This editorial by Brooklyn Roberts was published in The Hill on May 12, 2019. Roberts is the director of the health and human services task force at the American Legislative Exchange Council; she previously served as campaign manager for Alabama Attorney General Luther Strange’s successful re-election campaign.
Don't Import Prescription Drugs
Prescription drug pricing has been the subject of much debate over the last year. Pharmaceutical manufacturers have taken most of the blame and were recently called before Congress to answer for their actions. Several states are looking at importing drugs from Canada as an answer to the concerns over high prescription costs. In fact, in a move reportedly supported by the Trump Administration, the Florida legislature recently approved a plan to import drugs from Canada where prices are lower, rather than purchasing them domestically. Importation programs like the ones proposed in Florida are neither safe nor effective ways to lower the price of medications.
Importation, or reimportation as it is sometimes called, is a dangerous gamble. Neither the safety nor efficacy of imported medications can be ensured, placing every patient who takes these medications at great risk. There is no way to verify these medications originated in Canada and Canadian authorities have made it clear they will not be responsible for the quality and safety of prescription drugs being shipped from or through their country.
Often, these drugs come from what appears to be a legitimate source, but testing has shown that many are counterfeit, manufactured in unsafe conditions and contain little, if any, active pharmaceutical ingredients. In fact, a 2017 report from the World Health Organization showed about 1 in 10 medications from developing countries were fake or substandard.
Under the current law, the Secretary for the Department of Health and Human Services would have to certify that the importation program does not put consumers health and safety at more risk than if the program didn’t exist. No Secretary, of either political party, has ever been able to do so.
In fact, Secretary Alex Azar has stated, “the last four FDA commissioners have said there is no effective way to ensure drugs coming from Canada really are coming from Canada rather than being routed from say a counterfeit factory in China. The United States has the safest regulatory system in the world. The last thing we need is open borders for unsafe drugs in search of savings that cannot be safely achieved. You can’t improve competition and choice in our drug markets with gimmicks like these.”
Other states have tried to implement similar programs. Their experiences tell us that the cost of implementing these programs far outweigh any supposed cost savings or benefits to consumers. In fact, most consumers were not interested in importing foreign drugs because of long delays in receiving the medications and safety concerns.
Proponents of the legislation believe consumers will benefit from the option to purchase drugs from Canada at a lower price. Citing prices in foreign countries, especially Canada, has become a familiar refrain in the debate over prescription drugs. Why are the same drugs cheaper in foreign countries than in the United States? In many of these countries, the government sets the price they are willing to pay for each medication. Manufacturers can either sell at that price or run the risk of patent infringement.
But price fixing does not work to the benefit of consumers. An October 2018 report from the Department of Health and Human Services Assistant Secretary for Planning and Evaluation found that countries that set prices had fewer treatment options and patients experienced delays in accessing treatments. By importing drugs from Canada, states will also be importing those price controls, and the patient treatment delays.
The safety of our prescription drugs relies on a closed system where drugs can be traced to manufacturers, distributors, pharmacies and patients. Opening that system to foreign drugs would allow the potential for dangerous and potentially deadly medicines to land in the hands of the American public. Patients harmed by these drugs would have little recourse. In the absence of a closed system, tracking where the drugs that caused the harm originated — and where else they may have gone — is difficult.
If legislators truly want to lower the cost of prescription drugs, they must consider the entire supply chain and ensure whatever measures they take protect the health and safety of our citizens. Importation programs like those proposed in Florida, Oregon and Utah will not lower the price of prescription drugs and could easily make things worse. Patients in the United States have access to the very best cutting-edge medicines and treatments and any policies we put in place should make sure to keep that advantage, and most importantly, keep consumers safe.