Pharmacy Law and Ethics
Description of the Assignment –
Each group is assigned a scenario that contains an ethical question or dilemma. I have included some questions at the end of each scenario to start the conversation. These questions to consider are not an exhaustive list. Please address other issues you identify.
· As a group, work through the case using the 4-Step Framework for Ethical Decision Making discussed in class.
· Prepare a 5 – 10 minute presentation, including a very brief summary of the scenario, a description of the process used and discussion, the relevant ethical principles, the list of alternative actions developed (with anticipated consequences) and the course of action selected.
A grading rubric will be provided.
Group 7 Drugs from Canada for Montgomery County, MD Employees
On November 1, 2005, the County Council of Montgomery County, Maryland passed a bill requiring officials to give county employees and retirees the right to obtain lower-cost prescription drugs from Canada. The proposal, which passed 6 to 2, would permit 12,500 county employees and retirees to turn to a particular Canadian health benefits company, Canusa, based in Windsor, Ontario, and could potentially save the county between $15 million and $20 million, according to estimates (although other estimates placed the figure much lower). Individuals would thereby help their county, preserve county resources, and possibly save on co-payments. The plan, if ever it overcomes substantial legal hurdles, could be expanded to other employees of the school system, planning agency, Montgomery College, and the Suburban Sanitary Commission, thus impacting as many as 85,000 people. It could also serve as a pilot for other government agencies to opt for cheaper Canadian drug sources.
The FDA, who’s headquarters is located in Montomery County and alarmed by these developments, dispatched a top official to emphasize that in its opinion, the importation of drugs was illegal as well as unsafe. The FDA has held this (position) even though many of the drugs originate in U.S. manufacturing plants, are imported to Canada, and are then “reimported” to the United States.
In the face of persistent opposition from the FDA, the county suspended the development of its plan, and it sued the FDA in an attempt to obtain a waiver to permit its implementation. In August 2006, a U.S. District Court dismissed the suit.
Some Questions to Consider
Those who give weight to the ethical principle of autonomy would surely support the county proposal. Are there long-term American interest in addition to the purported concerns about drug safety? Drug prices vary by country due to market differences. Prices may be lower in a developing country where patients cannot afford American prices. As more drugs are purchased in Canada, would Canadian prices stay low or rise, making any cost saving insignificant?