U.S. states that have looked to Canada to help their residents win steep discounts on prescription drug prices are turning to Europe for the same deals because the Canadian government is considering shutting off the southbound flow. Illinois and three other states already have authorized reimportation programs that recognize shipments of prescriptions from such places as the United Kingdom and Ireland.

It’s unclear how successful they and other state legislators might be with that initiative because there have been moves in Europe to restrict access to low-cost drugs across national lines. But lawmakers say it is important to explore every possible avenue toward cheaper prices.

States from Illinois and Wisconsin to New Hampshire and West Virginia have either authorized reimportation of prescription drugs from Canada or explored the idea. Several of them now have added Europe to the mix because Canada’s health minister has said the government was considering significantly limiting sales to individual U.S. consumers.

"The idea was to spread the risk" of drug manufacturers cutting off supply to an individual country that reimported prescriptions to the United States, said Caleb Weaver, project manager of I-SaveRX, the initiative launched by Illinois and now available in Wisconsin, Missouri and Kansas. Vermont would join that program.

The European Court of Justice is considering whether manufacturers can limit supplies to countries with cheap prices. That would crack down on consumers who get their drugs cheaper from neighboring countries via "parallel trade" among European Union nations, according to the U.S. National Legislative Association on Prescription Drug Prices. There have been several such challenges in the past.

Patients blame the pharmaceutical industry for efforts to choke off supplies from countries where prices are low because of strict government regulation. They accuse the industry of using its economic muscle to force such national policy decisions.

"You actually have an industry that’s bullying around countries," said House Health Care Chairman John Tracy, D-Burlington. "It’s bizarre that we’re even in this position."

Wanda Moebius, a spokeswoman for the industry trade group Pharmaceutical Research & Manufacturers of America (PhRMA), disingenuosly spins the line that the lobby group is concerned about the safety of drugs being imported to the United States and those concerns are increased by the possibility of importing from Europe. Really Wanda's worry is profits - European drugs are exactly the same and are regulated just as strenuously.

Wanda claims European imports could threaten safety because they could carry labels in languages that consumers don’t speak. "There’s no guarantee English will be used," Wanda said. "When you start going outside the U.S., you are opening yourself up to a number of safety issues." Wanda seems not to know which language the English speak.

Dr. Peter Rost, a marketing vice president with Pfizer Inc., told Vermont lawmakers Thursday that reimportation from Europe was a logical and viable alternative. Parallel trade, a version of reimportation among European countries, has operated successfully for 20 years, he said.

"Just authorizing a scheme where drugs come from Canada is doomed to fail," said Rost, who emphasized he was not speaking on behalf of his company. "You must look to the European Union." Despite the myriad obstacles, including opposition in Washington, state legislators continue to push for reimportation because consumers can save an average of 50% on the costs of drugs purchased in Canada.

"For very expensive drugs it really can be a lifesaver," said Sharon Treat, executive director of the National Legislative Association. "Unfortunately in this country many people don’t have any kind of prescription drug coverage that approaches those savings, or any (coverage) at all."

Prescription drugs are big business and have become a big political issue. A recent federal report said retail sales of prescription drugs amounted to $179.2 billion in 2003. That represented 11% of all health care spending. Precise estimates are hard to come by but between 1 million and 2 million Americans get their drugs from Canada. The Canadian model developed after U.S. Rep. Bernie Sanders, I-Vt., began staging high-profile bus trips to Canada more than five years ago. He took senior citizens to Montreal and its suburbs, where they got so-called maintenance drugs at significant savings. Maintenance drugs are those that patients must take regularly to care for a chronic disease such as high blood pressure.

What has developed since then is an Internet-based system in which a prescription from an American doctor is co-signed by a Canadian physician, filled and then shipped to the United States. Sanders unsuccessfully sought in the federal Medicare bill to explicitly authorize reimportation from Canada and 18 other countries.

"While we don’t think it would necessarily be bad if it was just Canada, we think it’s important that the state of Vermont as well as the federal government open as many markets as possible so you don’t give the government and pharmaceutical companies so much power to manipulate the situation," said Sanders spokesman Joel Barkin. "We are encouraging Vermont and the federal government to look for any licensed pharmacy outside the U.S. where people can find affordable, safe drugs."