JustCare

Tag: PhRMA

  • FDA allows Florida to import lower-cost drugs from Canada

    FDA allows Florida to import lower-cost drugs from Canada

    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:

  • Biden calls for lower Medicare drug costs

    Biden calls for lower Medicare drug costs

    President Joe Biden finally called on Congress to lower drug prices for people with Medicare and to cap their out-of-pocket drug costs, reports Rachel Cohrs and Lev Facher for Stat News. The President also said he wanted private insurers to be able to benefit from Medicare negotiated drug prices.

    Mr. Biden recognizes that fair drug prices are critical to enable Americans to get the health care they need and should have no bearing on the development of new drugs.  In a speech last week, he said: “We can make a distinction between developing these breakthroughs and jacking up prices on a range of medications for a range of everyday diseases and conditions.”

    The White House released a new document on prescription drugs. However, it did not go into any details on how to set drug prices. It did not call for international reference pricing either. International reference pricing would ensure that Americans paid no more on average for their drugs than people in other wealthy countries.

    That said, the document does support a provision in the House of Representatives 2019 bill, H.R. 3, which would allow compulsory licensing of drug patents in instances in which pharmaceutical companies were unwilling to negotiate a drug’s price. In effect, the government could give competing drug companies a license to manufacture the drugs.

    In Biden’s words, “[Medicare negotiation] means drug companies would have to sell their drugs to all distributors at the Medicare price, or face up to a 95% excise tax.” He also supports imposing penalties on drug companies that raise their prices higher than the rate of inflation. And, he wants to allow states to import drugs from Canada. Why only Canada?

    PhRMA responded in its typical way, even though there is no compelling evidence that lower drug prices would affect innovation. It’s time we heard a chorus of people drowning out PhRMA’s voice and calling out drug companies for charging such high prices that they effectively leave tens of thousands of Americans dead each year.

    Mr. Biden actually did just that. When he was vice president and he was leading an effort to cure cancer, he told the pharmaceutical companies that it would be “unacceptable” for them to charge whatever they pleased for a cure. “That means a significant number of people can’t afford it, and they will die without it.”

    Of course, as Mr. Biden said, Medicare drug price negotiation would still leave pharmaceutical companies with healthy profits. And, he was not prepared to call for price negotiation of generic drugs. Increasingly, many generic drugs have become extremely expensive.

    Here’s more from Just Care:

  • Drug coupons drive up overall health costs

    Drug coupons drive up overall health costs

    Pharma has many tools for generating big profits. Drug coupons, which cover the copay of a high-cost drug, are one such tool. For patients, drug coupons can make extremely high-cost drugs free. But drug coupons drive up overall health costs; they also may incent people to take drugs with unknown risks when other safe drugs are available.

    Drug coupons can seem very attractive to patients. Coupons can make the out-of-pocket cost for a very high-priced drug lower than the patient’s cost for a low-cost drug. Patients need to keep in mind though that drug coupons tend to be for drugs that are new or relatively new to market. And, unless you’re in a situation where no other drug works for you, you should try to avoid taking newly approved drugs.

    Newer drugs can cause serious side effects about which the doctor is unaware, since it’s hard to evaluate a drug’s potential for harm until it has been on the market for several years. That’s why, to be safe, it’s wise to take drugs that have been used for a long time, where the risks of harm are well understood.

    Drug coupons are not only geared to get patients to take expensive drugs that have not been well-tested; they effectively undermine the value of a tiered copay system for drugs.  The tiered copay system is designed to help keep insurance premiums down. It steers people to the lowest-priced drug in a category because it comes with the lowest copay.

    When the doctor gives a patient a coupon for a drug in the highest copay tier, the tier becomes meaningless as the patient is not responsible for the copay. Pharmaceutical companies use coupons to keep patients away from competitor lower-cost drugs. Since the coupon covers the cost of the copay only, the drug companies still get paid a lot for the high-cost drug.

    Federal health care programs forbid the use of drug coupons under the “anti-kickback statute.” So, Medicare does not allow them. But, the Government Accountability Office has found that pharmaceutical companies don’t always have systems in place to prevent the use of drug coupons by people with Medicare and that six percent of people with Medicare do use them.

    Why do doctors prescribe a tier three drug when a lower-cost drug is available to treat a condition? In many cases, the doctors don’t know the price of the drug.  In other cases, a pharmaceutical company has persuaded doctors that its drug is better than other drugs.  Or, patients may ask for the drug because they’ve seen ads for it on TV.

    Here’s more from Just Care:

  • With drug prices soaring, millions buy drugs abroad

    With drug prices soaring, millions buy drugs abroad

    Brand-name drug companies continue to price their drugs sky high, and generic drug companies are following suit on drugs that have traditionally cost little. In response, according to Kaiser Health News, some 19 million consumers are buying their drugs abroad. And millions more are simply foregoing needed drugs because they are no longer affordable. Meanwhile President Trump and the Republican leadership fail to take any action to rein in drug prices.

    In a recent New York Times article, Gretchen Morgenstern reports that because drug companies have been under attack, many pharmaceutical company executives are “laying low,” slowing their price increases. Of note, Morgenstern does not name any who are laying low. Why would they slow price increases? Pharmaceutical companies have every reason to drive prices higher and higher, while they can.

    Morgenstern further reports that some pharmaceutical companies “believe their jig is up,” but it is hard to see why. Congress has shown little interest in ending their monopoly power over brand-name drug prices. Beholden to Wall Street and their shareholders, with no legal obligation to the public, drug companies have every reason to reach for the moon with their brand-name drug prices until Congress steps in to stop them. That’s how they maximize profits.

    Moreover, nothing is stopping pharmaceutical companies from charging high prices for many generic drugs, so long as they do not violate antitrust laws. Morgenstern reports that the Government Accountability Office issued a 2016 report on the soaring cost to Medicare of generic drugs in the five years between 2010 and 2o15, with one in five more than doubling in price.

    As just one example of a company pushing the envelope, Lanett, which manufactures generic drugs for a range of conditions, including thyroid conditions, irritable bowel syndrome and congestive heart failure, is raising prices between three and seventeen-fold on some drugs, while the Justice Department investigates it for antitrust violations.

    Not surprisingly millions of Americans are importing drugs from abroad for personal use in order to save money and get needed treatment. Technically, they are violating the law. But, the FDA allegedly has never enforced the law against individuals who import drugs from abroad for personal use. Until Congress acts, what choice do people needing costly medications have?

    Meanwhile, the pharmaceutical industry, through PhRMA, its trade association, relies on the non-profit it has created to fight any possible Congressional action to permit importation of drugs from abroad, as Senator Bernie Sanders’ bill would do. The alleged concern is “safety.” But, there are no reported deaths from anyone taking a drug imported from abroad from a pharmacy requiring a legitimate prescription.

    For the moment, the Republican leadership seems to think it’s OK for the Americans they represent to be required to pay many times more for drugs than people everywhere else in the world.

    If you want Congress to rein in drug prices, please sign this petition. 

    Here’s more from Just Care: