 billion worth of prescription drugs. If they could have bought those drugs at the same price that the VA buys those drugs, her estimate was that taxpayers would have saved $1.9 billion last year.

Now, my assertion is that if we open up the markets, we are going to save the VA, we are going to save Medicare, we are going to save Medicaid, we are going to save consumers, we are going to save corporations.

Last year, General Motors spent $1.3 billion on prescription drugs. Imagine how much they could save if they had access to world market prices.

I would just simply say that I hope we can have a vote. This is the people's House. Vox popolurum est vox dei, the voice of the people is the voice of God. There is where the people's business should be done. Occasionally we have partisan differences and we vote differently, but this is one that crosses party lines. It is not a matter of right versus left; it is right versus wrong. It is wrong for Americans to be held captive.

Absolutely. I know the gentleman wants to catch his plane, but I just want to say this. Regardless of what happens in the next week or two, we are not going to go away. This issue will not go away. We will stay here, on a bipartisan basis, every night for the next 6 months, 9 months, 3 years. We are not going away. The issue is not going to go away.

There is no way that our leadership, the administration, the FDA, the drug companies can defend a situation where Americans pay two and a half times more for the same drugs than our counterparts in Germany. I am not going to give up, my colleagues here tonight are not going to give up, and God bless you all.

Mr. Speaker, I rise again tonight to talk about the high price that Americans pay for prescription drugs relative to the rest of the world. I have with me a chart, and some of my colleagues have seen this chart, and I apologize, it is a little hard to read for the Members who are watching in their offices on C-SPAN, but what it really shows us are 10 of the most commonly prescribed drugs that I and my staff purchased when we were in Germany about 2 months ago at the Munich Airport Pharmacy, and then a comparison of what those drugs sell for here in the United States.

Let me just read for my colleagues what some of those prices are. Cipro, a drug that we learned a lot about when we had anthrax here in the Capitol complex, is a very effective antibiotic, made by a company called Bayer. They also make aspirin and a lot of other drugs. The price in Germany for 10 tablets, 250 milligrams: $35.12. That same Cipro here in the United States: $55.05.

A drug that my father takes, Coumadin, is a blood thinner. Some of my colleagues say, well, we cannot open up markets because people might get rat poisoning. Mr. Speaker, Coumadin is rat poisoning. It was developed at the University of Wisconsin veterinary schools, and it sells under the generic name of Warfarin. But Coumadin in the United States, and my father takes it, the price for 100 tablets, 5 milligrams in the United States: $89.95. In Germany you can buy that same Coumadin for $21.

Glucophage is a very commonly prescribed drug for people who have borderline diabetes. In the United States the price is $29.95 for 30 tablets. In Germany we bought that drug for $5.

Another drug that we paid for, the taxpayers, you paid for this drug, Tamoxifen, a very amazing anti-breast-cancer drug, we paid about, I think the number was over $500 million through the NIH to develop and take the drug through phase 2 trials. We pay in the United States $360. They buy that drug in Germany for 60 bucks. Now, we paid for the development, and now, apparently, we are paying for the marketing, the advertising and, ultimately, for the profit on that drug.

The bottom line is these 10 drugs bought in Munich, Germany, the total price in dollars: $373.30. Those same drugs bought here in the United States: $1,039.65.

My colleagues do not have to take my word for it. Today, like Diogenes, I finally found an honest person inside the administration who will talk honestly about what we pay for drugs. She is an IG, an inspector general, in the Department of Health and Human Services. Her name is Dara Corrigan. She testified before the Committee on the Budget today. She said that Medicare last year spent about $8.2 billion on drugs, drugs that are administered in hospitals. She said, according to her research, that the Medicare people paid $1.9 billion more than they would have had to pay for the same drugs had they bought them through the VA.

Now, I asked her, had they or anybody done any comparisons between how much Medicare is currently paying or will pay as we move down the road towards a prescription drug benefit under Medicare; how much would they pay if they could have bought those drugs from pharmacies right off the rack in Germany or Switzerland or some other industrialized country?

The bottom line is this, I say to my colleagues: We need to do something about this, because it is not so much shame on the pharmaceutical industry, although it is hard for me to defend this. I am a Republican; I believe that profit is a good word. But profiteering is a bad word, and somehow we have to come to grips and create a market environment so that we have competitive prices, because Americans deserve world-class drugs, but they deserve to be able to buy those drugs at world-market prices.

So my answer may not be the best answer, but at least it is an answer: to bring an element of competition, competitive tension, into the prices that we pay relative to the rest of the world.

I believe that Americans should pay their fair share of the cost of research, and I am proud of the fact that we do pay our fair share. In fact, I think we ought to be able to subsidize, we ought to be willing to subsidize the people in sub-Saharan Africa, but I do not think we ought to have to subsidize the starving Swiss.

This is not just about economics, it is not just about the prices we pay. There is a moral undertone to this. I think, I say to my colleagues, it is time for us to take a very clear stand. The rumor is we may actually get a vote on this in the next week or 10 days. When we do, we are going to be asked, will we stand with the large pharmaceutical companies, or will we stand with our consumers? I hope we will give the right answer.

Mr. Speaker, I rise tonight in honor of Minnesota's 135th Infantry.

It is hard for us to imagine what it must have been like in the spring of 1861 when cannons announced the first battle of the Civil War by firing on Fort Sumter in Charleston Harbor. Minnesota's first Governor, Alexander Ramsey, happened to be in Washington on other business. Upon learning the news, he raced to the White House to become the first Governor to volunteer troops for the Union Army.

A few nights later, in Red Wing, Minnesota, William Colvill used his considerable size and agility, as he stood almost 5 feet, 5 inches tall, to elbow his way to the front of the line to become the first volunteer in the first regiment of the first State that volunteered troops to preserve the Union.

Minnesota's First Regiment fought with distinction in many of the bloodiest battles in the Civil War, including Fredericksburg, Bull Run, and Antietam. American history has a special footnote, however, to commemorate their actions on July 2, 1863 in that most famous of Civil War contests, the Battle of Gettysburg.

General Winfield Scott Hancock, commander of the Union forces, saw the vulnerability of General Sickles' New Yorkers, who had moved forward, leaving a huge gap in the Union line. Hancock noticed that the First was positioned somewhat south of the middle of the long Union line on Cemetery Ridge. He nervously rode up and asked, Colonel Colvill, how long can you hold your position? Colvill, who spoke in short, crisp sentences firmly answered, ``General, to the last man.''

Now, this was no idle boast. By the end of that day, the regiment would suffer 82 percent casualties.

That single phrase, ``to the last man,'' survives today as the motto of the Minnesota National Guard detachment that traces its heritage to the Minnesota First Regiment.

When the regiment headed off to war from Fort Snelling in 1861, they were 1,023 strong. After Pickett's charge at Gettysburg had been repelled only 2 years later, just 67 men could answer the call.

The Minnesota First went on to see action in the Spanish American War and served with distinction in the Philippine Insurrection. During World War I it was mustered into service, but did not see action as a unit.

That changed in 1941 when war clouds gathered far across the sea. The 135th Infantry became the first division to be activated and shipped out. Advance units of the 135th sailed to Africa to take on the famed Africa Corps of Field Marshal Rommel. Despite being outmanned and underequipped, the 135th turned back the Desert Fox and his Army.

After World War II, the 135th once again saw action in Korea.

Today, the 135th is a battalion; no longer a regiment. It has five companies compared with 20 years past. It is concentrated in southeastern Minnesota as a member of the historic 34th Red Bull National Guard Division.

That is why, this July 11 through 13, the thin ranks of the 135th Infantry's combat veterans of World War II and the Korean War, the ``Sons of Colvill'' as they are known, will gather to remember. They will close ranks in Mankato, Minnesota, to honor those who have fallen and to remember one more time the sacrifices of a generation.

Once again, they will listen to the special music that identifies the 135th: ``March of the Red Bull Lesions,'' ``The Old Gray Mayor,'' ``The Sons of Colvill.'' It will be a final hoo-ah for the surviving men of World War II, and it will be one more commemoration for the thinning ranks of the Korean War vets. And, it will be one last chance for us to say, ``thank you, well done, oh good and noble servants. You have brought hope and freedom to millions who will never know your names.''

Mr. Speaker, I salute the brave Minnesotans who have given so much to keep the lamp of liberty burning brightly throughout the world. To the families of those who have made the supreme sacrifice, we cannot adequately salve the wounds that will never heal. The best that we can say is that we will never forget.

May God bless you. May God continue to bless our country and all who defend her.

Mr. Speaker, let me first of all say that the gentleman from Ohio who just spoke, he and I strongly disagree. I happen to believe that it is time to modernize Medicare, it is time to give seniors more choices, and we will come to different conclusions on that particular issue. But there is an issue that we do agree on, and that is that Americans pay far too much for the same pharmaceuticals.

Last week, on Thursday, I was privileged to welcome to the Capitol and to one of my news conferences a true American hero. Her name is Kate Stahl. Kate Stahl wears a little pin that says ``Kate Stahl: Old woman.'' She is 84 years old and she is proud of the fact; in fact, she describes herself as a drug runner. I would encourage Members to get a copy of the June 9 edition of the U.S. News and World Report, and they will see a picture of Kate Stahl in that edition. And in there it says, and she is quoted as saying, ``I hope they put me in jail.'' Because what she does every day, working with the senior Federation in the State of Minnesota, is she helps seniors get access to world-class drugs at world-market prices. As a result, our own Federal Government treats her as if she is a common criminal. But she is prepared to go to jail to make a point, and that is that Americans should not have to pay the world's highest prices for prescription drugs.

We also welcomed to Washington last Thursday Dr. Wenner from Vermont. She is working with pharmacists in Canada so that her patients from her clinics can save, and these are her numbers, have been saving 62 percent on the same prescription drugs by working with pharmacies in Canada.

Now, the FDA acknowledged at a hearing that we had last week that any of the evidence about safety is only anecdotal. As a matter of fact, by their own numbers, they cannot come up with a single case where an American patient has suffered serious injury as a result of taking a legal prescription drug from a pharmacy from a different country. We also know that more people have become seriously ill and some have actually died from eating imported fruits and vegetables. We know that, for example, in one year, just a few years ago, over 1,100 Americans became seriously ill by eating raspberries that had been imported from Guatemala.

Now, when we talk about safety, I think the real question is, who are we protecting from whom? Who is really being protected by our FDA? More and more of us are coming to the conclusion that the only people really being protected are the big executives of the large pharmaceutical companies. We ask ourselves, why are Americans, the world's best customers, paying the world's highest prices? And the answer is, because we are a captive market and because our own FDA literally puts a border around our country and will not allow Americans to have access to those drugs.

As I mentioned, we import thousands of tons of food every day from all over the world. Last year, for example, we imported 318,000 tons of plantains. People say, well, somebody might get into these Fed Ex packages and get inside the tamper proof packages and somehow substitute counterfeit drugs, but again, the evidence of that is anecdotal at best, and if we stop and think just for a moment that if terrorists really wanted to get at the broad base of the American consumers, would they really resort to trying to break into UPS offices, Fed Ex offices to get into those packages and somehow tamper with those pharmaceuticals? I think common sense tells us that that simply is not going to happen.

We as Americans should be willing to pay our fair share for all of the costs of the research and development for the miracle drugs that are coming out of the pharmaceutical companies that help save lives. We ought to be willing to pay our fair share, but we have to be willing to say that it is time for us to say, yes, we will subsidize sub-Saharan Africa, but we are going to stop subsidizing the starving Swiss.

I am a Republican. I believe that the word ``profit'' is actually a good word. There is nothing wrong with the word ``profit,'' but there is something wrong with the word ``profiteer,'' and I am delighted that we have people like Kate Stahl who will stand on the shoulders of the sons of liberty who threw tea in Boston Harbor because they saw something clearly was unfair, and they were not going to take it anymore. She represents literally millions of seniors and consumers here in the U.S. who are saying enough is enough, we are not going to take it anymore.

I would like to thank the gentleman from Illinois for taking a leadership role on this important issue. This is a huge issue. Members need to know that the estimate that the Congressional Budget Office is currently using is that seniors alone over the next 10 years will spend $1.8 trillion on prescription drugs. As the gentleman alluded to, I have been doing research. I should not say I have been doing research; there have been groups who have been sending me research for the last 4 or 5 years in terms of these great disparities between what Americans pay for name-brand prescription drugs versus the rest of the world. We have heard a lot about Canada; we have heard a lot about Mexico. But what has intrigued me the most is the differences between what we pay in the United States and what they pay in the European Union.

What I have here is a chart of about 12 or 13 of the largest-selling prescription drugs. This chart is old and the numbers have changed, but the percentages remain the same. This information is confirmed by research that I have done, that others have done, several groups have done this; but let me just run through a few of these examples. Augmentin, sold in the United States for an average of $55.50. You can buy it in Europe for $8.75. I have examples of these drugs. We actually went to Germany and bought some of these drugs. This is Augmentin. This is Cipro. Cipro is made by the German company Bayer. They also make aspirin. As you can see, it is a very effective antibiotic and especially in the days when we had anthrax here in the Federal buildings, we bought an awful lot of Cipro. In the United States it sells for an average of $87.99. In Europe you could buy that same package of drugs for $40.75 American. Claritin, $89. It is $18 there. Coumadin, this is a drug that my father takes. He is 85 years old. It is a blood thinner, a very effective drug. Coumadin in the United States at that time was selling for about $64.88. In Europe you can buy it for $15.80.

And the list goes on, but let me give an example, and the gentleman from Illinois, I think, made a great point about the amount that American taxpayers spend to develop these drugs. This is a drug that really chaps my hide. This is a drug, Tamoxifen. In many respects, this is a miracle drug. It is probably the most effective drug against women's breast cancer that has ever been invented. This drug we bought at the Munich airport pharmacy for $59.05. We checked here in the United States. This same package of 100 tablets of Tamoxifen in the United States sells for $360; $60 in Germany, $360 here.

As I say, the evidence is overwhelming that most of the research,

and I have a report if any of the Members would like a copy, this is a Senate report done in May of 2000, and in the Senate report, if I could just read into the Record, the National Cancer Institute, part of the NIH, has sponsored 140 clinical trials of Tamoxifen. It also participated in preclinical trials consisting of both in vitro, laboratory and live-subject tests. In other words, here in a Senate report we have confirmed that the taxpayers paid for much of the testing that was done on this drug.

He also referred to the drug Taxol. There was a story just a couple of weeks ago in The Washington Post. Let me just quote some of these numbers about what the taxpayers paid to develop this drug and what the pharmaceutical company got out of it.

Bristol-Myers-Squibb earned $9 billion from Taxol, which has been used to treat over a million cancer patients; but the National Institutes of Health received only $35 million in royalties. You go down the article a little bit further and it says, the GAO, the investigative arm of Congress, said that the NIH spent $484 million on research on Taxol through the year 2002. So the taxpayers invested $484 million, took it most of the way through the research pipeline, and we got $35 million back.

Unfortunately, on Taxol I do not have that comparison. I do not think it is on my list, but the comparison is essentially the same. It is about three times more, or at least it was when it came off patent in the United States; it was more than three times more in the United States than they paid in Europe, and the American taxpayers paid for most of the R&D costs. By the GAO's own estimate, the taxpayers spent at least $484 million developing the drug, and I yield to my friend.

No. I have plenty of information, but the interesting thing about these charts and these comparisons, if people doubt what they paid for these drugs, we have the receipts. So we can literally go through and say, yes, this is what we paid for Tamoxifen, $59.05 in Germany, and we did not have a special discount card. We are not German citizens; so we were not going in for socialized medicine. These are drugs that we just bought off the shelf or from the pharmacist at the Munich airport. So it is not as if they are being subsidized by the German Government. The truth is they are being subsidized by us, and what I have always said is that Americans should be prepared and we are prepared and willing. I think most Americans are willing to subsidize the research for these miracle drugs. In fact, I think we are willing to subsidize people in developing countries like Sub-Saharan Africa, but we should not have to subsidize the starving Swiss.

And finally, let me just make one last point, and I will yield back. I am with the gentleman. I happen to be a Republican. The gentleman is a Democrat, but we are both capitalists. We both understand that there is nothing wrong with the word ``profit,'' but there is something wrong with the word ``profiteer,'' and there is growing evidence now that the big pharmaceutical companies are actually spending more on marketing and advertising than they are on basic research.

Mr. Speaker, if the gentleman would yield.

I think he used the word earlier and I think it is the critical word. He said that we are a captive market, and if we look around the world, whether it is beef and Japan or blue jeans in the former Soviet Union, anytime there is a captive market, what will happen is they will create an artificial price barrier which will guarantee that the consumers will pay outrageously higher prices, and that is what has happened here in the United States. The German pharmacist has the right to go anywhere within the European Union and buy this Tamoxifen where he can get it the cheapest for his consumers. That is part of the reason that Tamoxifen is $60 in Germany and $360 here in the United States. In fact, the companies are protected by our own FDA from any real competitive pressures which would help to keep prices down. And I do not say shame on the pharmaceutical industry; I say shame on us. They are only exploiting a market opportunity which our government has given them.

Let me just share with the gentleman and other Members from a book called ``The Big Fix'' because I think it helps tell the whole story by Katharine Greider, and she quotes a study that was done in 1998 by the Boston Globe, and they looked at the 35 highest-selling prescription drugs in the United States; and they claim, the Boston Globe, and then is repeated in the book ``The Big Fix,'' that 32 of the 35 largest- selling drugs in the United States a few years ago were actually brought through the research and development chain by the taxpayers through the NIH, the NSF, the Defense Department, or other Federal agencies, principally the NIH. So it is not shame on them, but it is shame on us. We do not get a rate of return. We get nothing except for millions of our consumers the highest prices in the world, and it is time for us to change that.

Mr. Speaker, let me just talk about a couple of things, and I think as we talk about this new benefit, and I think we all recognize there are far too many seniors that are not getting the prescription drugs that they need, there was a study done several years ago by the Kaiser Foundation, and they found in their survey that 29 percent of seniors responded that they have had prescriptions which they did not have filled because they could not afford them, 29 percent.

About one third. And I say shame on us because we have the power to do something about that.

I spoke several weeks ago to the Community Pharmacists, and I just had received this report from the Kaiser Foundation. I asked them as I looked out over this audience of roughly 300 pharmacists from all over the United States, ``Has this ever happened to you, where seniors come into the pharmacy, they hand you a prescription and you tell them how much it is going to be, and they drop their head and they say, `well, I will be back tomorrow,' and they never come back?''

Shame on us. Shame on us. We need to do something about that.

But as has been mentioned by several of my colleagues, if we go about this in the wrong way, we may not do enough to really help those seniors who really need the help. But, worse than that, we may bankrupt our children, and there is something wrong with that.

Let me also mention that we are moving ahead with this, and we have heard some of the sponsors of the various bills say, oh, but we will have these groups, and get very significant discounts and really good deals on prescription drugs.

Well, this is a study recently done by one of the cardinals of the Committee on Appropriations, and they literally went through and found out how much the Federal Employees Benefit Program is paying for some of these drugs. It is rather eye-opening.

There are some areas where they are actually getting good discounts and are competitive with the prices they get in Europe. But let me give you some examples. The Blue Cross-Blue Shield plan, for example, on Coumadin mentioned earlier, even with their discount, the combination of what the Blue Cross-Blue Shield plan cost is, and you add in the beneficiary cost, the total cost for Coumadin under the Blue Cross Blue Shield plan for a Federal employee is $73.74. Now, Coumadin can be bought for $15.80 in Europe. So $73, that is the Federal plan. You read down the list of all kinds of other drugs. It is very similar.

Zocor, the total cost for Zocor under the Federal plan, Zocor is one area where it actually is cheaper, but not much cheaper. With their deep discount, the total cost is $17.48. That same drug in Europe would be $28.

But as you go through the list, what you find is in virtually every category, even with these ``deep discounts'' that the Federal employees' plan is able to get, it still is significantly more than the average consumer gets them for in Europe.

One final point, if I could, the argument that many people make against reimportation is safety. But what about safety?

We import every day thousands of tons of food. It surprises me how many tons. In fact, the number I remember is we import roughly 318,000 tons of plantains every year, and every time we eat a plantain that comes in from a foreign country, we take a certain amount of risk, because that could contain some food-borne pathogen.

We keep very good records on how many people get ill from eating imported foods. Let me give a couple of examples. In 1996, 1,466 Americans became seriously ill eating raspberries from Guatemala, 1,466. The next year they did a little better. Only 1,012 Americans became seriously ill from eating raspberries from Guatemala.

The point I am really trying to make here is we take a certain amount of risk. I believe that the risk, particularly with the new technologies, and I am holding in my hand a tamper-proof, counterfeit- proof package for pharmaceuticals.

Here is one that is currently in use by the company Astrozenica. This is the first version of the tamper-proof, counterfeit-proof packaging. So this whole issue of safety relatively speaking, even today, it is very, very safe.

But with the new technology that is going to be coming on line, I am holding in my hands, and you cannot see this, but a little vial, and inside this vial there are 150 microcomputer chips. They are so small you can barely see them with the naked eye. But this literally is the next version of the UPC code.

Within 2 years they will be embedding these chips into packaging, so that we absolutely can know that this package of drugs was produced at the Bayer plant in Munich, Germany, on September 8 of this year, and was shipped to so and so.

So the whole idea that we cannot do this safely, it seems to me, is a specious and almost goofy argument. So I do not think we should even engage in it. It can be done, it is being done. It is far more safe to import drugs than it is raspberries from Guatemala.

I appreciate the gentleman mentioning the bipartisan nature of this, because we did a special order last week, and we had Democrats and Republicans. We had some of the most conservative Republicans, and what I think most of us would agree are some of the most liberal Democrats, agreeing on this issue, and that is Americans should not have to pay

the world's highest prices when we are the world's best customers and when we spend more for the development of those drugs.

I am also the vice chairman of the Committee on Science. Just to share with my fellow colleagues how much we spend on research, and we should be proud of this, this year in this budget we will spend almost $29 billion on various kinds of basic research. In fact, we represent as Americans less than 6 percent of the world's population; we represent more than half of all of the basic research done in the world. I am proud of that. But we should not have to pay for these drugs a second and a third time when we helped develop them.

We are not asking for special breaks. All we are asking for is fairness. Reimportation or importation is not a perfect answer, but we do know that markets are more powerful than armies, and ultimately markets, whether it is the market for grain or the market for diamonds, has a tendency to level prices all over the world.

Let me just mention one other thing, and I mentioned this in a 5- minute special order I did earlier. This is the June 9 issue of U.S. News and World Report. In it there is a true American patriot. Her name is Kate Stahl. She is 84-years-old and she describes herself as a drug runner.

The tragedy is that the American government treats her as a common criminal because she helps her fellow seniors through the Senior Federation of Minnesota acquire drugs from other countries at affordable prices. In the article she says, and this is why I think she is a patriot, ``I would like nothing better than to be thrown in jail.'' That is a patriot. She is willing to do that for her fellow seniors so that they can get affordable prices on drugs.

Mr. Speaker, just one last comment, and I thank the gentleman for this Special Order tonight. As we mentioned earlier, this is not a matter of right versus left, this is right versus wrong. It is simply wrong to make American consumers pay the world's highest prices for drugs which largely the American taxpayers helped develop in the first place.

The gentleman mentioned one other thing, and I think it is a very serious concern. Some people are saying, well, through these plans in Medicare, we will squeeze down the prices, but if we do not do something to bring market forces to bear on the overall cost of prescription drugs, what may well happen is the price for these prescription drugs will go up even more for those 41 million Americans that are currently uninsured. They are the ones who have to pay cash, they are the ones whose kids get sick with tonsillitis or ear infections or conjunctivitis, and they need those prescriptions as well.

So this is not just about helping to keep down the price of prescription drugs for seniors; it is for all consumers and particularly for those uninsured or partially insured Americans who pay the world's highest prices. Hopefully, on a bipartisan basis, we will ultimately begin to get at those issues, whether it is the whole issue of importation of prescription drugs or bringing the generics to market faster

so that Americans have those drugs at affordable prices.

But again, this is not a partisan issue as far as I am concerned. I look forward to working with the gentleman and other Members on the other side of the aisle because ultimately we owe it to every American to make certain that we get fair prices for the drugs that they desperately need.

Mr. Speaker, I thank the gentleman from Illinois (Mr. Emanuel) for this Special Order.

Mr. Speaker, I ask unanimous consent that when the House adjourns today, it adjourn to meet at 12:30 p.m. on Monday next for morning hour debates.

Mr. Speaker, I ask unanimous consent that the business in order under the Calendar Wednesday rule be dispensed with on Wednesday next.

Mr. Speaker, I rise again tonight to talk about the high cost that Americans pay for prescription drugs. I am so lucky. Today I got to spend a good part of my day with a true American hero. Her name is Kate Stahl. For Members who have not seen it, I recommend, and I will submit for the Record, a copy of last week's U.S. News and World Report; and they did a story, the title of which is ``Health on the Border, Elderly Americans head north and south to find drugs they can afford.''

Featured in the story is this American hero. Her name is Kate Stahl. She is an 84-year-old grandmother. She was here in Washington today. She wore a little sign. It just said, ``Kate Stahl, Old Woman.'' In my opinion, Kate Stahl is an American hero, and she is a patriot. She stands on the shoulders of great patriots like the Sons of Liberty who threw tea in Boston Harbor, because she has said in this article, and I will quote, ``I'd like nothing better than to be thrown in jail.''

Kate Stahl has thrown herself into this fight for lower prescription drug prices. She calls herself a drug runner. She goes to Canada regularly to bring back prescription drugs for her friends and neighbors who cannot afford them. She is a patriot. Recently, the Kaiser Foundation did a study. They found that 29 percent of seniors say that they have had prescriptions that have gone unfilled because they could not afford them. I do not say shame on the pharmaceutical industry. Shame on us. Because we have the power to change it. The reason that we pay so much, and no one disputes this, and they have charts in here and comparisons of what people pay in Canada, Mexico and in Europe. No one disputes the charts. The numbers are always the same. America, the world's best market for prescription drugs, pays the world's highest prices. No one disputes that.

But the question is why. The answer I think is pretty simple. Because we are a captive market. Because the FDA has literally said that Americans, unlike most other people in the world, cannot take drugs across the border.

I am a Republican, and I happen to believe that there is nothing wrong with the word ``profit.'' But, ladies and gentlemen, there is something wrong with the word ``profiteer.'' They have every right to expect a reasonable rate of return on their investment and their research, but they should not get it all from American consumers like Kate Stahl. Kate Stahl, is she a common criminal? I do not think so. But our own government treats her like a common criminal. In the end, we are going to have a debate in the next several weeks about prescription drugs; and in the end every one of us is going to have to decide, will we stand with those brave patriots like Kate Stahl or will we stand with the huge pharmaceutical industry? I hope we make the right choice.

[From U.S. News & World Report, June 9, 2003]

Health on the Border

elderly americans head north and south to find drugs they can afford

(By Susan Brink)

It's become something of a joke along the Maine-Canada

border. So many busloads of retired people crisscross the

line looking for affordable drugs that the roadside stands

should advertise, ``Lobsters. Blueberries. Lipitor.

Coumadin.'' Except, of course, that such a market in

prescription drugs would be illegal.

These senior long-distance shopping sprees fall in a legal

gray zone. But as long as people cross the border with

prescriptions from a physician and have them filled for no

more than a three-month supply for personal use, customs and

other federal officials leave them alone. The trip might be

tiring, but people can save an average of 60 percent on the

cost of their prescription drugs. For some, that's the

difference between taking the drugs or doing without. ``The

last bus trip I was on six months ago had 25 seniors,'' says

Chellie Pingree, former Maine state senator and now president

of Common Cause. ``Those 25 people saved $19,000 on their

supplies of drugs.'' Pingree sponsored a bill known as Maine

Rx, which authorizes a discounted price on drugs for Maine

residents who lack insurance coverage. The law was challenged

by drug companies but recently upheld by the U.S. Supreme

Court. It hasn't yet taken effect.

For years, field trips of senior citizens who live near the

borders have been organized to roll north to Canada and south

to Mexico. People in the middle of the country sometimes

found, if their prescription drug costs were especially high,

that they could save money on medications even if they flew

to Europe. The Internet has made it even easier for people to

fill their prescriptions from mail-order pharmacies.

Figuring out ways to spend less on prescription drugs has

become a multi-faceted national movement of consumers,

largely senior citizens. The prescription drug bill in

America is $160 billion annually, and people over 65 fill

five times as many prescriptions as working Americans on

average. ``But they do it on health benefits that are half as

good and on incomes that are half as large,'' says Richard

Evans, senior analyst at Sanford C. Bernstein, an investment

research firm. What's more, seniors account for 20 percent of

the voting public.

Face-off. It's little wonder that the May 19 Supreme Court

ruling got the attention of drug manufacturers and

politicians across the country. The often-over-looked state

of 1.3 million tucked in the northeast corner of the country

became David to the pharmaceutical industry's Goliath. The

face-off began three years ago when state legislators like

Pingree began questioning why Maine's elderly population

had to take all those bus trips.

Americans who are elderly and uninsured pay the world's

highest prices for prescription drugs. That's because they

buy their drugs individually, without the bulk bargaining

power of an insurance company or the federal government.

Other industrialized countries, like Canada, France, Germany,

and Japan, have national healthcare systems and can use the

bargaining power of their entire populations to negotiate

drug prices and set limits on how much drug manufacturers can

charge.

Though Congress has been debating a prescription drug plan

for years, seniors today still have no drug coverage under

Medicare. The Maine plan does not provide a drug benefit.

Seniors and the uninsured would still purchase their own

medicines, but the plan helps them get a discounted price on

drugs similar to that available to Medicaid recipients, in

effect bringing hundreds of thousands of individual (and

powerless) consumers into a powerful negotiating block.

Teaming the elderly and uninsured with Medicaid recipients

gives them bargaining power they've never had before. Drug

manufacturers are required to give Medicaid a discount of

about 15 percent below the list price or match the lowest

price on the market. That creates an incentive to keep the

market price as high as possible, says Katharine Greider,

author of The Big Fix: How the Pharmaceutical Industry Rips

Off American Consumers. But most consumers don';t notice the

high drug prices, because with health insurance they only pay

a small copayment. Only those lacking prescription drug

coverage--including many elderly--end up paying full retail

price for drugs.

The law's leverage disturbs the drug industry. It would

create formulary, or list of preferred drugs, for this block

of patients, similar to those used by many managed-care

organizations. If a manufacturer did not lower its prices, it

would not be on the state's formulary. Drug companies oppose

the law as a quality-of-care issue. ``Under Maine's program,

government officials, rather than doctors and patients, would

effectively decide which medicines will be available for

Medicaid and non-Medicaid patients,'' says a statement

from Pharmaceutical Research and Manufacturers of America,

the industry's trade organization.

The Maine drug plan was crafted three years ago, and health

officials are now refining a draft of the law to send to the

Legislature. But the pharmaceutical industry is far from

ready to give up the fight. ``I don't go to any meetings that

don't have five lawyers sitting around the table,'' says

Peter Walsh, acting commissioner or the Maine Department of

Human Services. Even when it goes forward, one small New

England state's law won't solve the nation's prescription

drug crisis.

The greater hope for consumers--and the greater threat to

the industry--is the clout of about 18 other states that have

filed bills similar to Maine's. ``The point at which you get

half or more states to do this, it becomes a more and more

significant intrusion into the market. And it becomes harder

for the pharmaceutical industry to fight back. That's why

they had to fight so hard against Maine's law,'' says Sara

Rosenbaum, professor of health-policy law at George

Washington University.

Going south. Meanwhile, individual consumers are figuring

out their own ways to bypass steep American drug prices. For

example, Bill Goff goes to Tijuana, Mexico, four times a

year. He flies from his home in Reno, Nev., to San Diego,

stays in the Travelodge, rents a car for a day, and crosses

the border to visit Carlos Cortez of Farmacia Internacional

with a fist-full of prescriptions. He has a host of medical

disorders, including rheumatoid arthritis, diabetes, asthma,

glaucoma, and osteoporosis. He would spend $32,000 a year on

prescription drugs in the United States, but he has cut his

annual cost to $9,500, even including travel costs. ``It's

not a matter of saving money. It's a matter of living,'' says

Goff. ``If I didn't go to Mexico, I couldn't afford the

drugs. I'd be dead.''

Others are skipping the travel altogether, some with the

help of 84-year-old Kate Stahl. She is not above using the

``grandmother'' image to further a cause. ``I'd like nothing

better than to be thrown in jail. People would say, `Oh, the

poor, frail old granny,''' she says with a laugh. ``I can be

very frail if I have to.'' Stahl volunteers with the

Minnesota Senior Federation, helping people get the forms and

information they need to get mail-order prescription from

Canada. The plan, called the Canadian Prescription Drug

Importation Program (www.mnseniorfed.org), is open to anyone

in the United States. But while no one seems ready to throw

the likes of Stahl in the slammer, the program's legality is

murky.

Though the Food and Drug Administration says it cannot

guarantee the safety of imported drugs (even if they're

exported from the United States, then reimported, as many

are), individuals filling their personal prescriptions are

generally left alone. But the agency has sent warning

letters to profit-making drugstores in the United States

that

help consumers get mail-order prescriptions from Canada,

saying that reimporting cheap drugs is a violation of the

law and a risk to public health.

Since Stahl and her organization do not profit from their

efforts, so far no one has hassled them. Rep. Gil Gutknecht,

a Minnesota Republican, is trying to pass legislation that

would make it easier for people to get their drugs from

Canada or overseas. Laws to that effect have passed twice

before, but both times the FDA protested that it could not

guarantee the safety of drugs reimported from Canada, and so

the law has not taken effect. Still, Gutknecht is not alone

in interpreting present laws in a way that allows people to

buy personal three-month supplies of drugs overseas without

problems.

Cortez has a conference table display of brand-name

prescription drugs in his Tijuana office. One by one he holds

them up. Pfizer's Lipitor, Eli Lilly's Prozac. Merck's

Fosamax. They're not loose pills; they are individually

bubble-wrapped within sealed boxes. ``We have no doubt that

what we're buying is what it is. It comes from world-class

labs,'' he says. And the 30 percent of his customers who are

American seem to agree.

He's aware of the irony: a businessman from the developing

world profiting on sales to desperate citizens of the

wealthiest country on Earth. ``It doesn't get more stark than

right here. You can see so clearly: Third World,'' he says,

pointing to the roadside squalor in Tijuana, the concrete

barriers at dusk crowded with men waiting for nightfall and a

risky dash across the border. ``First World,'' he finishes,

pointing toward the city of San Diego across the border. ``My

business thrives on people coming here from the States. But I

shouldn't have people thanking me for making it possible for

them to survive when they are from a country like the United

States.''

Mr. Speaker, I ask unanimous consent to claim the time of the gentleman from Indiana (Mr. Burton).

Mr. Speaker, I thank the gentleman, and it is not just Minnesotans and Michiganers who are smart. One of our favorite Presidents, Ronald Reagan, said it best: Markets are more powerful than armies. Starting several years ago, consumers figured out that they could buy their prescription drugs cheaper in Canada and Mexico, and now they know in Europe and almost every other industrialized country in the world they can buy the same drugs for dramatically less.

Mr. Speaker, as they used to say on The Tonight Show, you would be wrong, oh, great one. That is the irony. We are the world's best customers by any measure, and some people have challenged some of the sources, but nobody challenges the numbers. The numbers speak for themselves. Even now the pharmaceutical industry acknowledges that the world's best customers, the Americans, pay the world's highest prices for their drugs.

We are not just talking about a little bit more.

The gentleman is correct. It is one of the mysteries that we as public policymakers have been wrestling with for several years trying to figure out why is it the world's best customers pay the world's highest prices. It seems to me that we have an obligation as policymakers not only to try and get answers to those questions but, more importantly, to try and do something about it. I think the reason is, if I can just say this, if you go to Tokyo, Japan, and this is starting to change in Japan because Japan is starting to open up its markets, but for many years, if you went to Tokyo and you wanted to have a good steak----

It would be over $100. The same steak that you could get in Grand Rapids, Michigan, for $15 or the same steak that I could get in Rochester, Minnesota, for $15, you would pay over $100 in Tokyo. Another example is blue jeans in the former Soviet Union. The Soviets decided that people did not need blue jeans, did not want blue jeans, and therefore they were not going to produce blue jeans in the former Soviet Union. So a black market started to develop for blue jeans. The price reached over $100 a pair for blue jeans. The example is analogous because any time you have a captive market, as they have in Japan with beef or they had in the Soviet Union with blue jeans, you will find that market forces will just go amuck because you are a captive market. Americans are being held captive not so much by the big pharmaceutical companies, but by our own FDA.

Wrong again. Let me give you an example. This is a drug that my 85-year-old father takes. It is called Coumadin. Coumadin is a wonderful drug. It actually was developed at the University of Wisconsin.

It was paid for by the taxpayers. Originally, as it was developed, the drug was called Warfarin. They are basically identical drugs, but Warfarin is used as a rat poison. It is a blood thinner. What they do is they give it to rats, rats will eat it, they go back to their little dens, they bleed to death internally, no mess, no fuss. It kills rats. They found that this made a great blood thinner for human beings as well.

Let me give you the differences in what Americans pay. The average price for this package of Coumadin in the United States is about $84.

Warfarin, Coumadin, developed at the University of Wisconsin. The price here in the United States, about $84 for this package. The price in Canada, only $25. But here is the real kicker. Over in Europe they buy this same drug, as a matter of fact we bought this drug in Munich, Germany, for about $16. About $85 in the United States; $16 in Germany. Here is the other interesting thing. People say, well, they have price controls in Canada. To a certain degree that is true. I am not one that supports price controls and neither, I think, do you.

Here is the interesting thing. They do not have price

controls in Germany. What they do in Germany is what we ought to do here, and that is they allow the pharmacists to shop for the best price.

There are only 600 FDA-approved facilities that make prescription drugs in the world. They have to be made in an FDA- approved facility. So, yes, these drugs essentially, this probably came out of a plant in the United States. Or it may have come out of a plant in Puerto Rico, which is part of the United States. Or it may have been made over in Europe somewhere, but they supply essentially the entire world from that plant. It is much more efficient.

I also have in my hand something, and it bothers me, some of these prices because we bought 10 and if anybody doubts my research, we have the receipt for the 10 largest-selling drugs. We bought these at the airport pharmacy in Munich, Germany. The total for this worked out to about $373 American. Those same drugs, we checked the prices here in the United States of America, and again cash prices, walking in off the street, we are not talking about going to an HMO or any of these other things, the cash price was almost $1,100 in the United States, more than double, almost triple the price for the same 10 most popular drugs.

Let me give you this example. This is the one that really chaps my hide. This is a drug called Tamoxifen. It is a very effective breast cancer drug. But it was developed essentially with Federal taxpayer dollars at the National Institutes of Health. They paid for almost all the research. This drug in the United States, this package of drugs sells for $360. We bought it at the Munich airport pharmacy about a month ago for $59.05 American. $360 here, $60 there. Worse than that, the American taxpayers paid for almost all the research costs on this drug.

Kate. Kate Stahl.

Kate Stahl is a true American patriot. Once in a while you meet some people like this; and you just say again, as Ronald Reagan said, people who say there are no more American heroes, they do not know where to look. We met an American hero today. Her name is Kate Stahl. I want every Member of Congress to get a copy of last week's edition of the U.S. News and World Report, and there is a special report by Susan Brink, the title of which is ``Health on the Border, Elderly Americans head north and south to find drugs they can afford.'' It features Kate Stahl who works with the Senior Federation in the State of Minnesota. The caption above her little picture here says, ``I'd like nothing better than to be thrown in jail.'' She stands on the shoulders of the Sons of Liberty who threw tea in Boston Harbor and said, enough is enough. She calls herself a drug runner. She goes to Canada to buy drugs for her friends.

The FDA says it is.

Wrong again. They treat Kate Stahl and literally almost a million, or more than a million, Americans just like her, they treat her like a common criminal. This is an 84-year-old grandmother who is only doing this to try and save her friends and neighbors some dollars on the cost of prescription drugs. If one of them is suffering from breast cancer, $360 is a lot of money. They can afford $60, but $360 is a lot of money. And it repeats itself, with all the drugs. Zoloft, Zocor, we have got all the drugs. Glucophage. This is outrageous what they charge for Glucophage here in the United States. This drug has been around a long time. It is a miracle, marvelous drug. It really helps people with diabetes. But the bottom line is Americans are required to pay way too much because they are a captive market.

Longer than I want to remember. Actually I got started with this about 5 years ago. I always tell people that I have moved from fan to fanatic. Winston Churchill said a fanatic is one that cannot change his mind and will not change the subject.

Absolutely. Let me just talk about this Glucophage. This package of Glucophage in the United States sells for over $100. We bought it in Munich, Germany for $5. $5.

I must admit I am using it as an example because it is probably the most egregious example, with the possible exception of Tamoxifen, which the taxpayers paid for.

That is the point. If we are going to have a prescription drug benefit for seniors, which I think virtually everyone agrees we should, we ought to first of all deal with the issue of affordability. Because just shifting the responsibility of buying $100 Glucophage onto the shoulders of the taxpayers really makes no sense, because ultimately we are going to bankrupt our children if we make a stupid mistake and do not deal with this issue of affordability in price. Listen, we are Republicans. I am a Republican. I do not think the word ``profit'' is a dirty word, but I do think the word ``profiteer'' is. I think it is time if we are going to get in this business, we ought to demand some accountability from the pharmaceutical industry.

Absolutely. The time is now. You mentioned in coming from Michigan, General Motors has been a fabulous employer. Not only in the State of Michigan but for suppliers all over the world. The interesting thing is General Motors, I met with a General Motors lobbyist last week. Do you know how much they are going to spend this year on prescription drugs, the company? This is just for their employees and their retirees. $1.3 billion. GM will spend $1.3 billion. What is worse, that number is going up 16, 17, 18 percent per year. That is a cost before they sell the first automobile, before they sell any cars. Those are costs they have to pay for.

Right.

We are absorbing that cost, and I think when we talked about this at a conference today, what somebody said is we are subsidizing the rest of the world in health care and prescription drugs, and we are subsidizing, I think your term is, the ``starving French,'' or the ``starving Swedes,'' or the ``starving Swiss.''

You can use whichever. I would say Americans are willing to pay their fair share. We understand there is a cost for research. We understand we have to pay that $3.9 billion that one of the big pharmaceutical companies will spend this year on advertising and marketing. We understand that has to be paid. We are willing to pay our fair share. We are willing to subsidize the people in Sub-Saharan Africa. But we should not be willing to subsidize the starving Swiss.

Well, the real bottom line is virtually every other company has to compete in a world marketplace. What we are saying is let markets work. Open up the markets.

Finally, we are all concerned about safety. But this is a counterfeit-proof package. It is a blister pack, one of the first versions. It is getting better.

There is a great little company out in California that is helping to develop the technology for the new $20 bills to make them counterfeit- proof. It is good enough for the U.S. Treasury, but, so far, not good enough for the FDA.

We are going to demonstrate in the coming weeks how we can have safety-sealed counterfeit-proof packaging which will guarantee the safety of drugs wherever they happen to come from. If the drug companies have to compete in a world marketplace, the way General Motors does, the way Eastman Kodak does, the way IBM does, the way Microsoft does, or the way every other company in America has to compete, you will see prices in the United States drop dramatically; and that amounts to billions and billions of dollars of savings, not just for retirees, but for all Americans.

We just have a few more minutes, and I will close by saying this. The gentleman is exactly right. We import in the United States thousands and thousands of tons of fruits and vegetables and meats. As a matter of fact, this year we will import 318,000 tons of plantains. If we can safely import 318,000 tons of plantains, we can surely figure out a way to import Prilosec and Glucophage.

There is no way people will argue we cannot do this safely. We have the technology today. The time has come to open up markets, let our people go and stop this captive market. We will see prices drop in the United States by at least 30 percent.

Mr. Speaker, we have heard the word ``outrage'' used several times on the House floor, and I rise tonight to talk about the outrageous prices that American consumers pay for prescription drugs. And I have behind me a chart, and I apologize for those here on the floor and Members who may be watching on their television sets, it is a little hard to read. But I want to go through this because what it compares is what Americans pay, on average, and this varies because we have a very complicated average wholesale price situation formula they use here in the United States, but these are the average prices, and these are prices that we actually checked ourselves.

People have questioned some of the credibility of the sources that I have used. So we did our own research and we went to Munich, Germany about a month ago, and we bought 10 of the most commonly prescribed drugs in the United States. And let us run through.

Cipro, drug made by Bayer. They make the aspirin. They are a German company. In the United States, the average price for 10 tablets, 250 milligrams, $55. We bought it at the Munich airport pharmacy for $35.12, American.

Coumadin. My 85-year-old father takes Coumadin. In the United States the average price, $89.95. The price in Munich, Germany, $21.

Glucophage, a very popular drug, has done wonderful things for people who suffer from diabetes. Glucophage, $21.95 in the United States, only $5 in Germany.

Pravachol, $62.96 in Munich; $149.95 here in the United States.

The list goes on, Prozac, Synthroid, Tamoxifen, $60 in Germany; $360 in the United States.

Zocor, $41.20 in Munich; $89.95. It is the same drugs.

My father takes this Coumadin every day. It is a wonderful drug. Many Americans take Glucophage, and the Congress has spoken on this. We have statutes on the books that would allow Americans access to these drugs at world market prices, but the FDA and the Department of Health and Human Services, under first a Democratic administration and now a Republican administration, has said, oh, no, no, we cannot do that, we cannot guarantee safety.

So we are introducing a new bill and we want to deal with that issue because we want Americans to have access to safe world-class drugs.

What I am holding in my hand is a counterfeit-proof package. There are companies right now that are helping people, like our own Treasury who helped develop the technology that goes into our new counterfeit- proof $20 bill. They now have packaging which they are making for the pharmaceutical industry. For a cost of somewhere between 2 and 5 cents, they can make a blister-pack, counterfeit-proof package.

It goes beyond that. They are coming out with new technologies that are not only counterfeit-proof, but it is tamper-proof. So we can bring these drugs in and the technology will get better to make these drugs safe. For example, I am holding in my hand a little vial, and in this vial my colleagues cannot see it, I can barely see it. Inside this little vial are 150 microcomputer chips. This is the next UPC code so that we actually embed it in packaging, so that we can know where this product is made, where it came from, everything we need to know about it. It can be counterfeit-proof. It can be tamper-proof, and now it can be virtually fail-safe.

People say, well, what about safety? Every day we import thousands of tons of food, and the FDA is responsible for the food and drug safety in the United States. We import tons and tons of food. Last year, we imported 318,000 tons of plantains, and somehow we eat those plantains every day, and we do not worry about the safety.

We can import world-class drugs. I am a Republican and I think that there is nothing wrong with the word ``profit,'' but there is something very wrong with the word ``profiteer.'' I think it is right that Americans pay their fair share of the cost for research in the world, but we should not have to subsidize the starving Swiss.

We have an opportunity in the next several weeks to do something about this. The greatest tragedy in America today is that roughly 29 percent of all seniors tell us that they have had prescriptions that went unfilled because they could not afford these outrageous prices.

Shame on us. Shame on us. We should do something about that. We have the power to change this, and I think this year we finally will.

Mr. Speaker, I rise again tonight to talk about the outrageously high prices that Americans pay for prescription drugs. But before I get started, I want to yield to the gentleman from Indiana (Mr. Burton) because the gentleman wants to correct something that he said earlier.

And there are published reports that the president of SmithKline Beecham 2 years ago earned over $200 million.

Mr. Speaker, as the gentleman from Indiana mentioned earlier, we had a Special Order the other night and we had Republicans and Democrats, and we hope to do it next week with Republicans and Democrats because this issue about what Americans pay for prescription drugs is not a matter of right versus left, it is right versus wrong.

I think anybody who spends any time at all on this issue realizes it is wrong to force American consumers to pay the world's highest prices partly because we subsidize the research and development. There was a study done by the Boston Globe several years ago, and what they found was that of the 35 largest selling drugs in America, 32 of them were brought through the R&D channel by the Federal Government. The NIH paid for the basic research and development, got them to phase 3 trials. So we subsidize them in the research and development, we subsidize them in the Tax Code, and yet we are still required to pay the world's highest prices.

Two years ago this Congress came together, the House and Senate, and we voted 304-101, I believe was the final vote, but it was over 300 votes in the House, and we said Americans ought to have access to world-class drugs at world-market prices. That bill passed. It is on the books right now.

But unfortunately the FDA is not enforcing the law because in the conference committee they put a little safety language in there that says essentially if they cannot absolutely guarantee safety, the FDA does not have to enforce that.

Ladies and gentlemen, I want to talk about safety. What I have in my hand tonight is a counterfeit-proof package of prescription drugs. It is called a blister pack, counterfeit-proof package of prescription drugs. This packaging is available today at a cost of about two cents per package. It is available today. Let me tell you what is available soon. They have been working on this at MIT. I do not expect anyone to see this because I cannot see it; but in this little vial, and if you would like to see this, I will share this with Members, in this little vial are 150 tiny computer chips, microchips. Ultimately, this is going to become the next UPC code. With this little chip, we can know where that product was manufactured, where it came from. It can help with inventory control, and ultimately it can guarantee that it is in fact Prilosec and not something else.

Ladies and gentlemen, we can solve this problem. I have said before, it is not shame on the pharmaceutical industry; it is shame on us. The President of Glaxo or SmithKline does not work for us, but the head of FDA does. It is time for us as Members of Congress to do our responsibility, to make certain that Americans have access to world- class drugs at world market prices. No, there is nothing wrong with the word profit. I believe in the word profit. But there is something very wrong with the word profiteer. It seems to me in the heritage of Teddy Roosevelt and so many other politicians who have been here in this city who stood up for the little guy, it is time for us to say, it is not a matter of right versus left; it is a matter of right versus wrong. We need to do the right thing. We need to open American access, we need to create competition here in the United States, and we need to make certain that Americans have access to world-class drugs at world market prices.

Mr. Speaker, once again I rise tonight to talk about the high cost of prescription drugs here in the United States, and especially the high cost relative to what the rest of the industrialized world pays for the same drugs.

I have told this story to many of my colleagues repeatedly about how about a month ago we went to Munich, Germany, and bought a list of 10 of the most commonly prescribed drugs in America. The total price tag for all 10 of those drugs compared to the average price here in the United States is about triple. It is more than double what we pay in the United States.

I have used the example of this drug, and this is the actual drug, Tamoxifen, one of the most popular, most effective anti-breast cancer drugs ever developed. The interesting thing is that the National Institutes of Health, using taxpayers dollars, paid for most of the research. What makes us even more upset is not just that the American taxpayer paid to develop the drug, but the difference now between what American consumers have to pay for this drug compared to the rest of the world.

This drug, for example, we bought at the Munich airport pharmacy for $59.05 American. To put that in context, this drug sells at pharmacies here in Washington, D.C., for $360. In other words, to round off the numbers, $60 in Germany, $360 in the United States. Worse than that, the American taxpayers paid for the research.

Like Will Rogers, though, all I know is what I read in the newspaper, and this weekend in The Washington Post there is a very compelling story. What it essentially says is it is not just Tamoxifen any more. In fact, let me just read for you from essentially what is a GAO study.

The headline is, ``U.S. Netted Little From Cancer Drug, GAO Reports.''

``The U.S. Government spent hundreds of millions of dollars to help develop Taxol, the best-selling cancer drug ever, but failed to get much money back on its investment, according to a government report issued yesterday.

``Drug maker Bristol-Myers Squibb earned $9 billion from Taxol, which has been used to treat 1 million cancer patients, but the National Institutes of Health received only $35 million in royalties, the Government Accounting Office found.''

Now, on top of that, Medicare has spent over $687 million on Taxol, so there are more taxpayer dollars going into Taxol.

Finally, the report says, and I am shortening it down to the bottom, but if you want a copy we will have this up on our Web site by sometime tomorrow afternoon, but the bottom line is the GAO, the investigative arm of Congress, said that the NIH spent $484 million in research on Taxol through 2002.

Mr. Speaker, we subsidize the pharmaceutical industry in three separate ways.

First of all, we subsidize it on all the money we spend on basic research. I am proud of the fact that here in Congress, the NIH, the National Science Foundation, even DOD, we will spend this year about 29 billion taxpayer dollars on various kinds of basic research. Much of that research goes to benefit the pharmaceutical industry. So we subsidize them through the basic research we pay for them.

Secondly, we subsidize them through the Tax Code. They receive very generous tax benefits for the research we do.

Finally, and what disturbs us the most, is we subsidize them in the prices we pay. Americans pay far more than the rest of the industrialized world for prescription drugs.

I believe Americans should pay their fair share. I think we should be willing to subsidize Sub-Saharan Africa, but I do not think we ought to have to subsidize the starving Swiss.

Americans deserve world-class drugs at world market prices. I hope Members will support my bill, which I hope to introduce later this week, to open up American markets to foreign competition to bring prices down to reasonable levels so that all Americans can afford them.