Survival of the fittest - can Carson City pharmacies compete with low-cost Canadian prescription drugs?

Pharmacist Kirk Wentworth knows his customers by name and what prescriptions they need. When his customers have a medical concern about their drugs, they talk to him over the counter about it.

Which is service a Canadian pharmacy can't provide, he says.

As the owner of one of Carson City last two remaining independent pharmacies, Wentworth said his business could be affected by a bill signed last week by Gov. Kenny Guinn that would help consumers buy prescription drugs from Canadian pharmacies.

The law, which goes into effect July 1, makes Nevada one of the nine states, plus Washington D.C., opposing the Bush administration's drug importation policies. State officials will inspect Canadian pharmacies, license those that qualify and then list them on a state Web site by November, a state pharmacy board official said.

The Bush administration opposes prescription drug imports and federal regulators warn they can't guarantee the safety of drugs from outside borders.

Wentworth, who owns Medcare Pharmacy on North Carson Street, said mail-order prescriptions filled by foreign pharmacies complicate the medical review process. In the more traditional pharmacist model, the patient patronizes one pharmacy and that pharmacist knows all the medications the patient is taking.

"It has some pitfalls," Wentworth said. "Mail order can be inconvenient. You have to wait up to three weeks to get your medicine. Some like it OK. Some don't. There is a significant problem with maintenance medications that are bought in these different pharmacies. How are we going to review the conflicts between different drugs? Something could get missed."

To keep this from happening, he recommends patients keep a current list of all the medications they are taking and their allergies.

Maintenance drugs are diagnosed for acute or chronic illness, such as bladder infection or high blood pressure. Canadian drugs are subject to price controls and can be up to 40 percent cheaper than the same medication found in the U.S. But the pharmaceutical industry argues that buying the drugs from Canada doesn't mean that they're made in Canada.

Wentworth said he thinks his business will whether this storm. He has worked here for 24 years and in that time two other family-owned pharmacies have gone out of business and the chain companies have come in at full force.

LaVerne Simione, a 68-year-old Carson City woman, spends about $300 a month on her prescription asthma and allergy medicine. She lives on Social Security and has only Medicare to pay for her medical costs. Simione said she wants to find out more about Canadian pharmacies because the American system is confusing her.

"If it's going to be 40 percent less or better that'll be fine," she said about the cost of drugs. "So many people are seniors, including me, and we don't understand the prescription drugs through Medicare (system)."

But Simione doesn't have a computer, so she worries how she'll get access to this Web site that will tell her which Canadian pharmacies to purchase from.

Pharmacist Mike Hautekeet, who owns Mike's Pharmacy on Curry Street, said he would sell drugs cheaper if he could buy them cheaper from the manufacturers.

"That would be a better solution than losing all the business to Canada," he said.

What would it take for cheaper prescription drugs to also be sold in America?

"I don't know," Hautekeet said, then he laughed. "The manufacturers have to make a decision. If we can't buy our drugs cheaper, we can't sell them cheaper."

He said it probably will be the smaller, independent pharmacies that are most affected by the new legislation.

Nevada State Board of Pharmacy executives will travel to Winnipeg from July 11 to 13 to research and interview pharmacies for the Web site. They'll visit each pharmacy again before the Web site is launched.

"They have to be licensed pharmacies and the drugs have to be products that are FDA approved," said Executive Secretary Keith Macdonald. "We'll be there seeking those guarantees for the protection of Nevadans."

He said there are from 30 to 40 pharmacies in Manitoba that could import to Nevada and also some in Alberta and British Columbia.

n Contact reporter Becky Bosshart at bbosshart@nevadaappeal.com or 881-1212.