Several groups from northern states plan to meet in Philadelphia in March to discuss banding together to buy drugs from outside North America.
They would use countries that are listed in an importation bill pending in the Senate that authorizes purchase of drugs from Canada, Australia, Japan, New Zealand and members of the European Union.
"As it becomes harder and harder to get drugs from Canada, we are all looking to explore options elsewhere," said Lee Graczyk, legislative director of the Minnesota Senior Federation. "There isn't a day I don't get contacted from an exporter from outside Canada."
The supply of some drugs from Canada has already decreased as American manufacturers cut off sales to Canadian pharmacies that sell to U.S. customers. Now, the Canadian government is considering several proposals that could choke off Internet sales of drugs, such as requiring that people see Canadian doctors to get drugs in that country.
President George W. Bush's administration opposes importation of drugs from Canada and other countries, arguing the practice is unsafe. Last November, Mr. Bush discussed the issue of drug imports with Canadian Prime Minister Paul Martin. But the White House has denied accusations that Mr. Bush pressured Martin to make it harder for Americans to buy drugs from Canada.
Importing drugs into the United States is technically illegal, but the Food and Drug Administration generally does not stop small amounts purchased for personal use.
"I can buy a three-month prescription from Canada for around $400," said Ruth Ronk, an 81-year-old widow from Appleton, Wisconsin, who suffers from high blood pressure and high cholesterol. "If I buy it here, it costs $200 a month."
Joining the Minnesota group at next month's meeting will be activists from Wisconsin, New York, Pennsylvania, Indiana and Oregon. The organizations help the elderly purchase drugs from Canada by recommending pharmacies there, where prices tend to be cheaper because of price controls.
The groups' effort is separate from government programs in several states that direct residents to Canadian pharmacies. But the state programs are facing the same supply issues.
A Web site started by Illinois lets its residents and those of Wisconsin, Missouri, Kansas and Vermont buy drugs from the United Kingdom as well as from Canada. And Minnesota, which has its own Web site for Canadian pharmacies, is looking into the possibility of buying prescription drugs from Europe.
Proponents say those countries have regulatory systems that are just as safe as those in the United States.
But the FDA, which opposes all imports, says that allowing drugs from Europe raises even more concerns than importing them from Canada.
"At least with Canada, it's a regulatory system we know fairly well," said Bill Hubbard, the FDA's associate commissioner for policy and planning. "In Europe, they operate under parallel trade; any country can import drugs from any other country. You're only as strong as the weakest link."
But sponsors of the legislation to allow imports argue that Europe's system should serve as a model on how regulated drugs can be shipped safely across borders.