This week, the Trump administration formally announced support for not only state prescription drug importation programs, but also HHS Secretary Alex Azar’s own importation plan. Until this week, it was known that Trump had instructed Secretary Azar to work with Republican Governor Ron DeSantis of Florida to help implement its new law to permit wholesale drug importation from Canada for public payers, which also includes importation from other countries for the private market. Now, there is real movement.
Before diving into Trump’s drug importation plan more fully, please take note that this plan actually allows for the importation of what the FDA has called “foreign unapproved drugs,” ones that they have said they don’t want Americans ordering online and importing for their own use. These drugs, as explained below, are safe and effective foreign brand versions of the same drugs sold here. This recognition of equivalent brand drug safety is a step in the right direction.
Forcing price transparency in drug ads, proposing international reference pricing for Medicare Part B, and even drug importation can all be found in President Trump’s lunchbox of policy ideas to take on the drug companies, who are “getting away with murder.”
Huh, am I dreaming?
Is Donald Trump really a Republican? Is former Eli Lilly President Alex Azar, now HHS Secretary, really advocating such radical ideas, such as importation, against his pharma friends? Scott Gottlieb, our free-market fanatic FDA Commissioner is crusading against high drug prices, too: winner of Patients for Affordable Drugs Price Fighting Hero Award!
Pinch me. Am I awake?
I am awake and I’m not fooled by this subtle, probably well planned out public relations defense against the progressive and populist tide, which includes Republicans and Democrats. Forget importation this week: 92% of Republican and 96% of Democratic voters support ending the ban on Medicare negotiating drug prices. Finally, the country is united!
Ending the ban on Medicare price negotiations could bring down prices for drugs in all of Medicare.
But Alex Azar’s proposal to reduce drug prices in Medicare
is only for Part B, half the country, and on a small group of medications.
Forcing drug companies to list prices on TV drugs ads does not bring those
prices down. And the importation
idea is good, but super limited, and it’s still just talk!
Jamie Love from Knowledge Ecology International’s comment on Trump’s Medicare Part B proposal is caustic yet correct in describing the Trump administration’s policy and general approach:
“If one was to design a program that appeared to address the need to curb high prices for drugs, without doing much in Trump’s first term, and promising nothing after 2025, it might look like the proposal.”
On the other hand—and this is where compromise begins to seep in and you can’t help but know it’s because Trump is no normal Republican—the former President of Eli Lilly USA, Alex Azar, is advocating for forcing price reductions on drugs in Medicare Part B and importing foreign versions of lower-cost medications for single source drugs; and working in an administration giving voice to drug price transparency. Who would have thought that possible two years ago?
In the first
two weeks of January, the prospects for drug importation to help alleviate high
drug prices in the U.S. are looking good. Before summarizing recent
developments, I’ll just note that millions of Americans who can’t afford
medicines and want to save money continue to use personal drug importation,
despite the federal prohibitions. This includes physically traveling across the
border to buy from Canadian or Mexican pharmacies, through international air
travel, and ordering from international online pharmacies.
This week,
the Philadelphia
Inquirer reported on Americans with Medicare falling through the
cracks on drugs dropped from formularies, particularly when they are prescribed
off-label, facing high costs and looking internationally for relief. As
reported, savings are even greater when Americans buy generic versions
overseas, of drugs that are still under patent domestically.
There’s a
lot of buzz in Congress, states, and the White House on the issue of drug
importation right now. Hopefully, current laws will be amended this year to
make importation expressly permitted instead of merely tolerated.
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