It’s true that while small-scale importation from Canada is
feasible, larger scale importation is not.
The future lies in pharmaceutical international trade beyond just Canada to include countries such as Japan and those in the European Union. Expanding importation programs to include the EU and Japan was recommended by Jane Horvath in a wonderfully written op-ed in Stat News earlier this week. Ms. Horvath is the leading healthcare policy expert working with the National Academy for State Health Policy and the states on drug importation programs.
Trump supports prescription drug importation, and he’s not alone. An article by Kaiser Health News reporter Phil Galewitz headlined Trump’s support for drug importation to fight high drug prices at the state level. His article delves into the history of earlier state importation attempts, which were personal drug importation not wholesale drug importation programs. But the coolest thing I took from it was that the three states that passed prescription drug importation laws have governors across the political spectrum. None are traditional right-wing Republicans or super left Democrats. What does that look like?
In Florida, you have Governor Ron DeSantis, fashioning
himself in the mold of a Trumpist Republican.
In Vermont, you have Governor Phil Scott, who can best be
described with a phrase practically unheard of these days: Liberal
Republican.
Finally, newly elected Governor Jared Polis from Colorado is
a moderate Democrat.
While the state importation bill failed to advance in Utah, its vociferous champion in the state assembly is a very conservative Republican, Norm Thurston (Provo).
With drug prices in the spotlight of our national healthcare debate, one could certainly view Amazon’s entry last year into the pharmacy space as a welcome development. After all, when it comes to upending traditional business models by undercutting their prices, Amazon is king. For Americans, the tens of millions who don’t fill prescriptions each year because of cost, relief can’t come soon enough. For Amazon to succeed, Jeff Bezos should consider teaming up with Senator Bernie Sanders. Amazon’s support for The Affordable and Safe Prescription Drug Importation Act, introduced by Senator Bernie Sanders (I-VT)—to allow for the importation of lower-cost prescription drugs—would be the game changer that would have American patients cheering and the pharmaceutical industry crying.
Recent bi-partisan efforts
to bring lower-cost generic drugs to market faster are a great step in
the right direction, but they don’t infuse our captive pharmaceutical
marketplace with competition to lower prices on patented – brand name –
prescription drugs. Importation would fuel that competition. An unlikely
alliance between our country’s most successful capitalist and
trailblazing, Democratic Socialist is what we need!
Activists with diabetes, organized through advocacy group T1International, are trekking or “caravanning” to Canada to buy lower cost insulin. Why wouldn’t they? According to reporting in the Washington Post, they ended up paying $1,200 for products that would have cost $12,000 in the United States. One vial of Humalog in the U.S. can cost $300 compared to $30 in Canada.
According to the Post, the activists “see buying in Canada as a short-term emergency measure and a way to call attention to U.S. pricing — not the answer.”
I fully agree that personal imports of more affordable medicine are an emergency measure, and I’d be happy if it were a short-term one. A recent T1International survey found that 26% of Americans who take insulin rationed their medication at least once last year because of cost. That’s higher than the worldwide rate of 18%. People with diabetes should not be forced to travel to Canada to get affordable insulin when it can be mailed.
This week, Florida’s Republican Governor Ron DeSantis signed into a law HB 19 to create a state prescription drug importation program. The goal is to lower the state’s prescription drug bill and the prices Florida residents pay at pharmacy counters by importing lower-cost medicines from Canada and other countries that have similarly strict pharmaceutical regulatory standards.
The main point of this blog post is to state that this law in Florida, much like the laws that have passed in Vermont and Colorado, create WHOLESALE not PERSONAL drug importation programs.
Yesterday, the Florida House Legislature voted
93-22 passing HB 19. The bill creates programs and processes for importing
prescription drugs from Canada, as well as from other countries. HB 19 actually
calls for the creation of two programs, which I have summarized below. For a
deep dive, you should read the Staff
Analysis from the Florida House of Representatives.
Canadian
Prescription Drug Importation Program (CPDIP)
If HB 19 becomes law, the Florida Agency for Health Care
Administration (AHCA) will create processes that meet the safety protocols
called for in the bill, which include inspections and testing of drugs, to
allow registered wholesale pharmacies to import from Florida-registered
Canadian wholesalers. In this program, lower drug prices will save taxpayers
money for government funded-entities, such as county health departments, free
clinics, and the Department of Corrections.
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