This editorial by Dr. Kenneth E. Thorpe was published in Town Hall on October 8, 2019. Dr. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.
Drug importation risks patient health
Ron DeSantis, Florida's Republican governor, recently signed a bill that could allow Sunshine State patients to purchase prescription drugs from Canada.
He's hardly the only politician to embrace drug importation. Colorado Governor Jared Polis, a Democrat, inked a similar bill this spring. Vermont Governor Phil Scott, a Republican, did so last year. And members of Congress from both parties support importation.
The United States has one of the safest drug markets in the world. Thanks to rigorous FDA oversight, American patients can trust the quality of their drugs. The FDA makes pharmaceutical companies prove the safety and efficacy of every drug in various tests, including multiple clinical trials. That's why it often takes up to 15 years to bring a single medicine from the lab to pharmacy shelves.
Most foreign governments don't have such high standards. As a result, their drug markets are riddled with unsafe counterfeit products. Indeed, one in 10 drugs sold in developing nations is either fake or substandard. That makes the counterfeit drug trade a $30 billion business.
The majority of fake drugs contain few, if any, active ingredients. Counterfeiters take common household items like cornstarch and chalk and pass them off as everything from antibiotics to cancer drugs. Patients taking these knockoff drugs are initially none the wiser -- but they soon grow sicker as the medicines fail to work.
Other counterfeit drugs are far more dangerous. FDA and World Health Organization investigations have found fake medicines to contain lethal substances including rat poison, paint thinner, and antifreeze. The WHO estimates that counterfeit drugs kill tens of thousands of people every year.
Supporters of drug importation claim patients can trust the quality of drugs imported from a developed nation like Canada. They're mistaken.
In 2018, U.S. prosecutors fined an online pharmacy that advertised itself as Canada's "largest" -- CanadaDrugs.com -- $34 million for funneling counterfeit cancer drugs into the United States. The two medicines, Avastin and Altuzan, contained no active ingredient -- they were completely useless.
To make matters worse, the majority of drugs imported from pharmacies that bill themselves as Canadian aren't actually manufactured in Canada. One FDA anti-counterfeiting investigation revealed that 85 percent of illegally imported, supposedly "Canadian" drugs came from 27 other countries, including Turkey and India. Many of the drugs that originated in these markets turned out to be counterfeit.
None of this is surprising. Canadian authorities have made it clear that they are not responsible for guaranteeing the safety of drugs that cross their border. And under Republican and Democratic administrations alike, the FDA has repeatedly stated that it can't guarantee the quality of drugs American patients import from Canada or anywhere else.
In other words, there's no such thing as a safe importation scheme. No matter what politicians say, counterfeit drugs are too pervasive for regulators to protect American patients. No wonder Health and Human Services Secretary Alex Azar calls drug importation "a gimmick."
It's important for lawmakers to find ways to lower patients' drug bills. But any plan that would endanger Americans' health is no solution at all.