While the federal government struggles to implement a new prescription drug plan for seniors, it has begun cracking down on the importation of cheaper but illegal drugs from Canada.
U.S. Customs agents now are regularly seizing many of the prescription drug shipments to individuals that until recently were left alone.
Federal officials acknowledge the stepped-up enforcement but say it has nothing to do with the new Medicare drug program, known as Part D, which has been riddled with technical and management problems since it began Jan. 1. Enrollment in the voluntary program has been below government estimates.
But several members of Congress, Republicans and Democrats alike, are calling for an inquiry or at least an explanation after receiving a flurry of calls from angry residents whose drugs were seized en route from Canada.
"There should be a kinder, gentler way to enforce this law," said Rep. Ginny Brown-Waite, a Brooksville Republican who wants to allow Americans to import lower-cost prescription drugs from other countries.
Sen. Bill Nelson, the Florida Democrat, has received about 130 calls in recent days and wrote a sharply worded letter asking the Department of Homeland Security to investigate whether the change in enforcement is related to Part D.
"I am particularly disturbed by the timing of this new wave of seizures," he wrote. "This raises questions about whether the government is trying to force seniors to enroll in the new Medicare drug program."
Senators are expected to ask Michael Leavitt, U.S. secretary of health and human services, about the Canadian drug issue this morning at a Senate Budget Committee hearing.
"The feeling is that the government wants them to sign up for Part D," said Shelley Kauzlaric, owner of Dunedin Meds of Canada, a business that helps Americans buy drugs from Canada. "It's the government's way to try to discourage importing those drugs. It forces the hands of seniors. It can't be a coincidence."
U.S. law prohibits importing drugs from sources that have not been inspected by the Food and Drug Administration, and the FDA has said it lacks money to expand its inspection program.
Despite pressure from drug manufacturers, U.S. agents have generally taken a hands-off approach toward those who imported drugs for personal use.
Nelson said the FDA had indicated in the past that it would allow individual Americans to purchase up to a 90-day personal supply of prescription medications from Canada. The House has repeatedly passed legislation denying the FDA authority to use taxpayer dollars to prevent the importation of drugs for personal use, though the Senate did not.
Zachary Mann, a spokesman for U.S. Customs and Border Security in Miami, said agents improved the existing screening process Nov. 17 - two days after the government began allowing enrollment in Part D. Mann could not explain why improvements were made but denied they were related to Part D.
"I'm being told they are not connected," he said. "The concern is in the best interest of the consumer. Ultimately we're trying to protect the consumer."
Brown-Waite said Canadian importers estimate that the government is now seizing 7 percent of shipments - up from 1 percent.
This change comes amid weeks of confusion over Part D in which pharmacists refused to fill prescriptions or overcharged because they couldn't confirm what plans people were on or what deductibles people should pay.
A divided Congress reluctantly approved the drug plan pushed by President Bush in 2003.
Almost 42-million elderly or disabled people are eligible to enroll in one of dozens of programs offered by private companies that are subsidized by the federal government. In Florida, 19 companies offer 43 drug plans.
About 4.9-million people have signed up for Medicare Part D drug plans since enrollment began Nov. 15. In addition, about 6.2-million poor people on Medicaid were assigned randomly to a drug plan.
The federal government hopes for 8-million to 10-million to sign up by the time enrollment ends May 15.
Sales from Canada have fallen as much as 30 percent since Part D began, according to the Canadian International Pharmacy Association.
"Many seniors are finding Part D is cheaper than going to Canada," said Ken Johnson of the Pharmaceutical Research and Manufacturers of America.
But some continue to buy drugs from Canada.
Barbara Horton, a 78-year-old from Osprey, south of Sarasota, said Canada is still a much cheaper source for the 10 drugs for her and her husband, Jim, who suffers from Alzheimer's disease.
Horton has been buying prescriptions from Canada for four years. She never lost a shipment until January, when a letter arrived from U.S. Customs saying her delivery had been intercepted and the drugs confiscated.
"That stupid drug bill is not taking off so now they're trying to enforce this other law," she said. "I feel certain they are connected. How could they not be?"
With its large population of seniors, Florida has seen an increasing amount of Canadian drug importing, a business estimated at more than $700-million in 2003.
Floridians can access Canadian pharmacies directly, by Internet or phone, and through dozens of storefront operations that place orders with Canadian pharmacies.
Congress considered but did not pass a bill allowing individuals and pharmacies to import drugs from Canada and other countries.
In the absence of federal action, dozens of states, counties and municipalities proposed or implemented their own drug importation programs.
Canada has long offered inexpensive brand-name drugs because its national health service negotiates deep discounts from manufacturers. Americans spend an average of $728 per year on drugs - compared with $507 in Canada, according to 2003 figures from the Paris-based Organization for Economic Co-operation and Development.
Horton said she saves about 50 percent buying her drugs from Canada. She was able to get a followup shipment for the $300 in medication she lost to Customs on Jan. 21, and her prescription supplier didn't charge her again.
"Like they don't have anything else to do than go after 78-year old people," she said of the federal government. "Idiots."
Times staff writer Stephen Nohlgren and researcher Caryn Baird contributed to this report.