Floor Statements

Mr. Speaker, if the gentleman would yield, I cannot answer that question; but I think it is the question that we in Congress should try to get the answer to.

Why is it that the FDA is investigating little old ladies trying to save money on Tamoxifen? I spoke recently to the Pharmacists Association, and I asked them, how many of you have had this experience, where an elderly person comes into your pharmacy, hands you a prescription. You tell them how much this prescription is going to cost, and their head drops, and they go, oh, well, I will come back tomorrow. Because we know from research done by the Kaiser Foundation, 29 percent of seniors in America are saying that they have prescriptions that go unfilled because they cannot afford them.

And the answer is, the FDA is not investigating companies that make $9 billion off of Federal taxpayer research; no, they are not investigating them, they are investigating little old ladies, treating them as common criminals.

It makes no sense to me. It is really time for us as Members of Congress to do something about it.

Well, the FDA is also responsible for all of the fruits and vegetables coming into the country. The issue they raise is safety, yet we import 318,000 tons of plantains that come into our borders, through our borders every year, and we do almost no investigation. We are much more likely to get sick from fruits and vegetables than we are from legal prescription drugs from FDA-approved facilities around the world.

Mr. Speaker, I rise again to speak to the House today about the cost of prescription drugs here in the United States, particularly relative to the rest of the world. Mark Twain once was talking about facts, and he said you can ignore the facts, you can deny the facts, you can even distort the facts, but in the end there they are.

I would like to talk today about the facts because there are people in this town who are attempting to both deny and distort the facts, but I think the facts more and more are indisputable. For example, we have been doing much of our own research. We purchased a number of the top- selling drugs in Munich, Germany, about a month ago. For example, we bought this package of Glucophage. Glucophage is a marvelous drug, particularly for those suffering from diabetes. We bought this drug in Munich, Germany, at a pharmacy for $5. This same package of Glucophage sells here in the United States for $29.95. We bought another drug, a very commonly prescribed drug that is a blood thinner. In fact, my father takes this drug. It's called Coumadin. Coumadin here in the United States, this package of Coumadin sells for roughly $84. We bought this drug in Germany for $21. But I think the one that bothers me the most, and I have talked about this before and I still do not have a good answer and frankly some of the people in the FDA ought to help us get the answer, this is a drug called Tamoxifen, perhaps the real miracle drug as it relates to treating women's breast cancer. Tamoxifen. We bought this drug in Munich, Germany, for $59.05 American. It sells here in the United States, the same box, same milligrams, it sells for $360; $60 in Germany, $360 here.

The question we have to ask is why? Why the big disparities? And some people say it is price controls, but that is not exactly true in Germany. The Germans do not have what some people say they do in terms of price controls. What they do allow is for their pharmacists to be able to shop around to get the best price. Unfortunately, Americans are held hostage. If one goes to Tokyo, Japan, and buys a steak, that steak will cost over $100. One can buy that same steak here in Washington even at inflated Washington, D.C. prices, for probably $25. Back in my home district one can buy the best steak in town in many of the towns I represent for $10 or $15. But the difference is the Japanese are held captive. They do not allow American beef into their markets; so those captive Japanese are forced to pay those higher prices.

What we are saying in the legislation which I hope to introduce next week is let our people go. Allow the markets to work, open up markets. And that is why I have sponsored the Pharmaceutical Market Access bill. Facts are stubborn things, as John Adams said. I would invite Members and those who may be watching to get a copy of this book: The title is ``The Big Fix, How the Pharmaceutical Industry Rips American Consumers Off.'' It is by Katharine Greider. I do not know that much about Katharine Greider, but she has got some very interesting things to say about what has been happening in the pharmaceutical industry.

Finally, let me say the big argument is safety, safety, safety, we cannot guarantee that if people buy their drugs from Munich, Germany, or Geneva, Switzerland, that those drugs will be safe. But I would invite the Members to look at some of the counterfeit-proof technology that is available today. There are companies that make this technology so that we can guarantee that this is in fact Coumadin and not something else. We can do this safely. Americans deserve world-class drugs at world market prices. Americans are willing to subsidize sub- Saharan Africa. We are unwilling to continue to subsidize the starving Swiss. I hope Members will get the facts. I hope Members will look at this bill. I hope

Members will cosponsor it with me. And I hope finally we will do something to stop these huge disparities between what Americans pay and what consumers around the rest of the industrialized world pay for the same drugs.

Mr. Speaker, I rise tonight again to talk about the issue of the disparity between the price that Americans pay for prescription drugs and what the rest of the world pays for the same drugs.

On several occasions I have used articles from the newspapers, whether it be the New York Times or the Wall Street Journal, other newspapers, and I started many of my conversations with something that Will Rogers said so many years ago, and that is ``All I know is what I read in the newspapers.''

Today I read in one in the publications up here on Capitol Hill a story that really surprised me, the first story that they have actually done on the whole issue of prescription drugs, and they decided to do essentially a piece that destroys the credibility of one of the groups that I have gotten much of the research information that I have gotten in the past from, and that is the Life Extension Foundation, and I want to talk about some of the numbers that they have sent me.

I have never personally met anybody from Life Extension, but everything they have sent me checks out. So I have used their statistics in the past, and I will use them in the future. I have also been quoting from a book by

Katharine Greider. The title of the book, and I recommend it to all of my colleagues, is ``The Big Fix: How the Pharmaceutical Industry Rips Off America.'' I do not know what her philosophy is. I do not know what her politics are. I do not know what religion she practices, but I have to say that the research that she has done is extremely good and it raises some very difficult questions.

The other thing that I have been doing is talking to Members about these huge disparities between what we pay in America and what the rest of the world pays for the same drugs. Let me give my colleagues some examples. These are my own research, drugs that we actually bought at the Munich airport in Munich, Germany, and then we compared what the price is in the United States. Let us take the drug Glucophage. Glucophage is a wonderful drug, particularly for those people suffering from diabetes. Glucophage in the United States, 30 tablets, 850 milligrams, sells for about $30. That same drug in Germany sells for $5.

We can go on down the line. Cipro. This is the drug Cipro, a very commonly prescribed, very effective antibiotic made by a company called Bayer. In the United States we usually call it Bayer, Bayer aspirin. We are probably more familiar with that. But this drug in the United States sells for an average of about $55. It sells in Germany for $35.

We go on down the list. I will not read the whole list tonight, but the one that really chaps my hide is this drug right here. This is Tamoxifen. We bought this drug at the airport pharmacy in Munich, Germany, for $59.05 American. In this quantity, 100 tablets, 20 milligrams, in the United States this same drug sells for $360. $60 in Germany, $360 here.

The real point is this. I have shared this story, too. If you go to Tokyo, Japan and you order a steak dinner, about the cheapest you will find it in Tokyo is about $100. You can buy an equal quality, in fact perhaps a better quality steak anywhere here in the United States for probably $20. Why is there so much difference between what you pay for a steak in Tokyo versus here in the United States? The answer is simple. The people of Japan are a captive market. They do not allow other products to come in. That is what we have done with drugs in this country. We literally have made Americans a captive market.

We are talking about a prescription drug benefit and everybody is talking about coverage. Ladies and gentlemen, the issue is not so much coverage, because every senior in America has at least the opportunity to buy prescription drug coverage through the AARP and lots of other organizations. The problem is not coverage. The problem is affordability. We will never solve the entire problem for all of those seniors. One of the points that is made by Ms. Greider in her book, she mentions a study that was done. This is one of the most damning studies and every one of us should be ashamed. The study says that 29 percent of seniors say that they have had prescriptions that went unfilled simply because they could not afford them.

A couple of weeks ago I was addressing community pharmacists, and I asked them the question: Have you ever had a senior come in and give you a prescription and you told that senior how much this was going to be and they sort of dropped their head and said, well, maybe I'll be back tomorrow. And they do not come back because they cannot afford it. That is something we can change, that is within our power to change. Shame on us if we do not. I hope you will cosponsor my bill to give Americans access to world class drugs at world market prices.

Mr. Speaker, it was Will Rogers who said, ``All I know is what I read in the newspapers,'' and I was reading yesterday's Wall Street Journal, and I would invite my colleagues to read the Wall Street Journal of yesterday, as well, because there is a story there that is just shameful about American policies as it relates to prescription drugs.

Let me read from this article from the Wall Street Journal front page yesterday. Let me read a couple of paragraphs. In fact, the headline is, ``Empty Shells: As U.S. Balks on Medicine Deal, African Patients Feel the Pain,'' and the subtitle is ``Big drug makers protecting their patents seek limits to a global trade accord, searching for insulin in Chad.'' As one reads the article, it is shameful.

Let me just read a couple of paragraphs for the benefit of Members. ``Wealthier countries where drugs are produced and patented promised 18 months ago at global trade talks in Qatar to loosen patent restrictions in order to ease shortages and reduce prices. It was just after September 11, and the U.S. led the rhetorical charge, eager to demonstrate its desire to battle suffering among the world's poor while mounting a war on terrorism. But last December when all of the other 143 countries in the World Trade Organization had lined up behind a new plan on the trade of medicines, the United States blocked the proposal.

``The Bush administration, under heavy lobbying from the pharmaceutical industry seeking to limit the scope of the deal, endorsed a list of some 20 infectious diseases, and that was it. That was all they were willing to address. These included HIV-AIDS, malaria, tuberculosis, typhus, hemorrhagic fever, and others categorized as epidemics in the developing countries, but that was it. Drug manufacturers feared that without the limitation, the deal could lead to a broader undermining of their lucrative patent rights. Poor nations were outraged.''

Mr. Speaker, we should be outraged. As we speak, there are people suffering from diabetes in the country of Chad in sub-Saharan Africa that cannot get insulin. It is time for us to take control of this issue. For too long we have allowed the special interests and some of the misinformed people over at the FDA to sort of box us into a corner so Americans now pay the world's highest prices. We are the world's best customers, but yet we pay the highest prices for prescription drugs.

Do not just take my word for it. We were in Munich, Germany, about a month ago, and we bought and I have the receipt here for what we paid for these drugs. Let me take this drug, Cipro, which we all know about after the anthrax scare. In Germany, at the Munich airport, we paid 35.12 Euros for this product. That is about $34. This same product in the United States sells for $60. The average price in the United States, according to one study, is over $80. We paid $34.

Let me take Coumadin, and this is a drug that my father takes, made by DuPont. This drug in the United States, the average price is over $64. In Munich, Germany, we bought this drug for 20.43 Euros. That works out to about $19 in American currency; $64 in the United States, $20 in Europe.

Glucophage, a marvelous drug for diabetics, which we bought in Germany for $5. This drug can cost as much as $100 here in the United States of America.

But here is the one that really got to me. This is a drug called Tamoxifen, probably the most effective drug we have ever seen on the market in treating and perhaps preventing breast cancer among women. It is a miracle drug, and we are thankful it exists. We bought this drug at the Munich Airport pharmacy for $59.05 American. This same drug here in the United States sells for $360 for the same box; $60 in Germany, $360 in the United States.

Mr. Speaker, it is not shame on the pharmaceutical industry, it is shame on us. We have created an environment where we permit these companies to literally run roughshod over American consumers.

Let me add one other thing about this drug, American taxpayers paid for almost all of the R&D costs to have it developed. In fact, the company originally said they would not patent it because it was the taxpayers who paid for the R&D. But I guess they have patented it.

I will yield back the balance of my time, but I will be back; and I have a bill that will begin to resolve this, and I hope all Members, Democrats and Republicans, will join me in cosponsoring that legislation.

Mr. Speaker, I want to thank the chairman for putting this special order together tonight, and I want to thank my colleagues on both sides of the aisle for joining us.

As has been mentioned, this is not a matter of right versus left, this is right versus wrong, and it is wrong to force Americans to pay the highest prices in the world.

The gentleman from Maine was talking about Tamoxifen. I am also now the chairman of the Congressional Study Group on Germany, so I was in Germany about a month ago. While we were there, we went to the pharmacy at the Munich Airport and we bought some of the most commonly prescribed drugs. Now, most people know that if you want to get a bargain, you probably do not go to the airport to buy it, so this is probably not the cheapest place in Germany to buy drugs.

Incidentally, compared to what you hear all the time, Germany really does not have price controls in the sense of setting the prices that the pharmacist in Germany can sell the drugs for. What they do allow is for German pharmacists to shop to get the best price. If they can buy their Tamoxifen cheaper in Sweden, they buy it in Sweden. If they can buy it cheaper in Spain, they buy it in Spain. They use market forces to help keep prices down in Germany.

We bought this Tamoxifen. It is 100 tabs of 20 milligrams. I am going to tell the whole story about Tamoxifen. We bought it at the Munich Airport pharmacy for $59.05 American. This same box of drugs here in the United States sells for $360; $60 in Germany, $360 here.

What makes the story even worse about this particular drug is, this was developed with taxpayers' dollars. This was developed essentially by the National Institutes of Health. Almost all of the research and development costs were paid for by the taxpayers.

As the vice chairman of the Committee on Science, here is something we should all be proud of. We in the United States represent less than 6 percent of the world's population, but we represent over 50 percent of the basic research done in the world. This year, this Congress will authorize and spend $29 billion taxpayer dollars on basic research.

In fact, there was a study done, and I want to recommend a book, if you have not seen this book, I hope every one of my colleagues will pick up a copy of this book. The title is ``The Big Fix.'' The subtitle is ``How the Pharmaceutical Industry Rips Off American Consumers.'' It is written by Katharine Greider. What is in this book is compelling, and every American ought to read some of the things that are in here.

You talk about the research. A study was done by the Boston Globe just a few years ago, and they found that of the 35 largest selling drugs in the United States, 33 of them had most of their research and development costs paid for by the taxpayers.

Now, it is one thing to say we have all these research costs, and therefore American consumers have to pay all the freight. But the bottom line is, we subsidize the pharmaceutical industry in three separate ways.

First of all, in that $29 billion we will spend this year in basic research through the NIH, the National Science Foundation and even DOD; we do an awful lot of basic research in the DOD that ultimately benefits the pharmaceutical industry. We do all of that on that side.

Secondly, we subsidize them in the Tax Code. They get very generous write-offs for the amount of research and the other expenses that they have.

Finally, we subsidize them in the prices we pay.

Let me share with you some of the other prices that we got at the pharmacy at the Munich Airport in Munich, Germany.

Glucophage, a miracle drug. I want to pay homage to the people who helped develop it. Millions and millions of Americans and people around the world are living better quality lives because of Glucophage. So I am not here to beat up on the pharmaceutical industry. They have done a lot of wonderful things.

But how do you justify this difference? This package of Glucophage here in the United States, we checked the price, is $29.95. We bought this one month ago in Munich, Germany, for $5 American.

Let us look at Cipro. We all know a little more about Cipro in the last couple of years because of what happened with the anthrax scare. We bought Cipro in Germany. This is actually made by a German company called Bayer. They also make aspirin. But Bayer makes this drug. We bought Cipro in Germany for $35.12. Here in the United States this same package sells for $55. $20 does not seem like much, but it adds up.

We bought Coumadin. My 86-year-old father takes Coumadin. This package of Coumadin we bought in Germany, we paid about $14 for this drug. Here in the United States, it is about $64. Those numbers just go on and on.

Zocor, very commonly prescribed, we bought it for $41.20. Here in the United States, $89.95.

As Will Rogers said, all I know is what I read in the newspapers. Well, read the newspapers. Read today's Wall Street Journal, the front page, about what the drug companies and PhRMA are doing, not only to make certain

that Americans keep paying the highest prices in the world, but they are literally now saying to sub-Saharan Africa, well, we will subsidize AIDS drugs for you, but we will not let you have access to many other drugs, including insulin.

Right now, you cannot get insulin in Chad at any price. Read the article. In fact, if I have time, I will read one of the paragraphs here, just a few sentences.

They talk about how all of the countries, 148 countries in the world, were ready to come up with a trade agreement, some language, to deal with some of these problems about drugs going across borders. But last December, when all of the other 148 countries in the World Trade Organization had lined up behind a new plan on the trade of medicines, the United States blocked the proposal. As you read, it gets worse, why they blocked it. It was all about the big pharmaceutical companies afraid that they might lose some profits.

This is not a matter of right versus left; this is right versus wrong. The time has come for Congress to stand up and say we are not going to be played the fool any longer. It is time that Americans have access to world-class drugs at world-market prices. That is not too much to ask. That is not a Republican idea, that is not a Democrat idea; that is an American idea.

We have what is called NAFTA. Many of us believe in free trade. But, it is interesting, we have free trade when it comes to plantains, have free trade when it comes to pork bellies, we have free trade with things called pears. In fact, we import hundreds of thousands of tons of fruits and vegetables every year, hundreds of thousands of tons; and that is regulated by a group called the FDA, the Food and Drug Administration.

Do you know how much inspection they do of all of those fruits and vegetables crossing our borders every year? Almost none. Do you know how many people get sick every year from imported fruits and vegetables? Thousands. In fact, one estimate is, thousands die as a result of eating contaminated foods that have come from other countries, that have food-borne pathogens. The FDA's own study said that 2 percent of all fruits and vegetables that come into the United States are contaminated with food-borne pathogens, including things like salmonella. Salmonella will kill you.

But we have to stop these prescription drugs because our own research says people could get sick and die. Do you know how many people have died? The FDA keeps records of all the people who have taken legal FDA- approved drugs coming in from other countries. It is an easy number to remember. It is a nice round number. It is zero. Zero.

More importantly, we are going to introduce a bill sometime by the end of the week that is going to require the FDA to begin to put counterfeit-proof blister packs in place, whether they come from the United States or wherever they come from.

Once we begin to require this, this whole safety thing just goes out the window, and we begin to realize it is not about safety, it is about profits; it is about making American consumers pay the highest prices in the world.

Let me just close with one other thing, because I say, shame on us. I do not say, shame on the pharmaceutical industry; shame on us. We let this thing happen. But the most shaming thing of all was a study done by the Kaiser Foundation a few years ago. What they found out was 29 percent of seniors say that they have let prescriptions go unfilled because they could not afford them.

Two weeks ago, I spoke to the Community Pharmacists, and I asked them, we had hundreds of pharmacists from around the country here in Washington, and I asked them, has this ever happened to you, where a little old lady comes up, hands you a prescription, and you tell her how much it is going to be, and she drops her head and she says, well, maybe I will be back tomorrow, and she never comes back. And every head in that place shook like this.

It has happened. It happens every day. And I do not say, shame on the pharmaceutical industry as much as I say, shame on us, because we have the power to do something about that.

Twenty-nine percent of prescriptions go unfilled. That is an outrage, and we can do something about it. And the reason is they cannot afford it. They can afford $14 for Coumadin; they cannot afford $64.

If I could have one additional minute, I do want to mention to all my colleagues, we have been working for a year trying to come up with a bill that would make sense. We think we have it. It is called the Pharmaceutical Affordability Act of 2003. Now, some may not like the acronym; it works out to PHARMAA. But the bottom line is, we think we have come up with language which really deals with the issues that people have raised, ultimately safety. I hope that Members will join me in cosponsoring that bill. Hopefully, if we put enough pressure on all of the people here in this body, we will get a vote on it this year. If we do, it will pass.

Mr. Speaker, the gentleman quoted one of my favorite Presidents. Let me quote another one. Ronald Reagan said, ``Markets are more powerful than armies.'' This idea that American consumers should be charged $360 for these pills when we can buy them in Munich, Germany, at the airport pharmacy for $59.05.

One-sixth. That will not stand. That is defending the indefensible, and sooner or later, it may not happen this year, may not happen next year, but sooner or later this wall will collapse just like the walls of Jericho.

I want to thank the gentleman for his leadership, and I want to thank my colleagues on both sides of the aisle. As I said at the beginning, this is not a matter of right versus left. This is right versus wrong. This is wrong, and we should do something to stop it.

Mr. Speaker, I rise tonight to talk about an issue that I think all of us are aware of, but I do not think most Members of the House really understand the dimensions of the problem.

Mr. Speaker, I know that there is work going on in several committees to try and deal with the issue of prescription drug coverage for senior citizens. It is a rather sad story, and most of us have talked to constituents about the problems that they have in terms of buying the drugs that they need to sustain their lives.

Unfortunately, even though I feel good that we are getting serious about this issue, I think, in many respects, many of my colleagues are missing what is the real story. The real story is how much drugs cost in the United States relative to the rest of the world.

Let me say right here, I am not here tonight to beat up on the pharmaceutical industry. I know that I have colleagues who say shame on the pharmaceutical industry. Essentially what I am here tonight to do is to say shame on us, because we as policymakers, and especially the people at the FDA, have allowed this system to grow out of control and literally have put Americans in an incredibly difficult position in terms of buying the drugs that they need.

Let me first show a chart. I know that these are hard to read, especially as Members are in their offices watching this on C-SPAN. Some of these numbers are awfully hard to read, because one of my colleagues the other day, I had the chart up, and he said, ``I was squinting very hard to read your numbers.''

Do not take my word for this. You can actually find this chart on my Web site, Gill.House.Gov.

More importantly, these are not my numbers. These numbers have been developed. There is a group down in Florida called the Life Extension Foundation. They are one of the groups that has sent me an enormous amount of information. They have been studying the differences in drug prices for more than a decade. Frequently in Minnesota we hear from constituents who get on buses and go to Winnipeg or they go into Canada so that they can buy their prescription drugs at much lower prices.

The interesting thing is, virtually all of the research that I have seen demonstrates that, yes, drugs are cheaper in Canada, but the amazing thing is that they are even cheaper in Europe. I want to talk about that tonight and perhaps some of the reasons, but, most importantly, what I think we as public policymakers here in Congress, in the administration, and especially over at the Department of Health and Human Services and in FDA can do to bring about some real change that will make real differences in real people's lives.

Let us talk about some of those differences. I have this chart. Again, these are not my numbers, but, frankly, there has been research done by a number of different groups, and they all come to the same conclusion. That is that Americans pay way, way too much for the same drugs. Let me give some examples.

Let us talk about the drug Augmentin, a very popular drug here in the United States. The average price for a 30-day supply is $50.50. But we can buy that drug in Canada for $12. That same drug in Europe sells for an average of $8.75.

Another popular drug is Cipro. In fact, I have some Cipro here that we bought in Germany. The average price in the United States for a 30- day supply of Cipro, and I am sorry, it is not a 30-day supply, I believe that is a 10-day supply of Cipro, is $87.99 in the United States. That same drug in Canada sells for $53.55, so a savings of 35 to 40 percent. But the interesting thing is it is half-priced, more than half-priced, if we buy the drug in Germany. It is the same drug made in the same plant under the same FDA approval.

Let us go down here and talk about a drug that my 85-year-old father takes, Coumadin. It is a wonderful drug, a blood thinner. It has done a lot in terms of preventing strokes and heart attacks in the United States. Coumadin in the United States today sells for almost $65 per month. Now, if we buy that same drug in Canada, it is only $24.94. But the interesting thing is, it is even cheaper in the European Union. The average price is only $15.80.

To go on down the list, another very popular drug, and in many respects a miracle drug, and, as I say, I am not here to beat up on the pharmaceutical industry, all of these drugs are miracle drugs for Americans and millions of people around the world, but the question is whether we ought to pay 30 to 300 percent more than for the rest.

Glucophage. For the people suffering from diabetes, one of the most debilitating diseases known to man, Glucophage is a wonderful drug, but the average price in the United States is over $124 for a month's supply. We can get that same month's supply in Canada for $26.47, but in Europe it is only $22.

The list goes on and on. I am not going to read all the prices.

Let me also talk about a drug called Zocor, down at the bottom of the list. Zocor, in the United States the average price for a 30-day supply is $123. We can buy the same drug in Canada, here is a package of Zocor which we bought in Germany, we can buy that same drug in Canada for $45.49, but we can buy that drug in Europe for $28.

Now, again, Mr. Speaker, these are the same drugs made in the same FDA-approved plants under the same FDA approval.

The story goes on and on. Again, Members do not have to take my word for it, but this is an ad that appeared last week in a newspaper in the State of Michigan. At the top it says, ``Save up to 86 percent on your prescription drugs,'' the same brand name drugs and generics. This is for a group, and I will not give the number or anything, but this is for a group out of Canada. They are now advertising in the United States.

Some of the prices they list, let us take Lipitor, a very commonly prescribed drug that does a wonderful job for those people who have elevated cholesterol in their blood. The average price they list for a 90-count package in the United States, the average price is $288. But we can buy it from Canada for $165. That is a savings of over 43 percent.

The list goes on. Members do not have to take my word for it, but everybody is beginning to realize the dirty little secret. That is that Americans are being required to pay for virtually all of the research, for virtually all of the marketing costs, and for virtually all of the profits. The list goes on.

Let us pick some other drugs people might recognize.

Synthroid, that is a drug that my wife takes. My wife takes Synthroid. They say that the average price in the United States for 100 tablets, the average price in the U.S., $41. We can buy it in Canada for $14.

We have to ask ourselves, how did we wind up in a situation like this? How is it that the rest of the world can buy drugs for so much less than we buy them for? Then the question becomes, what are we going to do about it? I do not think the answer for seniors is, well, we are not going to do anything.

I have been joined tonight by my friend, the gentleman from Indiana (Mr. Burton). I would like to yield to him now, because, as the chairman of the Subcommittee on Wellness and Human Rights on the Committee on Government Reform, he is one of the few chairmen that have had the courage to actually have a hearing and bring in some experts to talk about this problem. Because it is a major problem. We will talk in a few minutes about the dimensions of the dollars that we are talking about here in the United States, what it costs American consumers.

I welcome and yield to the gentleman from Indiana (Mr. Burton).

We have the law.

I want to thank the gentleman for joining this discussion tonight because, as I say, there are a number of us here in the House who have been willing to speak out, but the gentleman is among the few chairmen of committees who have had the courage to have some hearings, bring in some experts, have people talk about this, what really does happen in Canada.

One of the things we have learned, for example, is that over 1 million Americans today are actually buying their prescription drugs from other countries today. The FDA, the Food and Drug Administration, keeps very accurate records. If 1 million people are buying their drugs from other countries, we would think, especially along the Canadian border, but more importantly along the Mexican border, where, again, we have learned from research done by a professor at the University of Texas something like two out of every three Americans who cross the border and go into Mexico bring back with them prescription drugs, which they buy there for a fraction of the price that they can buy them in the United States for. They bring back drugs.

More importantly, they do not just bring back a few drugs. Usually when they go across the border they take a list with them. They come from a senior center, they come from a retirement center, they come from a condominium project where most of the people are seniors, and they take a list with them when they go into Mexico, and they bring back thousands of dollars worth of prescriptions.

Now, with all those people buying drugs illegally, according to the FDA, you would think, if this is so dangerous, you would think that all of these seniors would be dropping like cord wood in Minnesota, and in Texas, and in California, and the other States where this is very common. But the fact of the matter is we know exactly how many people have died from taking prescription drugs which they bought from other countries. The FDA keeps perfect records. And according to the FDA, it is an easy number to remember. It is a nice round number. It is zero.

It is called the Food and Drug Administration. They are also responsible

for protecting us from all of the imports of food that comes into the United States. Every day we import millions of tons of food. I think last year we imported into the United States something like 317,000 tons of plantains. Now, I had to double-check to see what is a plantain. But we import tons and tons of food every day. And you know what the FDA says about all that imported food?

Not much. They wave as it goes by. But they do keep records as well; and according to the FDA, eating imported strawberries, something like 25,000 Americans have gotten ill and some have died from eating imported strawberries. Yet we eat strawberries every day, many of them are imported; and the FDA does almost nothing.

But one area where we can absolutely guarantee safety, the FDA has put a wall between American consumers and being able to afford these drugs. Let me give an example.

I am holding in my hand a package of Tamoxifen, and this is probably one of the examples that makes me angrier than any other. Tamoxifen is an amazing drug. It is a miracle drug, and particularly for women who are suffering from breast cancer. This may save their lives. This is an amazing drug. The most amazing thing is we helped pay for it. We, the taxpayers. This drug was developed almost exclusively with research and development dollars from the NIH.

The company decided originally, because it was developed with taxpayers' money, that they would not patent it. Then they thought about it again and said, no, I think we will patent it. And I guess they had a right to patent it. But this is what really bothers me. We bought this drug in Munich, Germany 3 weeks ago for 60.33 Euros. Now, on that day the equivalent, and the dollar and the Euro vary a bit, but that worked out on that day to $59.05 American for this package of 100 tablets, 20 milligrams, Tamoxifen. This same drug, we called a pharmacy here in Washington, D.C. and asked how much is 100 tablets, 20 milligrams, Tamoxifen. The answer: $360. Sixty dollars in Munich, Germany; $360 in America.

Six times the amount. And here is the real tragedy. There are American women who need this drug and they cannot afford it.

The interesting thing is the FDA does not keep those records. They are only concerned about drugs being safe and effective. But Dr. Steve Schondelmeier, one of the top pharmacologists in the world, certainly in America, he has a great quote. He said: ``A drug that you cannot afford is neither safe nor effective.''

I want to come back to something, because it fits with this point. There is a new book out called ``The Big Fix,'' written by Katherine Greider; and she has done an amazing amount of research on this. One of the saddest statistics in this book is that she said that 29 percent, 29 percent of the prescriptions written to senior citizens in America today go unfilled.

Twenty-nine percent. I do not know if the gentleman has ever experienced this, but I met this morning with community pharmacists, and I asked them this question: How many of you have had the example where a senior citizen comes in to buy a drug that they need and they hand you the prescription, you tell them how much it is, and they get a real sad look on their face?

They drop their head and they say, well, maybe I will be back tomorrow.

Twenty-nine percent of the prescriptions written to senior citizens go unfilled because they cannot afford them, and they are proud people.

How many people, how many women in America cannot afford Tamoxifen? Now, maybe they could afford $60, but $360 starts to get real expensive. And that goes on and on and on.

Now, I am not here to say shame on the pharmaceutical industry, but shame on us, because we have the power to change that.

One of my favorite Presidents was President Ronald Reagan, and he had some great quotes. One of them he used often was that markets are more powerful than armies. It is time that we open up the markets and say to Americans you have legal access.

You ought to be able to go to your local pharmacy, to your local pharmacist, whom you trust, and who is an important part of the health care delivery system, and you ought to be able to go in there and say, I need Tamoxifen. And he ought to be able to say to you, well, listen, I can fill it from my inventory in the United States on the back shelf and your price will be $360; or I can go on line and I can order it for you from a pharmaceutical supply house in Geneva, Switzerland, or Munich, Germany, or Paris, France, or you name the country, as long as they are an industrialized G-7-type country where we can expect and trust the equivalent of their FDAs, as the Canadians have announced; but he ought to be able to go on line for that customer and order that and say, we can have it to you in 3 days for one-sixth of the price.

The interesting thing, Chairman Burton, is that we cannot guarantee anything. You cannot guarantee that when you pull into a gas station and you fill your car up that that is in fact unleaded gasoline and not buttermilk. The truth of the matter is every time you put your key in your car, every time you do anything, you take a certain amount of risk. But with modern technology, we can make it absolutely as safe to buy drugs from Geneva, Switzerland, as it is to go down to your local pharmacy.

As a matter of fact, the FDA has to admit that the only proven example where someone has tampered with prescription drugs in the United States happened inside the United States. There are no examples where contaminated drugs have been shipped from legal pharmacies in other parts of the world. There just are not any examples.

If this is safe enough for the U.S. Treasury, this is the same company that has developed these technologies to make counterfeit-proof packaging.

I will be introducing a bill sometime in the next week; and I am trying to get, I hope, hundreds of my colleagues to vote for it. In fact, the last time we had a vote on this issue of opening up markets, we got 323 votes here in the House. The House has spoken fairly clearly that we want Americans to have access to world-class drugs at world market prices.

But if this technology is good enough for the U.S. Treasury, if they can produce technology to make counterfeit-proof packaging for the entertainment industry, for the video game industry, they certainly can and they are making packaging for the pharmaceutical industry. As a matter of fact, I think there are four or five of the

companies that are already using this technology.

It goes even further. Last week, I was at a demonstration, and this is a little vial, and I do not expect anybody to see this, because I can barely see it looking at it here. But inside this vial there are 150 tiny, tiny, almost nanocomputer chips. The interesting thing is this is the next UPC code. They can literally now embed these chips in packaging, and these chips are bringing the cost down to probably less than a nickel apiece. And when you are talking about a prescription drug package that sells for $125, that is not much to make certain that this is in fact whatever the drug is and it was made at such a plant on such-and-such a day and has gone through the channels.

As a matter of fact, when people buy things and they have them shipped by UPS or FedEx or even the parcel post system, literally they put a bar code on that package. And literally you can go to UPS or any of the other package-handling companies, and now you can find out where that package is at any point in the delivery system.

Now, as opposed to that, how do you think the pharmaceutical companies ship their drugs? Armored cars?

They ship them the way they ship almost everything else.

So the idea that somehow it is easier for somebody to contaminate a drug going via UPS in a sealed package with a bar coded technology using counterfeit-proof packaging, that it is easier somehow to adulterate that drug than it would be to get onto a dock in New Jersey where it is sitting in an evergreen container.

From legal FDA approved drugs; that is right.

We are much more likely to die from eating imported strawberries.

Right.

Well, the only argument they use is safety.

MR. BURTON of Indiana. But that does not hold water.

As the gentleman saw at the hearing, they are very oblique even on that issue. Because we can demonstrate it is safer to buy drugs from a legal pharmacy. And we are not talking about illegal drugs. I want to make that very clear. We are only talking about FDA- approved drugs that came from FDA facilities. We are not going to go down the path of talking about other drugs, because there are people in south Miami that import drugs every day. Those are not legal drugs. We are not talking about any of those.

But let us talk about what the law actually says, and this is where they hang their hat. It says, and let me read this: ``Section 381: The Secretary of the Treasury shall deliver to the Secretary of Health and Human Services, upon his request, samples of food, drug, devices and cosmetics which are being imported or offered for import into the United States, giving notice thereof to the owner or consignee who may appear before the Secretary of Health and Human Services and have the right to introduce testimony.''

Now, this is what they say. This is where they hang their hats and they keep Americans from legally buying imported drugs from countries around the world. Here is the operative sentence: ``if it appears from the examination of such samples or otherwise that (1) such article has been manufactured, processed, or packed under unsanitary conditions.''

Well, there is no evidence that any of these drugs are packaged under unsanitary conditions.

``(2) That such article is forbidden or restricted for sale in the country in which it was produced or from which it was exported.''

These are all legal drugs, so that one does not apply.

``(3) Such article is adulterated, misbranded or in violation of section 355 of this title.''

None of that really applies, in my opinion.

But that is the slender reed upon which our own FDA has constructed this wall around the United States; and that is the reason, my colleagues, that American consumers pay $360 and Germans pay $60.

Mr. Speaker, I try not to get into that because the presidents of the large pharmaceutical companies do not work for us, but the head of the FDA does. I think the presidents of some of the pharmaceutical companies have to answer to shareholders and the public, and one day they are going to have to answer to God.

This book, and there is more research coming out, and the interesting thing is especially after Sarbanes-Oxley, we are going to find out more about how the money actually gets spent. I think we will find more and more of these pharmaceutical companies are spending more on advertising and marketing than they are on research and development.

One of the things talked about in this book, there was a study done by the Boston Globe, and they took a close look at the 35 most important and top-selling drugs that the FDA approved over the previous 5 years. All but two of them had been brought through the R&D pipeline with the help of the NIH or the FDA.

That is correct, and that happens again and again. I am the vice chairman of the Committee on Science, and our research shows Americans represent something like 6 percent of the world's population, but we represent over 50 percent of the basic research done in the world. It is because of Americans that we have places like the Mayo Clinic, and it is because of the American spirit that we do what we do. It is because of the American spirit we put men on the moon and return them safely. We want to do this research.

This year we will spend roughly $29 billion taxpayer dollars on research. The interesting thing is many of the pharmaceutical companies work very closely with the various research institutes that do this research, and they pay very close attention. Many times this research that is done, once the research is completed, that information is available free of charge. They get this research free of charge. In many respects, we subsidize the pharmaceutical industry with that $29 billion of taxpayer money.

There is a second way that we subsidize the pharmaceutical industry, and that is in the Tax Code. The research they do, they write it off dollar for dollar. Most are in at least a 40 percent tax bracket, so the taxpayers are subsidizing 40-50 percent of the cost of research. And on top of that, many qualify for research and development tax credits. I am not an accountant, but a credit is better than a deduction. On top of that, many of them have moved their facilities to places like Puerto Rico. Puerto Rico is part of the United States, but some people do not know if you are in Puerto Rico you pay no Federal income tax.

Exactly. I am not going to argue about the special benefits, but the bottom line is we subsidize the development of new drugs through the NIH, through the National Science Foundation, through the Department of Defense. They do a lot of research which ultimately leads to these miracle drugs. Finally, we subsidize them in the prices we pay.

Now, my bottom line is I think Americans ought to pay. I think it is part of the American spirit. We believe in finding the new cures. It is something that makes us Americans. I think we ought to pay our fair share. I think it is the right thing to do; and, frankly, I think we ought to subsidize people in developing countries. I think we ought to pay more than the people in sub-Saharan Africa. I think we ought to pay more than the people in Bangladesh. I think we ought to pay more than some of the people around the world.

But I think it is ridiculous that our own FDA makes Americans subsidize the starving Swiss. I think it is time for the Swiss, the Germans, the French, the Japanese, I think it is time for them to pay their fair share.

I also think it is time for a much clearer account from the pharmaceutical industry of how much exactly do you spend developing a new drug? How much does it cost to get FDA approval? How much profit do you really make? There is a report, and I cannot confirm this, but the president and CEO of one of the pharmaceutical industries got $227 million in stock options. That was above and beyond his salary. Most of us could live fairly comfortably on a salary of $6-10 million, which is what the average CEO of the nine largest pharmaceutical companies make.

Mr. Speaker, I think there are two things that we ought to do.

First of all, we ought to pass strong legislation that says very clearly as it relates to countries, and I have them listed in the bill that we are working on, countries like Canada, the European Union, Japan, Israel, and a few other industrialized countries where we know they have very effective equivalents of our FDA, there is no reason in the world that Americans and their pharmacists should not have the right to import drugs from those countries. It ought to be part of any prescription drug benefit package, and the truth of the matter is, and I did not get to this, how big this problem is.

The estimates by our own Congressional Budget Office say that seniors will spend, and these are 65 and over, will spend $1.8 trillion, and that is a huge number, on prescription drugs over the next 10 years. Our estimates, and I think this is the most conservative of conservative, if we simply implemented and forced the FDA to do what they ought to do and what we do with virtually every other product, we could save at least 35 percent. That is minimum. In fact, the number may be more like 55 or 65 percent.

It is $630 billion over the next 10 years. If we do not do this, and I know people are coming up with discount cards and all of the rest. They say we can get a 20 percent or 30

percent discount. A 30 percent discount off of $360 is not enough to make this program work. Ultimately, you have to have access to markets.

I am not in favor of price controls, and I do not like what a few of the countries do in terms of price controls. I want open markets because I know what markets do; markets level. Ultimately, we will pay less; the Germans will pay more. That is how this will work long term, and that is fair, that is reasonable, and it is time we do it.

The second thing, to get to your point, I think we ought to sic the General Accounting Office after these guys and get answers to these questions. Because these are legitimate questions that our constituents, the American citizens who send us here to Washington, have a right to know. Somebody ought to get inside those books and find out if it is true.

For example, one of the arguments that the pharmaceutical industry makes is that it costs $800 million to develop a new drug, but they never back it up. They never open their books so we can see that, yes, it really is $800 million.

The truth of the matter is more and more of us are becoming very skeptical about how much it actually costs to bring a new drug to market and how much they really spend on research and development. In fact, this author believes they actually spend less on research than they do earn in profits. So maybe what we ought to do is ask the General Accounting Office to do some research for us, to get some of the facts and report back to the Congress. I am not sure what we should do about it because I believe in free enterprise, and if company XYZ wants to pay their chief executive $227 million, I am not sure we should do anything about it.

But I will tell you what we ought to do. We ought to make sure that everybody knows it. Because I think the pressure from the public is going to start to say, this is lunacy and we should not have to pay it.

I think the people who developed this drug, Glucophage, are entitled to be rewarded for it. I believe in that. I believe in intellectual property rights. But I also say why is it we pay so much when the Germans can buy it so cheaply?

On this particular package, the price here in the United States is $29.95. This is a smaller package. We bought this in Germany for $5.

Six times. I do not care what kind of a discount card you have, the differences are still too huge. We have an obligation to our taxpayers to make certain that if we are going to have a prescription drug benefit for people who need that benefit, we have to make certain, as the gentleman says, that we get a fair price. But, frankly, as long as we are at it, why should we not get a fair price for all Americans? Why should we not just open up the market as we do for oranges or pork bellies?

In fact, I have told this story. People ask how did I get involved in this. The answer is kind of ironic. It was the price of hogs. People say, the price of hogs has something to do with the price of drugs? Let me explain. A number of years ago I had a meeting with some senior citizens groups in my district. They talked about their trips to Winnipeg to buy their drugs. I said, Fine. If you want to go to Winnipeg to buy your drugs, that's fine with me. That was it. I did not think much more about it. Then a few months later, the price of hogs in the United States dropped from about $50 or 50 cents a pound down to $9 or 9 cents a pound. All of a sudden our hog producers in my area were just going crazy. They could not afford to feed the pigs. They could not afford to slaughter the pigs. They were going bankrupt very fast. They were calling me saying, You've got to do something about it. I said, I'm not sure what we can do. They said, at least slow down the supply of Canadian hogs coming across the border to our plants in places like Austin, Minnesota, that are making our supply/demand situation even worse.

So I called the Department of Commerce. I called the USDA. I got the same answer. It is called NAFTA. It is called free trade. All of a sudden a light bulb went on in my head. I said, wait a second. You mean we have free trade when it comes to pork bellies, but we don't have free trade when it comes to Prilosec? This is nuts. One area where American consumers could save billions and billions and billions of dollars and yet our own FDA puts up a barrier and says, You cannot do that.

I do not know why.

I am not going to get into why. All I know is that I took an oath of office. You took an oath of office. We are here to serve the public interest. The pharmaceutical industry does not work for me. I do not work for them. But the boys over at the FDA do work for us, and they are required to serve the public interest. And a drug that a little senior citizen who sits there with a prescription and cannot afford to have it filled, she deserves somebody to speak for her. As long as I am here, as long as I have breath in my lungs, as long as I can hold these charts, I am going to keep talking about this and somebody is going to have to explain why the FDA keeps American consumers from buying safe and effective drugs from other countries for a fraction of the price. I am not going to give up on this. Because, as Winston Churchill said, you know what a fanatic is? A fanatic is a person who cannot change their mind and will not change the subject. I am not going to give up on this and neither are you. We are going to stay on this issue until Americans have access to world-class drugs at world market prices.

I think the time has come. Again, as Ronald Reagan said, quoting John Adams, facts are stubborn things. All we really want is the facts. I am not getting into motives. I do not care. I do not care why they do things. To me, that is not my job. My job is to stand up and speak for those people who cannot speak for themselves. When I read that statistic that 29 percent of prescriptions written to senior citizens go unfilled, and I have stood in pharmacies and I have watched them with their little slips and seen the look on their faces. It seems to me that we have an obligation to say on behalf of them that we are not going to just sit here and allow this to go on. This has gone on too long. The worst thing is it is getting worse and worse and worse per year. The difference between what we pay and what the European pays is not getting better; it is getting worse. Shame on us. Shame on the

I think that about says it all. As a matter of fact, let me just close with this. The Congress has spoken. When we voted on this matter in the House the last time, 323 of our colleagues voted with us on this.

In fact, in this ad it says, look how easy Congress has made it for you to save. That is what it says. Congress has spoken. Unfortunately we, put this language into that bill, in the conference committee and at somebody's request that says as long as they can guarantee safety. Well, they cannot guarantee safety on imported strawberries or pork bellies or plantains. We import hundreds and thousands of tons of broccoli a year. They cannot guarantee the safety. According to the FDA's own studies, 2 percent of the fruits and vegetables coming into this country are contaminated with food-borne pathogens, including things like salmonella. Salmonella can kill you. It does kill Americans. Yet what does the FDA do about that? Nothing. But if you try to save $45 on a box of Coumadin, they will come after you like stink on a skunk. There is something wrong with the system. We need to fix it. It is not so much shame on the pharmaceutical industry. It is shame on us. It is time that we make certain that Americans have access to world-class drugs at world market prices. That is what we want. That is what we expect. We will not stop until we get it.

I thank the gentleman.

Mr. Speaker, I thank the gentleman for yielding to me.

I am so honored to be here tonight to pay tribute to our friend, Larry Combest. A lot has already been said, and I do not want to be redundant and repeat some of the things that have been said, but I would like to mention a couple of things.

One is that he is probably one of the best dressers in the U.S. Congress. I have been with him at meetings with farmers, and he is always appropriately but the best dressed person there. And I think anybody who knows Larry knows that I am saying exactly the truth.

The other thing I should mention about Larry is the first time I ever met him was for a retreat for Republicans at some god-awful Xerox center about 50 miles west of here. It was my first chance to spend any time with Larry, and the one thing that was very obvious to me in our first real meeting and discussion, he is an incredibly good listener. Now, in this town that is a quality that is not developed in many of us, not the way it should be. But Larry is an amazing listener. He listens to what people have to say, and it is reflected in the success that he has had in his congressional career.

He came from west Texas. The district that he represents is one of the biggest energy-producing districts in the country, and yet he took the time to listen to our farmers and to other people on the importance of biofuels and ethynyl and biodiesel and came to the conclusion that it made an awful lot of sense long term for our energy policy. He did not put his own parochial interests above what was in the best interests of American agriculture.

So much has already been said, but it was because of that deep feeling that he was able to go to the Committee on the Budget a few years ago and get an unprecedented $73.5 billion out of the fiscal year 2001 budget so that we could create that farm bill. And he taught us so much about what it takes to make a farm bill, but it was his character that pushed it all the way through, and I mean that. Because passing a farm bill is much tougher than I ever thought. What he did was he demonstrated one of those things that we need to learn more about here in Washington and that is he was firm on principle but flexible on policy; and, ultimately, it was his vision of this farm bill that really won the day.

Now, Larry, we are going to miss you a lot. I am going to miss you more than you can even imagine. We will miss you a lot more than you will miss us. Certainly you deserve a little respite from this rat race. I can only say that I hope that you will not forget us rats.

Thank you very much and God bless you.

Mr. Speaker, I rise again today to talk about the high cost that Americans pay for prescription drugs, particularly relative to the industrialized world.

As I have mentioned on the floor before, we believe that Americans should pay their fair share in terms of the cost of the research and development of these miracle drugs. We even feel that it is fair enough that we should subsidize some of the developing countries, such as those in sub-Saharan Africa. We think, however, that it is outrageous that we are required to subsidize the starving Swiss.

Let me talk a little bit about what we did in the last 3 weeks. I was in Germany 3 weeks ago, and one of my staffers was able to go to one of the pharmacies at the Munich airport. Most of us know that when we buy things at the airport, that is usually not the cheapest place to buy things; and we went to the pharmacy there at the Munich airport and bought some drugs.

Among those we bought was Glucophage. Glucophage for 30 tablets, 850 milligrams, we bought at the Munich airport for $5 American. That same drug at a pharmacy in Minnesota back in my district is not $5 but $29.95.

Cipro is a very effective antibiotic made by a German company by the name of Bayer. They came up with Bayer aspirins. They have been around a long time, but Cipro became very important when we went through the anthrax scare here in the Capitol complex. We purchased it at $35.12 for 10 tablets at 250 milligrams. That same package in Minnesota sells for $55; $35 dollars in Germany, $55 in the United States.

Actually the story gets worse. Another very popular drug, Zestril, we bought for $25.04 American. It sells in the United States for $59.95, more than double the price for the same drug, and the list gets worse.

One of the worst examples is this. This is a drug called Tamoxifen. Tamoxifen is a miracle drug. It is probably the best drug ever developed in terms of treating breast cancer. We bought this drug at the Munich airport at the pharmacy there, 60 tablets, 20 milligrams for $59.05 American. This same drug, if we buy it here in pharmacies in Washington, D.C., will sell for $360; $60 in Germany, $360 for exactly the same drug here in the United States.

What makes this story even worse is that the taxpayers paid for almost all of the research costs to develop this miracle drug. It was developed essentially by the NIH. The company went out and got the patents, and now Americans are paying again.

Many of my colleagues say, well, shame on the pharmaceutical industry; and it is easy to say that, but I do not say shame on the pharmaceutical industry. I say shame on us. We are the policymakers. We are the ones who have created an environment that the pharmaceutical companies are taking advantage of; and shame on us for letting this happen, and let me give my colleagues another shame on us.

There was research that came out just a few days ago, the first time I had seen it; and what it said was that 29 percent of the prescriptions written to seniors in this country go unfilled because they cannot afford them. Shame on us.

We have created an environment where seniors today cannot afford the prescriptions that doctors write for them to save their lives. Shame on us. That is the problem.

The answer is open up markets. We have open markets for virtually everything else. The Food and Drug Administration allows hundreds and millions of tons of food to come into our country with virtually no inspection; but if a senior tries to import Tamoxifen to save their lives from Munich, Germany, they are treated as common criminals. Shame on us.

The answer is to pass commonsense, reimportation language this year. We are going to be talking about prescription drug benefits under Medicare here in the next several weeks in the Congress; but if we do not start seriously talking about affordable, if we do not talk about what we are going to do to control prices in this whole thing, there is not enough money in the Federal Treasury to pay for that benefit because we know the Congressional Budget Office tells us that over the next 10 years seniors in this country will spend $1.8 trillion on prescriptions. We have allotted $400 billion in this budget resolution over the next 10 years to take care not only of a prescription drug benefit but also to modernize Medicare, which is the right thing to do, and equalize the reimbursements.

The bottom line is that there is not enough money in this budget or any budget to pay for these huge disparities. Americans deserve world- class drugs at world market prices.

Madam Speaker, I come to the well of the House again tonight to talk about an issue that is an enormous issue particularly for seniors and that is the high cost of prescription drugs here in the United States. Today I received a copy of a new book by Katharine Greider, and the title of the book is ``The Big Fix, How the Pharmaceutical Industry Rips Off American Consumers.'' Ms. Greider has done amazing research in terms of what is happening in the prescription industry here in the United States, and it is not a pretty picture. In fact, one of the most troubling statistics she came up with as she did her research is that 29 percent of the prescriptions written in the United States are not filled because people cannot afford them. And here we have our own FDA, the Food and Drug Administration, which literally is treating law-abiding citizens like common criminals simply because they want to go to a foreign country to buy drugs that they need.

Let me give an example. We talked about this before. There is a drug called Tamoxifen. Tamoxifen is a miracle drug and I sort of have a love-hate relationship with some of the people in the pharmaceutical industry because Tamoxifen is a miracle drug, and it has saved lots of American women from breast cancer.

It is the most effective drug we have found. But the interesting thing is

much of the research was paid for by the American taxpayers through the

Mr. Speaker, I come to the floor of the House again tonight to talk about something that needs to be resolved, and we in Congress need to get serious about it, and that is the high price that Americans pay for prescription drugs relative to the rest of the world. And we see this chart here, and again I do not ask people to take my word for this. I would ask them to do their own research, but the interesting thing is millions of Americans are doing that research for themselves, and they are coming to exactly the same conclusion, and that is Americans pay far more than anyone else in the industrialized world for the same drugs.

Let us look at this chart. These numbers are average numbers, and they are from the year 2002. The source is the Life Extension Foundation, but there are other groups doing the same kind of research, getting essentially the same results.

Let us look at some of the drugs that we buy in large quantities in the United States. Cipro, we all know about Cipro after the anthrax scare. It is a very effective antibiotic. It is made by a German company called Bayer. We in the United States usually call it Bayer, Bayer Aspirin, for example. In the United States, the average price for a 30-day supply is about $88. That same drug can be bought in Canada for $53.55, but in Germany where they make the drug, they sell it for $40.75.

Going on down the list, here is another very important drug. It is a miracle drug for many people suffering with diabetes called Glucophage. In the United States, according to Life Extension Foundation, the average price for a 30-day supply is $124.65. That same drug can be bought in Canada in the same dosage for $26.47, and in Germany they can buy it for $22.

Let us look at Norvasc, another very popular drug here in the United States; $67 here, $46 in Canada and only $33 in Europe.

Mr. Speaker, I am not here to say shame on the pharmaceutical industry, and perhaps I should, but the truth of the matter is it is shame on us. We are requiring Americans to pay anywhere from 30 to 300 percent more.

Last week I had down on the floor a little box of some drugs, a very powerful and wonderful drug. It is called to tamoxifen. Tamoxifen is perhaps the best anti-breast cancer drug ever discovered, but let me share this. In the United States, and we checked it out at the local pharmacy here in Washington, for 100 tablets, 20 milligrams, the price was $360. We can buy that same package of drugs in Munich, Germany for $59.05; $60 there, $360 here, six times more that Americans are required to pay for this life-saving drug.

That is wrong, and we should do something about it.

Let me talk about the law because many people, particularly our friends at the FDA, are hiding behind the law. This is the actual law that they use to keep Americans from importing FDA-approved drugs from FDA-approved facilities, and here is what it says: The Secretary of the Treasury shall deliver to the Secretary of Health and Human Services upon his request samples of food, drugs, devices, and cosmetics which are being imported or offered for import to the United States, giving notice thereof to the owner or consignee who may appear before the Secretary of Health and Human Services, and some more legal goop, but here is what it comes down to. There are three criteria.

The first is, if it appears from the examination of such samples or otherwise, that one such article has been manufactured, processed or packed under unsanitary conditions. We cannot say that about these drugs.

Or, two, such article is forbidden or restricted in sale in this country in which it was produced or from which it was exported. These are legal drugs in both the United States and in the other countries we are talking about.

Or, three, and this is the last one, such article is adulterated, misbranded or in violation of section 355 of this title. These drugs are legal. We are not talking about bringing in illegal drugs; we are talking about legal drugs from countries that are FDA approved.

It is not shame on them; it is shame on us for letting this situation exist.

Let me just tell you what this amounts to. Our own Congressional Budget Office tells us that, over the next 10 years, seniors in the United States of America will spend $1.8 trillion on prescription drugs. Simple arithmetic, do the math yourself, we believe, and I think this is being very conservative, if we simply open up markets, as we do with every other product in this country, just open up those markets, we can save a minimum of 35 percent; 35 percent of $1.8 trillion is $630 billion. Shame on us.

We are going to be talking here on the House floor in the next several weeks about a prescription drug benefit, maybe under Medicare, maybe under Medicaid. Clearly there are a lot of seniors falling through the cracks. But the issue is not so much coverage; the issue is affordability. We need to do something about it.

I am going to introduce a bill later this week. I hope my colleagues will join me in cosponsoring that bill.

Mr. Speaker, I rise tonight to talk about an issue that I have talked about on this House floor before, and that is the high cost of prescription drugs here in the United States compared to the rest of the industrialized world, but before I do I want to just come back to something my colleague just was talking about in terms of the tax relief.

I am going to support the tax relief package because I understand that there are only three things people can do with their money. One is they can spend it. Two, they can save it, or three, they can send it to the government in the form of taxes. They can only spend it, save it or pay taxes. That is the only three things people can do, and we know that when the economy is soft, at least most of us believe, that if we allow people to keep their own money, that will grow the economy faster than having them send it into the Federal Government.

I want to talk about something else tonight because cutting taxes is not the only way that we can help the economy, and on this first chart I say if we want to allow Americans to keep and spend over $600 billion during the next 10 years, here is a good place to start.

We have got the picture of some prescription drug containers. That is right, according to the Congressional Budget Office, the CBO, American seniors will spend over $1.8 trillion on prescription drugs over the next 10 years. A conservative estimate would be that we could save 35 percent by allowing free markets to work. Thirty-five percent of $1.8 trillion equates to $630 billion. Now, if my colleagues doubt that, just look at this chart, and this chart is available on my Web site at gil.house.gov, and just check the number for yourself, but let me pull out a few of these.

A common drug we all know about is Cipro. It is made by a German company named Bayer. They also make aspirin. Cipro in the United States, it sells for $87.99. This is according to the Life Extension Foundation, but on average, last year, Cipro sold in the United States, a 30-day supply, for about $87.99. The average price in Canada for those same drugs, $53.55 and in Europe, $40.75, less than half the price in Europe for the same drug.

Let us look at GLUCOPHAGE, a very commonly prescribed drug for diabetes, in many respects a miracle drug. In the United States, average price for 30-day supply, $124.65. That same drug sells in Canada for $26.47, and in Europe the average price is $22.

We go on down the list, we look at drugs like Premarin, Premarin in the United States, $55; in Europe, $8.95. Zocor, very commonly prescribed drug, today $123 in the United States; $28 in Europe. Do the arithmetic. I think we are being very conservative.

At the bottom of this chart I have something from one of my favorite Presidents, President Ronald Reagan. He said, ``Markets are more powerful than armies.''

Tax cuts are great, but if we want to help seniors lower prescription drug prices and allow Americans to keep and spend $630 billion of their money, let us open markets now. Americans deserve world class drugs at world market prices.

I was in Germany not too long ago, and we actually bought some drugs. This is a very commonly prescribed, a very effective drug against women's breast cancer. This drug was bought at the Munich airport pharmacy for $59.05 American. This same box of drugs bought here in Washington, D.C., sells for $366. What makes matters worse, this drug was developed, almost all of the research expenses were paid for by the American taxpayers. I think Americans ought to pay their fair share for the price of research and development for all of these miracle drugs. I think most Americans believe that, but we should not be required to subsidize the starving Swiss.

The time has come to open up markets, to give Americans access to world class drugs at world class prices. We can do that in the next several weeks. I need my colleagues' help. Let us all work together to make certain that Americans have access to those drugs at prices that they can afford.

Madam Speaker, I rise tonight to speak about the issue of the higher cost of prescription drugs in the United States.

The gentlewoman who just preceded me who was talking about tax relief, I think I agree with some of the points she raised. When we talk about tax cuts, what we are really talking about is allowing people to keep more of what they earn. In soft economic times, I happen to believe it makes sense to allow people to keep more of what they earn.

As you see on this chart, which you can find on my Web site, we start by saying if we want to allow Americans to keep and spend over $600 billion during the next 10 years. Here is a good place to start. It has got a picture of prescription drug capsules here.

The next page says, ``That's right. According to the CBO,'' that is the Congressional Budget Office, ``American seniors will spend over $1.8 trillion over the next 10 years on prescription drugs.''

This is a conservative estimate. We are going to show you a chart in a minute that says that we could save 35 percent by allowing free markets to work. Thirty-five percent of $1.8 trillion translates to $630 billion.

Let me show you this chart. This is not my chart. I have a number of independent experts around the country that have been working on this a lot longer than I have, they are a lot smarter than I am, but they have actually done some of the comparisons in terms of what we as Americans pay for prescription drugs compared to the rest of the world.

This is a chart by a group called the Life Extension Foundation out of Florida. They have been studying this for more than a decade. Here are some of the figures in terms of the prices we pay versus what Canadian consumers pay and what European consumers pay for the same drugs.

Let us look at the top right here. We have Augmentin. In the United States, a 30-day supply sells for about $55.50. That same drug in Canada, made in the same plant under the same FDA approval, sells for $12. In Europe it sells for $8.75.

Cipro. We learned a lot about Cipro last year when we had anthrax here in the Capitol building. It is made by a German drug company called Bayer; we usually call it Bayer, Bayer aspirin. Cipro in the United States sells for $87.99 for a 30-day supply. That same drug in Canada sells for $53.55. Over in Germany it sells for $40.75.

My father takes a drug called Coumadin. Here in the United States the average price for a 30-day supply of Coumadin is $64.88. That same drug, again made under the same FDA approval in the same FDA-approved plant, sells in Canada for $24.94. Over in Europe the average price is $15.80.

Madam Speaker, as you look at this list, it just becomes very, very aggravating, when you see how much we pay. Glucophage, an amazing drug we sell here in the United States, the average price, according to the Life Extension Foundation, the average price in the United States, the average price, is $124 here. The average price in Canada for the same drug, same dosage, is $26.47. Over in Europe the same drug sells for $22. Glucophage.

A couple of weeks ago I and one of my staffers were in Germany. We had the opportunity to actually do some shopping of our own. We bought a drug called Tamoxifen. It is amazing in terms of being one of the most amazing drugs we have developed in the United States.

Let me just talk about the drug itself, because it was developed largely with American taxpayers' money. Tamoxifen is the most effective drug against women's breast cancer that we have developed, but the American taxpayers paid for most of the research costs.

This drug in the United States at a pharmacy here in Washington, D.C. for a 3-month supply just like this sells for about $360. In Munich, Germany, we bought it a week and a half ago for $59.05, the same drug.

Now, some people would say shame on the pharmaceutical industry; but I have to say shame on us, because we have allowed this environment to be created. It is not shame on them, because they are only exploiting a market opportunity that we have allowed them. The answer is open markets.

Many years ago President Ronald Reagan said that markets are more powerful than armies.

My time has expired, but I will be back in coming nights to talk about this issue and how Members can help solve this problem.

Mr. Chairman, with 30 seconds, I will be very brief.

Mr. Chairman, there is a term ``illegal diversion'' used twice in section 307. I just want to make clear that the authors have the intent to keep us from reimporting drugs that are being donated for AIDS in central Africa; that this will not be used to block what we may do in the future in terms of allowing Americans to have access to drugs from other countries.

I yield to the gentleman from Louisiana.

Mr. Speaker, I rise today as a proud lifetime Member of the National Auctioneers Association. We want to recognize today National Auctioneers Day, which takes place annually on the third Saturday of April. This year it fell on April 19. And I suppose some of my colleagues are wondering can he really do that? Yes, I do a lot of auctions even today: ``And now 35, I'll give you 40, now 5. Anybody bid 45? I'll give you 50.''

I have had the privilege of auctioneering events to raise money for the American Cancer Society, the Boys and Girls Club, Safari Club, Ducks Unlimited, the list goes on and on. As a matter of fact, since I was elected to Congress, I have raised almost $2 million for charity. Every year billions of dollars are poured into our economy from auctions of estates, of vehicles, thoroughbred horses, antiques and other goods. And auctions of homes and other real estate are increasingly more important as more and more realtors and homeowners see the advantages of selling by auction as their first choice.

On Auctioneer's Day this year, auctioneers across the country held a special fund-raiser for the Saint Jude Children's Hospital in Memphis, Tennessee, the chosen charity of the National Auctioneers Association. Auctioneers are generous and patriotic Americans, and I rise to salute their contributions to our great country.

Mr. Speaker, Daniel Webster said, ``God grants liberty only to those who love it and are always ready to guard and defend it.''

What you see here is a banner that was displayed and then signed by thousands of my constituents 2 weeks ago at a ``support the troops'' rally in Rochester, Minnesota. Now, I know rallies like this have been conducted all over the United States, but this particular banner is on its way with me to Germany and will be displayed to the brave Americans who are in the hospitals at Ramstein Air Force Base, and then hopefully it will make it from there down to the gulf so that the soldiers who are serving there can see this banner and know that people in Southeastern Minnesota as well as people all over the United States support them.

No nation has given more in the defense of liberty than we Americans. From Valley Forge to Gettysburg, from Normandy to this very day, we have demonstrated what President Kennedy meant when he said that, ``we will pay any price, we will bear any burden, we will meet any hardship, support any friend, oppose any foe, and shoulder any burden to keep the lamp of liberty burning brightly throughout the world.''

We have all been heartened by the stories coming out of Iraq. Many of us have read of the rescue of PFC Jessica Lynch as recounted by Central Command briefer Major General Gene Renuart. According to General Renuart, a Special Ops soldier called to Private Lynch as he entered the room saying, Jessica Lynch, we are United States soldiers. We are here to protect you and take you home.

As he walked over and took off his helmet, she looked up to him and said, I am an American soldier too.

But not as many of us have heard the story of the recovery of the remains of the soldiers believed to have been soldiers killed there. And I quote, ``At the same time,'' Renuart recounted, ``the team was led to a burial site where, in fact, they did find a number of bodies that they believed could be Americans missing in action. They did not have shovels in order to dig up those graves so they dug them up with their hands. And they wanted to do it very rapidly so they could race the sun and be off the site before the sun came up; a great testament to the will and desire of coalition forces to bring their own home.''

They did dig them up with their hands and raced the sun.

On a cold and windy Sunday afternoon just 2 weeks ago, the people of Southern Minnesota gathered to send a simple message. We sang songs, heard speeches, read letters, and most of us got a little misty eyed as proud parents held pictures of their sons and daughters wearing the uniforms of each branch of our military. Our purpose was simple. We wanted to say thank you for their service; and, second, we wanted them to know that we stand with them wherever they may be serving. All took their places in that long line, that long gray line that has never failed us.

The images of the Iraqi citizens cheering our Armed Forces make us happy and proud, but somehow not surprised. Once the Commander in Chief gave the order to liberate Iraq, most of us knew that the result and those images were inevitable. On behalf of all who have attended rallies, and especially those who signed this banner, let me say first that we mourn with those families who have borne the heaviest price of this battle.

No politician can adequately salve wounds that will never completely heal. The best that we can say is that we will never forget. To all those, who, like PFC Lynch, are ``American soldiers too,'' and to all our sailors, airmen and Marines, we say thank you. And we stand with you. May God continue to bless and protect our Nation and all who defend her.