Finally, in some part thanks to former President Trump and Governor Ron DeSantis, as well as to the Biden Administration’s Federal Drug Administration (FDA), the US plans to open its borders to drug importation, reports Christina Jewett and Cheryl Gay Stolberg for the New York Times. While that is not a long-term fix to unconscionably high drug prices in the US, it is a terrific first step–unless the pharmaceutical industry succeeds at blocking these drug imports.
To be clear, the FDA only has approved drug importation from Canada. And, as of now, only the state of Florida has approval. But, it is the camel’s nose under the tent and could save Florida as much as $150 million in drug costs in its first year.
Interestingly, while the Biden Administration supports drug importation, it took a lawsuit by the state of Florida against the FDA to get the the needed federal approval.
Americans already can buy drugs legally directly from Canadian pharmacies for personal use, but insurers are not required to cover those drugs. They still don’t. But Florida has approval to buy drugs for enrollees in its Medicaid program, people using its health clinics, and people in prison.
It’s also not clear whether drug importation from Canada will work better for states in theory than in practice. Canada might not have enough supply to provide the drugs Florida needs, let alone the drugs other states will also want to purchase once they have FDA approval.
You can bet your bottom dollar that Pharma is pulling out all stops to keep drug importation from happening. It plans to bring a lawsuit to prevent Florida from importing drugs from Canada. Moreover, some Canadian drug wholesalers have signed contracts with pharmaceutical companies agreeing not to export their drugs. In addition, Canada does not have a bottomless supply of drugs.
Time will tell how this story unfolds. Drug importation from Canada was a long time coming. The New York Times reports that Congress passed legislation allowing drug importation 20 years ago, but it is only now that the administration is implementing it. Allegedly, there were “safety” concerns. More likely, there were concerns about PhRMA’s wrath.
To be clear, patient safety concerns abound in the US because people cannot afford the drugs they need. Too often, they die as a result. And, even more often, they become sick or disabled because they cannot afford to fill their prescriptions.
There are no reports of people harmed from importing drugs from abroad. Nine million Americans import drugs from abroad every year without incident.
Colorado, Maine, New Hampshire, New Mexico, North Dakota, Texas, Vermont and Wisconsin have passed laws to allow their states to import drugs and likely many more will do so. Canada should not be the only foreign provider. Many drugs taken in the US are manufactured in India, China and elsewhere. Americans should be permitted to import drugs from verified pharmacies in any country.
Americans support drug importation. Of course, we do. We import food safely from abroad, and automobiles, and electronics and more. There’s no good reason that we cannot import prescription drugs safely. And, anyone who supports competition should support drug importation, especially since drugs in the US often cost four times more than drugs in other developed countries.
The big problem with drug prices in the US is that PhRMA can charge pretty much what it will for brand-name drugs. There’s little competition. PhRMA also can keep low-cost generic alternatives off the market for years.
The Inflation Reduction Act allows our government to negotiate drug prices, which is arguably the best way to bring down drug prices in the US. But, it only allows drug price negotiation for 10 high-priced drugs in the first year, and only for people with Medicare. It’s good, but way less than what we need.
And, while helpful, Medicare Part D drug plans can still cost you a bundle. If you want to keep your drug costs down, you need to compare your drug copays against the full cost of your drugs at Costco and other low-cost pharmacies. In some cases, you’ll pay less through Costco as this JustCare reader does.
Before it can begin importing drugs from Canada, Florida must specify the drugs it will import to the FDA and explain how it will ensure they are not counterfeit. Florida also must relabel the drugs.
Meanwhile, the Canadian government is none too happy about exporting drugs to Florida. The Canadian government could step in if it does not liking the consequences of drug exports. There is understandable worry that a country with fewer than 40 million people will find itself without needed drugs if it exports them to a state with 22 million people, let alone to multiple states with tens of millions more people.
Here’s more from Just Care:
- The deadly consequences of out-of-pocket drug costs
- Millions safely import low-cost drugs from abroad
- Six tips for keeping your drug costs down if you have Medicare
- Prescription drug middlemen, PBMs, will always drive up drug costs
- Case study: Costco saves one couple hundreds of dollars over Medicare Part D
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