Foreign Companies Eye U.S. Market for Lethal Injection Drugs

After the American manufacturer of lethal injection drugs pulled out of the market, states have turned to companies from Europe to India to fill the gap

Denmark hasn't had a civilian execution since 1882 and the country banned capital punishment in 1933, except for war crimes, and that exception was removed from the law in 1978.

But next Tuesday, Texas plans to use a drug supplied by a Danish pharmaceutical company, Lundbeck, in the scheduled execution of Cleve Foster, a former Army sergeant convicted for the murder of a 30-year-old woman he had met in a bar. (Foster has always maintained his innocence.)

The Lundbeck drug has already been used for three executions in Oklahoma and one in Ohio, and other states have purchased the drug.

Even though the European Union bans capital punishment, the Danish company is not the only European corporation to supply drugs to American death penalty states. A British company, Dream Pharma, has sold sodium thiopental, an anesthetic, to several states and it has been used in four executions in recent months, in Georgia and Arizona. German and Austrian pharmaceutical companies are also looking at the American capital punishment market.

Lethal injection was first proposed by a New York doctor in the 19th century, who argued it was cheaper than hanging. It has now been adopted by the 33 states that have the death penalty, and is seen as a "more humane" approach than the electric chair or gas chamber. (Utah executed a man by a firing squad last year.)

The general procedure is for the condemned to be strapped onto a gurney and wheeled into the execution chamber. Witnesses observe through a window. The man's arms are swabbed with alcohol and two intravenous tubes are inserted, one in each arm. From another room, unseen by the condemned or the witnesses, the executioners first release sodium thiopental, a general anesthetic, into the tubes. (In surgery, 100 to 150 milligrams are used; for executions, as many as 5,000 milligrams.) This is followed by a muscle relaxant, which paralyzes the diaphragm and lungs, thus making it impossible for the condemned man to breathe. Finally, potassium chloride may be injected, causing death by cardiac arrest.

The scramble for foreign-suppliers of lethal injection drugs, and the surrounding controversy, has arisen because the American company that manufactured sodium thiopental, Hospira, ceased production at its plant in North Carolina last year.

Initially, Hospira was going to import the drug from its plant in Italy after running into manufacturing problems in the U.S., but under pressure from anti-death penalty activists, the Italian government effectively stopped the export by demanding that Hospira guarantee the drug would not be used in executions, which the company declined to do.

Death-penalty states found a British wholesaler that operated out of the back room of a driving school in London. It was called Dream Pharma.

The median price for thiopental is $.97 per 500 mg vial, according to the International Drug Price Indicator. Last July, Dream Pharma sold 50 vials to the Georgia Department of Corrections for $5.81 a vial, according to department documents. The company quickly discovered that American death penalty states were desperate, and that it had a virtual monopoly. Two months later, Dream Pharma more than doubled the price, selling it to Arizona for $12 a vial. California paid three times that, or $35 a vial, in November.

Dream Pharma's managing director, Matt Alavi, declined to comment. "Have a nice day," he said, hanging up abruptly when reached by phone Wednesday.

The Food and Drug Administration has not licensed the importation of sodium thiopental for general medical or health purposes. But it has said that it will permit its importation for executions.

Last September, as Arizona was preparing to execute Jeffrey Landrigan for the murder of a man during an armed robbery, the state found it there was no sodium thiopental domestically. It sought assistance from the U.S. Customs and Border Protection division of the Department of Homeland Security and the FDA to expedite the importation of the drug from Dream Pharma. "We called and explained to . . .Customs what we were doing and why, as well as the time-sensitivity and criticality of the issue," an Arizona corrections officer wrote in an email (obtained by the ACLU in a law suit). "He provided us with e-mail verification that the shipment was to be expedited through Customs."

The Arizona official also spoke with an FDA official. "He notified his chain of command to Washington, D.C., with his recommendation that the shipment be processed expeditiously to us as it was for the purpose of executions and not for use by the general public. That was approved."

Landrigan was executed on Oct. 26.

Not long after that, a British-based human rights organization, Reprieve, filed a lawsuit to block Dream Pharma's exportation of thiopental. The British government responded that America's death penalty states would simply buy it elsewhere. But shortly after, the government effectively prohibited the export as Reprieve had requested.

Death penalty states have now turned to an Indian company, Kayem. Very little is known about the company or its quality control standards, but Nebraska has purchased enough of the drug for 166 executions, according to an article on the company's website.

With it becoming more and more difficult to obtain sodium thiopental, death penalty states are now switching to pentobarbital, the drug manufactured by Lundbeck. Some states plan to use it as an anesthetic in lieu of sodium thiopental. In other states, it will be used alone, as an alternative to the three-drug cocktail.

Through its three American distributors, Lundbeck's pentobarbital has been sold to Ohio, Oklahoma, Mississippi, and Texas, a company spokesman, Anders Schroll said this week.

He said the company did not approve of the drug being used for executions, but that after Lundbeck sold the drug to its American wholesalers. "We are in the business of improving people's lives," a company spokesman, Anders Schroll, said in a telephone interview. But he said there was nothing the company could do once it supplied the drug to its American wholesalers.

Reprieve called the Lundbeck position "extremely disappointing and cowardly."

Image credit: REUTERS/Ho New