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Canada’s Message to the U.S. on Drug Importation: We care more about our citizens than you.

The pharma-funded and industry opponents of drug importation from Canada just love to talk about how “even the Canadian government opposes importation.” For a quick clarification, Canada has not minded or stopped its pharmacies from safely dispensing medicines by mail to Americans. That’s personal drug importation. When I write that Canada opposes importation, I mean the wholesale drug importation currently proposed by the Trump administration.

Hey, if Canada doesn’t want this new policy, then what the hell can we do? As I see it, Pharma-funded groups, like the Partnership for Safe Medicines and Alliance for Safe Online Pharmacies, have—almost gleefully— pointed out to the U.S. FDA that Canada is opposed to the implementation of Section 804 to allow registered wholesalers in the U.S. to import drugs from Canada. This is mainly due to Canada’s fear of drug shortages. Drug manufacturers supply Canada to meet the needs of its much smaller population. If Canadian wholesale drug exports increase substantially under the new Trump administration policy then it could exacerbate supply problems in Canada.

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FDA’s Misplaced Advice to Patients in CanaRx Import Warning

Last week, in a warning letter and press release, the FDA went to great lengths to demonize what appears to be an exceedingly safe personal prescription drug importation program offered by a Canadian company called CanaRx Services, Inc. I believe the agency crossed the line with bad advice to patients. In a nutshell, about 500 U.S. cities, companies, and other organizations use CanaRx to offer their employees and retirees a lower-cost international pharmacy option. The prescription medicines are mailed from licensed pharmacies in Canada, Australia and the United Kingdom to U.S. consumers. CanaRx’s programs have been in effect for almost 20 years and helped taxpayers and patients save $250 million, according to the company.

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Nocturnal Reflections on Trump’s Blurry Overtures on Drug Prices

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?

Not me. Am I dreaming?

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