This editorial by the Sun Sentinel Editorial Board was published in The Sun Sentinel on December 9, 2020. The Editorial Board consists of Editorial Page Editor Rosemary O’Hara, Dan Sweeney, Steve Bousquet and Editor-in-Chief Julie Anderson.
There Go Those Cheaper Drugs.
Remember Florida’s plan to save money by importing prescription drugs in bulk from Canada?
Canada’s health ministry says no. The order applies as well to other states hoping to take advantage of a liberal new rule that the Trump administration put through in advance of the election.
When the president signed it, he had Gov. Ron DeSantis, his protégé, at his side. Cynical people said it was all about Florida’s 29 electoral votes.
DeSantis even out-muscled the pharmaceutical lobby to get the Legislature to authorize it.
Unaccustomed to such defiance, Big Pharma recently filed a federal court suit against the new federal rule. But it needn’t have bothered.
Canada’s announcement effectively bars the bulk export of any drug that’s subject to the nation’s mandatory shortage reporting requirements. In practical terms, that means all medications except those manufactured explicitly for export. While only 10 to 15 percent are actually in short supply at any particular time, just about all are subject to the law. According to Health Canada, nearly half of all drugs marketed there have been in actual shortage at one time or another.
The rule allows exceptions if the would-be shipper can justify them, but it’s unlikely that many would go to the trouble.
Florida’s plan had already run into domestic difficulty when the state drew no bidders on a proposed $30 million contract to manage the program.
Canada’s announcement reflected not only a concern for maintaining its own supplies. It also implied resentment that the United States would try to free-load off our northern neighbor’s success in keeping medical costs significantly lower.
“Our health care system is a symbol of our national identity and we are committed to defending it,” said Health Minister Patty Hajdu. “Canada is a small market, representing 2% of global drug sales, that sources 68% of its drugs internationally. The need for vigilance in maintaining the national drug supply continues.”
Considering how hard Canada has worked to keep medical costs down, they can’t be blamed for resenting that the United States hasn’t. Here, we spend nearly twice as much on health care overall as the average of 11 highly developed nations, and yet we have the lowest life expectancy. Because it has a single-payer system — in effect, Medicare for all — Canadians spend just some $551 a year per person to manage their system, compared to $2,497 a year in the United States, according to the Annals of Internal Medicine.
And that’s just for administration, overhead and corporate profits. Not a penny is for the doctors and nurses who treat us or the medicines they prescribe.
Speaking of prescription medicines, Canada’s are inexpensive by comparison to the U.S. but not to some other advanced nations. Drug prices in the U.S. are 3.43 times higher than Canada’s, according to the consumer-data company Statista, but Canada’s are higher than in Japan, Sweden, South Korea, the United Kingdom and France.
Even so, most Americans would be grateful for Canada’s prices, which we could have if we had the political courage to regulate ours the way Canada does. It enforces a pricing system based on what the medications sell for elsewhere.
The pharmaceutical companies claim their high U.S. prices subsidize life-saving research, and that is doubtlessly true. But without regulation, there’s no way to know whether the amounts for research and development are adequate or whether too much goes into profits. Any reasonable regulation would account for both.
For the United States to follow Canada’s example would be denounced by you-know-who as you-know-what: “Socialism!”
But that’s exactly what we already do to control what Medicare and Medicaid spend on everything but medications. Physicians and hospitals get what the government allows, not what they ask for. It is a complicated pricing system based in part on what they say it costs them to provide medical care.
Here, in fact, Congress has even prohibited Medicare from using its economic clout to bargain for lower pharmaceutical costs.
No wonder medicines cost so much in the United States. No wonder the Canadians aren’t sympathetic.