Medicare nomination may stall over drug 'reimportation'

Senate Democratic Policy Committee Chairman Byron Dorgan of North Dakota is threatening to hold up the nomination of Food and Drug Administration Commissioner Mark McClellan to head the Health and Human Services Centers for Medicare and Medicaid Services (CMS) over a lingering dispute about prescription drug "reimportation."

Speaking Tuesday at a summit of governors and members of Congress who support allowing U.S. citizens to buy cheaper drugs from Canada and other countries that control prices, Dorgan said he wanted to know "what's going on over at the FDA" on the issue. Until he does, McClellan's nomination "is going to spend awhile" in the Senate, he said.

McClellan, President Bush's White House health policy adviser before taking over at FDA in late 2002, is popular on Capitol Hill. Bipartisan approval by the Finance Committee, which will consider the nomination, greeted the announcement last week that he would be appointed to head CMS.

McClellan is considered a steady hand both politically and substantively, something the agency needs as it implements last year's massive Medicare law.

But another bipartisan, bicameral group of reimportation advocates considers McClellan an enemy because of his uncompromising opposition on safety grounds to opening the closed U.S. regulatory system for drugs -- a position his predecessors also held.

"I can understand why we are fighting the drug companies," said Wisconsin Democratic Gov. Jim Doyle, who announced at the meeting that his state would expand the Web site it has set up to facilitate the purchase of Canadian drugs. "But I cannot understand why we are fighting the federal government."

If Dorgan follows through on his threat to delay the nomination, it will be déjà vu for McClellan: Sen. Jeff Bingaman, D-N.M., briefly held up his nomination to run FDA after a spat between Bingaman and HHS Secretary Tommy Thompson over Thompson's withdrawal of support for a Bingaman bill to make pregnant women, rather than fetuses, eligible for the State Children's Health Insurance Program.