STAT black market importation policy recommendation based in rhetoric, not facts

The most recent editorial in Stat advocating black market drug importation under the guise of “ordering prescription drugs abroad” overlooks many safety dangers.

The most important oversight is in the characterization of the cost of medications. Over 80% of all medications dispensed in the U.S. are dispensed as generic, and generics as a whole are cheaper in America than Canada. But importation proponents often ignore generics and cite brand name price comparisons to justify their flawed policies.

The Stat editorial falls into the same trap.  It cites a price list from comparing prices for medications in the US versus other countries including Canada. This document excludes generic medications which are often cheaper in the US than Canada.

For example, one of the medications on the list is Crestor.  When you compare the brand name medications between countries it seems like it might be cheaper in Canada until you realize that in fact the generic version, rosuvastatin, is cheaper in the U.S. Our staff recently found that a 90 day supply of the generic in Canada is US$14.60 (after currency conversion), but in the US it’s only US$11.40.   

This isn’t an isolated case.  Also on the list is generic synthroid. Our staff found that a 30 day supply in Canada is US$11.00, while in the US it’s US$4.00.

In fact recently, found that for the top 50 prescription drugs filled in Q1 2016, all but 2 are generics.  And as Canadian patient advocates will tell you enviously, their generic prices in Canada are usually higher than the U.S. because we have a stronger competitive generic market.

By ignoring the lower cost of the generic medicines dispensed in the U.S., it’s easy to come to a faulty conclusion about black market importation based on erroneous and incomplete evidence.  

The Stat editorial should not have glossed over the fact that four FDA Commissioners, appointed by both Republican and Democratic administrations, said that drug importation can’t be made safe and would result in little actual cost savings for American patients.  As smart as everyone who works full time on this issue is, we don’t have the combined years of actual experience protecting American patients that these four experts have.  To believe we know the regulatory environment better than they do is foolhardy at best, and hubris at worst.

We urge the staff of STAT to set aside the rhetoric and look at the actual evidence of danger that is everywhere today.  As long as any importation scheme includes an unregulatable foreign actor, such as a foreign pharmacy or wholesaler, no importation scheme can be made safe.