Separating fact from fiction about drug importation at CNN’s recent Healthcare Town Hall

[The following is a response from PSM’s Board President to statements made at CNN’s Healthcare Town Hall event broadcast Monday September 25, 2017.]

Senator Bill Cassidy, Senator Lindsey Graham, Senator Amy Klobuchar and Senator Bernie Sanders
United States Senate
Washington, DC 20510


September 29, 2017

Dear Senators,

I appreciated Monday’s CNN town hall debate, which was a wonderful example of your deep concern for the well-being of Americans and your commitment to the democratic process. While your concerns about health care are well placed, the debate included some erroneous statements about drug importation.

Senator Sanders said that Americans pay “by far the highest prices in the world for prescription drugs.” This is not a true statement. Brand-name drugs are generally more expensive in the U.S., but generic drugs are much less costly, and they make up over 80% of the prescriptions filled in this country. In fact, the most commonly prescribed generic medications in the U.S. are more affordable to Americans than they are for our Canadian neighbors to the north. Generic Lipitor was the most frequently prescribed medication during the first quarter of 2016 in the U.S., and while Americans could get it for only $19, Canadians had to pay $40, over twice as much, for the same medication. A 30-day prescription for generic Prilosec only costs $4 in the U.S. while Canadians have to pay almost four times as much. Generic Abilify might cost Americans $96 for a 90-day supply, but at least we have a generic option. There is no generic version of Abilify in Canada, meaning Canadians have to pay almost $400 for a 90-day supply.

Senator Sanders also said that “One out of five Americans cannot afford the medicine they need,” a claim that ABC news rated as mostly false when they fact-checked it after the Democratic National Convention in 2016. The real number of Americans who cannot afford their medication is far lower. According to ABC, “the Centers for Disease Control and Prevention recently reported that only 5.6 percent of Americans go without medicine because of costs.”

Senator Sanders’ impression that medications from another country can meet U.S. demand is also incorrect. A paper that I wrote in 2010 and updated in 2017 makes it clear that if U.S. residents purchased legitimate Canadian medications, Canada’s drug supplies would be wiped out in 55 days. Even 20% of Americans would exhaust Canada’s drug supply in six months.

Finally, though it remained unspoken during the debate, drug importation presents insurmountable safety challenges. Just this week, FDA and Interpol announced, as part of the tenth annual Operation Pangea, an international week-long action organized by Interpol, that the FDA took action against 500 websites that illegally sold unapproved and potentially dangerous versions of prescription drugs to American consumers. Among those websites were ones owned by a notorious Russian criminal, famed for infesting computers worldwide with Trojans. Igor Gusev, a fugitive from Russia where he faces criminal charges, has operated under the name “Canadian pharmacy.” The medicines coming from these websites appear to be Canadian, but are not. The source of the medication is completely undocumented because the websites act beyond the law in every country. They are not safe, and they are sold by criminals who will take over your home computer, steal your identity, and then blackmail you. According to the Washington Post this year’s effort led to 400 arrests and the seizure of more than $51 million worth of dangerous medicines worldwide. The scale of this trade makes it impossible to regulate imported medicines, and U.S. regulators know it: every head of the FDA or the Department of Health and Human Services for the past 17 years has said the benefits that might be gained are far outweighed by the many dangers.

Public debate about healthcare policy is crucial because it so fundamentally affects American lives, but it’s important that accurate facts inform our debates.

With greatest respect,

Marvin D. Shepherd, Ph.D.
President of the Partnership for Safe Medicines
Professor Emeritus
College of Pharmacy, University of Texas-Austin