American medications are usually imported. Now you know.

Yesterday, PharmacyChecker released the findings of our new research that shows 70% of brand name medications sold in U.S. pharmacies are not made in America. Those same medications can be purchased at 70% less in Canada – and even less in other countries. As I’ve written before, there’s a troubling aspect of the public policy debate about drug importation: in many news stories, both policy-oriented and those dedicated to consumers, it seems as if drug importation is currently illegal, which is simply not true. Our data indicates that when Americans walk into their local Walgreens or CVS to fill a prescription, the pharmacist will mostly likely dispense an imported drug – that’s if the patient can actually afford it: 45 million did not fill their prescription last year because of cost.

Our findings come in the wake of an announcement from the Congressional Budget Office about The Affordable and Safe Prescription Drug Importation Act of 2017 (S.469), which aims to make it expressly legal to import lower-cost medications from Canada. CBO’s report shows that if S.469 becomes law, it would shave almost $7 billion off the deficit by 2027. We believe the savings would be much greater. The CBO report reflected deficit savings, but did not include the savings that individuals would also realize from buying lower cost medications from Canada.

In our report, we also noted that the FDA states that 80% of active pharmaceutical ingredients (APIs) found in “American” drugs are imported. The FDA began using that statistic frequently in 2010, usually to note that pharmaceutical imports were growing, emphasizing the need for global engagement in their regulatory efforts, which makes sense – and they still use it. But I later found that the percentage of APIs in American drugs have been constant since the 1990s, at least according to the FDA (Source: http://www.gao.gov/products/GAO/HEHS-98-21. P. 1).

The FDA also states that 40% of finished prescription drugs found in U.S. pharmacies were imported. Our data indicates that number is much higher: 70%. Yes, 20 drugs are a small sample size, but we didn’t cherry pick the samples, we used IMS Health data—the top 20 prescribed brand drugs in 2015. We look forward to researching more medications to see how many are made in America vs. abroad.

The crux of the matter comes down to who controls the importation, which means distribution, of medication. The answer is the drug companies. Their control means they can protect high drug prices here in America. That’s why even medications that are made in America and shipped to Canada and worldwide cost so much more here: re-importation is banned – except by the drug companies themselves! Of course, some Americans re-import medication at lower prices anyway by ordering it online.

Making it legal to import medication at a lower cost, including empowering more consumers to do so, will break the stranglehold of the drug companies on the throats of American patients.