Some older Americans have for years headed across the United States' northern border to buy the medicines they need but can't afford. Drug prices there can be half or a quarter of prices in the United States.

Canadian drug prices are so much lower because the country's system of socialized medicine keeps a tight hold on pharmaceutical costs. In addition, U.S. drug prices are high because companies add the cost of research and development as well as the price of lobbying and expensive advertising campaigns.

Senior citizens, many of whom are on fixed incomes and use more drugs than other Americans, feel the pinch. Horror stories abound: A Vermont woman who paid $95 a month for the tamoxifen that kept breast cancer at bay now goes to Canada, where the drug costs her $125 a year. An older couple who were paying thousands of dollars a year for medicines were able to cut that expenditure in half by a regular northward journey.

Some charitable organizations sponsor drug-buying trips, and a small industry has sprung up to help seniors. Chartered buses operate on a regular schedule from many areas within a day's drive - or sometimes more - of Canada. Once there, seniors see sympathetic Canadian doctors or U.S. doctors with licenses to prescribe drugs in both the United States and Canada. Pharmacies near the border accommodate Americans gladly; some even offer amenities such as free sandwiches while customers wait.

Now the United Health Alliance of Arlington, Vt., has opened a Web site that shows any doctor how to obtain drugs from Canada for patients. Using a fax machine, a standardized prescription form and the patient's credit card number, doctors can have drugs shipped to their office, where patients can pick them up.

Some legal experts have suggested that using a fax for prescription drugs is a gray area - not illegal, exactly, but questionable. It apparently has never been addressed by Congress or by federal regulations. Until lawmakers or regulators take up the question, though, any doctor anywhere in the country seems able to get cheaper Canadian drugs for his or her patients.

Some movement has been seen on the national front recently, where discussions are under way on proposals to reform Medicare to include drugs or offer incentives to companies or subsidies to the neediest seniors to bring down the cost of insurance to cover prescriptions.

Until some type of reform or change happens, it seems likely that more and more senior citizens will try to bypass the system to get drugs they need but feel they can't afford. Perhaps the added attention brought to the issue by the Web site will encourage Congress to focus its energies on a sound, bipartisan solution in 2001.

©2000 Omaha World-Herald Company

###