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Understand Executive Authority on Allowing Safe Personal Drug Importation

Originally Published as A Blueprint to Understand Executive Authority on Allowing Safe Personal Drug Importation on PrescriptionJustice.org.

Yesterday, President Trump announced four executive orders with the stated intent of substantially lowering drug prices. Briefly, the administration’s bluster on drug prices over the past three years has been far louder than any actions taken to actually do something about it. Better late than never.

The orders call for and include: 1) Lower prices on EpiPens and insulin, 2) Allowing personal drug importation, 3) Ending profit-taking by pharmacy benefit manager middlemen, and 4) “most favored nation” drug price negotiation in Medicare, meaning Medicare would get the lowest price on drugs of any country.

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NH Hops on the Wholesale Drug Importation Bandwagon. The Wait Continues.

Last week, yet another state, New Hampshire hopped on the Canadian drug importation bandwagon. Joining Vermont, Florida, Colorado, Maine and New Mexico, New Hampshire passed a law that would permit registered wholesale pharmacies to import lower-cost drugs from registered Canadian wholesale pharmacies. I have supported the initiative from the beginning, when the National Academy for State Health Policy (NASHP) came out with model legislation on drug importation from Canada. But now, frankly, I am annoyed. New wholesale drug imports from Canada can be helpful, but the issue seems to be used for political purposes. State legislators and governors, by passing Canadian drug importation laws, can say they are doing something, but nothing is actually happening.

One of the best opposing arguments surrounding these laws is that Canada is too small a country to take on large wholesale prescription drug exports to the U.S. With more and more states getting onboard with importation, the problem of Canada’s size becomes more salient. Expanding importation to the European Union is the key and yet this new state legislation, as well as federal law, does not address that.

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Hispanics Are More Likely to Use Importation to Find Affordable Prescription Drugs

A recent study in the Journal of the American Medical Association (JAMA) concluded that about 2.3 million people in the U.S. import medicine each year to save money. According to that same study, Hispanics in the U.S. are almost four times more likely to have imported medicine than non-Hispanic white people. I believe the percentage of Hispanic people is so much higher due to four main factors.

The first two factors are quantitative findings:

First, in 2018, almost 18% of Hispanics did not have health insurance, compared to only 5.4% of White and 9.3% of Black people. The JAMA study found that people who were uninsured were over three times more likely to import medicine than the insured.

Two, the JAMA study found that 4.4% of immigrants imported medicines for personal use, 3.2 times more than the average consumer. According to Pew Research, about 21% of Hispanics living in the U.S. are not American citizens, and 44% of all immigrants report Hispanic or Latino backgrounds.

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