Rx for votes

WHITEFISH, Mont. (AP) -- Brian Schweitzer is a farmer, not a pharmacist. Yet strangers call him every day to complain about their ailments and the pills they take.

Schweitzer, a Democratic contender for U.S. Senate, has known for months what many politicians just now are discovering: Americans' discontent with the high cost of prescription drugs is emerging as one of this election year's most potent issues.

Last November, the candidate organized a bus trip to Canada so elderly Montanans could buy drugs at much cheaper prices than they pay at U.S. pharmacies. It was meant as a publicity stunt -- a jab at what Schweitzer says is discriminatory pricing by the pharmaceutical industry and the failure of Congress to stop it.

So many people responded with their own sad stories that Schweitzer staged another ''Run for the Border'' in December. In February, he flew three dozen seniors to Mexico for even bigger savings on their prescriptions.

''This is bigger than a U.S. Senate race. People talk about this everywhere I go,'' said Schweitzer, who now carries a pocket-sized copy of the Physician's Desk Reference with him. ''There isn't a family in Montana that doesn't have somebody who's taking high-cost prescription drugs and wishes they could somehow pay less.''

Montana's Democratic primary is June 6, and Schweitzer is expected to have no trouble winning. Meanwhile, the political newcomer, a 44-year-old mint farmer who lives on a 500-acre spread in northwestern Montana, has already hit a nerve with his road show.

A national group backed by the pharmaceutical industry bought a big round of TV commercials accusing Schweitzer of trying to import Canadian-style socialized medicine and price controls. Republican Sen. Conrad Burns, whom Schweitzer is challenging, has started running his own ads and insists he's no ''Johnny-come-lately'' to the issue of high drug costs.

The issue is hardly confined to Montana. Buses filled with senior citizens have made demonstration trips to Canada from Michigan, Maine and Washington state.

In Congress, Republicans and Democrats are battling over how -- not whether -- to extend drug benefits to elderly Medicare patients. The Democrats favor including the benefits in the Medicare program itself, while Republicans support subsidized private insurance plans for low-income seniors.

Last month, Vice President Al Gore accompanied a retired clerk into a Hartford, Conn., pharmacy and watched her spend more than $500 for a month's supply of medicine. George W. Bush has come out in support of the Republican plan in Congress.

States are taking matters into their own hands. This month, Maine Gov. Angus King signed a law making his state the first to use its bargaining power to negotiate prices of prescription drugs for residents without drug coverage.

On one side are senior-citizen groups and candidates such as Schweitzer. On the other is the pharmaceutical industry, which has projected U.S. sales this year of more than $100 billion and enjoys one of corporate America's highest profit margins.

The issue is gaining steam now for several reasons, said Duane Kirking, professor at the University of Michigan's College of Pharmacy.

The rising cost of prescription drugs has outpaced inflation, he said, and new miracle drugs have raised both patients' expectations and costs of treatment. Illnesses that once hospitalized patients, with the cost of hospitalization and drugs paid by health insurance, now can be treated more cheaply out of the hospital with new drugs -- but the cost of those drugs often is borne by the patient.

The highest drug prices hit those least able to afford it. Bulk drug buyers such as the federal government and HMOs negotiate big discounts from pharmaceutical makers. Foreign countries such as Canada impose price controls to keep health-care costs down for their citizens. But U.S. citizens without insurance covering drugs end up paying full retail price for their medications.

They include people like Joan Stroup, a retired school principal from Butte who went on Schweitzer's trip to Mexico. She pays about $800 a month for prescription medicines that treat high blood pressure, migraines, asthma, allergies, skin conditions, anxiety and depression.

Her trip to Mexico saved Stroup over $1,000 for a three-month supply of drugs.

With two mortgages on her home and a fixed retirement income, Stroup said she often stands at her bureau drawer full of medications, counting pills and calculating which she'll run out of first before the end of the month: medicine or money.

When she runs low, she skips doses, saving cash for other necessities.

''I do have to eat once in a while, too,'' she said.

Representatives of the pharmaceutical industry counter that many of the medications that make life better for people like Stroup wouldn't have been developed if limits had been in place on drug companies' profits. They say a new medicine costs $500 million on average to develop and bring to market.

Americans may subsidize consumers in countries with price controls on drugs, the industry says, but Americans also get breakthrough drugs first, because the United States is the world leader in developing new medicines.

Citizens for Better Medicare, a group largely backed by pharmaceutical companies, has run TV commercials across the northern tier of states -- with a special effort in Montana. The ads show a bus traveling into the United States and say Canada's price controls and socialized medicine result in a health-care system that drives Canadians south of the border.

''Government control on our prescription medicines?'' said one ad appearing in Montana. ''Tell Brian Schweitzer no thanks.''

If price controls are instituted in the United States, ''you can anticipate a huge drop in research into new medicines,'' said Dan Zielinski, spokesman for Citizens for Better Medicare.

Sen. Burns has started running his own ads, expressing his concern for getting senior citizens the drugs they need. He supports the Republican plan in Congress to help the elderly buy drug coverage from private insurers.

Schweitzer favors legislation to reduce U.S. drug prices by rescinding a 1987 ban on importing prescription drugs. But Burns echoes the pharmaceutical industry's argument that allowing drugs in from other countries would increase the risk of tainted or counterfeit drugs.

Burns also said he's not inclined to second-guess the pharmaceutical industry's business practices or set prices for it.

''Does this just apply to pharmaceuticals, once you empower the government to do such things?'' Burns said. ''If you get into price controls ... you take away innovation, you take away the ability to market, you take away our ability to do research and development.''

Schweitzer, now planning another bus trip to Canada on June 1, dismisses Burns' recent interest in high drug prices. He says Burns and other Republicans have had years to do something about the problem but haven't acted because of the influence of the pharmaceutical lobby.

''Conrad Burns can come with us,'' Schweitzer said. ''But he'll have to sit in the back of the bus until we know he's well behaved.''