Thousands of Mainers again will be able to get their prescription medication at a discount now that some mail order pharmacies located outside the country can do business here. That had been the case until last summer, when then-Attorney General William Schneider ruled that the Canadian-based CanaRx was not licensed to do business in Maine.

That was bad news for employees of both the state and city of Portland, who had been getting their medications through the company at about 50 percent of the cost. It was also bad for the taxpayers, who were ultimately responsible for a higher bill for public employees’ medications.

Now that the Legislature and Gov. LePage have acted, those employees may again be able to get those discounts. But that leads to bigger questions: Why do people have to leave the country to get these deals? Why are prescription drugs so expensive here?

CanaRx is based in Canada, but that is not where all the medications it sells are manufactured. Many of them are made in the United States and shipped to Canada (or the United Kingdom, Australia or New Zealand), where they are sold at a sharply discounted rate. The reason they are sold at such a low price — in some cases, 80 percent less than what the same medication would cost here — is that their governments negotiate with the manufacturers. In this country, the government does not control the price of medication. Big insurance companies and medical providers do, but people without insurance are forced to pay the full cost.

That put the burden on the American taxpayer, who funds prescription coverage for people on Medicare. When the program was created in 2005, the law was written to require the government to subsidize the cost of the medication, but prohibits it from negotiating the price.

The high inflation rate for health care is a major public-sector burden on both the state and federal levels. Since the government is a big purchaser of health care services, both for its employees and through programs like Medicaid and Medicare, it would make sense that it would use its market clout to get the best deal for taxpayers.

The Legislature did the right thing with CanaRx, but it shouldn’t stop now. Every Mainer — every American — should be able to buy medication at prices similar to those paid in Canada and other countries for the same product.

We can control health care costs without rationing care. Negotiating prices with pharmaceutical companies would be the right place to start.


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