This vote was on an amendment by Thad Cochran, R-Miss., that would stipulate that prescription drugs could only be imported from other countries if the Health and Human Services Department certified those drugs as safe and will lower consumer costs. Cochran's amendment was itself offered to another amendment previously put forward by Byron Dorgan, D-N.D. Dorgan's amendment would allow Americans to purchase prescription drugs from Canada and several other Western countries (often referred to as "drug reimportation"). Drug reimportation is currently illegal.

Chuck Grassley, R-Iowa, who favors allowing drug reimportation, said Cochran's amendment is a "poison pill" that, if adopted, would kill Dorgan's amendment allowing drug reimportation. "There is an attempt to kill drug importation as has been done many times before in this Chamber. I am referring to an amendment by my good friend from Mississippi, Senator Cochran. His amendment would require a certification about health and safety. That amendment is designed to kill drug importation once again. It is a clever amendment but it is a poison pill," Grassley said.

Cochran said recent reports have shown that contaminated medicine has poisoned hundreds and possibly thousands of people around the world, and that his amendment would strengthen safety standards. "We have had this issue before the Senate on several previous occasions. In all of these cases, the Senate has adopted this certification amendment overwhelmingly. Safeguards continue to be necessary and are even more important now considering the terrorist threats we face," Cochran said.

Many progressives (along with a few Republicans who dislike any market restrictions) support the idea of allowing Americans to purchase prescription drugs from other countries, where drug prices are generally cheaper, even for the same product. Progressives and others support drug reimportation because they believe it would help drive down health care costs and make prescription drugs more affordable for low-income Americans, including the elderly and others on fixed incomes.

According to the Congressional Budget Office (CBO), the price for prescription drugs in the United States has outpaced cost growth in every other health category. The CBO also found that in 2002, U.S. patented drug prices were 67 percent higher on average than those in Canada.

Those who oppose allowing drug reimportation say it is a matter of safety. They argue that those who purchase prescription drugs from other countries risk ingesting drugs that are counterfeit, that have been tampered with or are otherwise unsafe. They point to the same CBO report that concluded, finally, that allowing drug reimportation in the United States would only create a "modest" cost savings, in part because of the middle-men involved in sales and because of the potential for other countries to enact export limits.

The amendment was offered on a bill that would overhaul the Food and Drug Administration (FDA)'s drug approval program. This program essentially allows pharmaceutical companies to pay the FDA to review and possibly approve their new drugs, if they are found to be safe.

By a vote of 49-40, the Senate adopted Cochran's amendment, which had the effect of tacking it onto Dorgan's amendment. Republicans mostly voted for Cochran's amendment, though 11 voted against it. And Democrats mostly voted against Cochran's amendment, though 15 voted for it. Dorgan's amendment was later adopted, along with Cochran's.