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Drug Importation in Colorado: An Overview

map of colorado with pill bottle displaying a maple leaf label. The label peels back to show a poison symbol

Synopsis:

In May 2019, the Governor of Colorado signed SB19-005, a bill which creates a "Canadian Prescription Drug Importation Program" in the Department of Health Care Policy and Financing.

first page of colorado SIP analysis

Read PSM's analysis of Colorado's March 2020 Draft Importation Plan

Current status:

Colorado published a draft proposal of the program in March 2020 along with comments to HHS on the proposed federal importation guidelines. Their comments revealed that the architects of the plan don't think importation can work financially as designed because of the small size of the Canadian drug supply and the cost requirements of testing.

 

PSM has documented several problems with the draft proposal for Colorado's program in this analysis.

How should we evaluate this program?

The program hasn't started yet so there's no way to measure whether it saved money or kept patients safe, both promises made at the time of passage. However, the 2003 Medicare Modernization Act contains requirements for safety requirements built into any such program.

Official actions and statements

  • October 15, 2020: The Department of Healthcare Policy and Financing updates stakeholders: Slides
  • September 23, 2020: Department of Health and Human Services Alex Azar certified that Canadian drug importation would pose no additional threats to consumers and would save Americans a significant amount of money on prescription drugs.
  • June 10, 2020: The House Committee on Health & Insurance postponed SB20-119, which would have expanded Colorado's importation program beyond Canada, indefinitely.
  • March 9, 2020: Colorado releases draft importation proposal and appendices.
  • February 13, 2020: Colorado Health and Human Services Committee hearing on SB 119
  • January 2020: The Colorado legislature considers SB20-119, which would expand importation from Canada to prescription drug suppliers from other nations.
  • May 16, 2019: Colorado SB19-005 is signed into Law
  • October 11, 2019: The Department for Healthcare and Public Financing issues RFIs to pharmacies and wholesalers.
  • November 2019: Colorado's Department of Health Care Policy & Financing held webinars to engage stakeholders: Slides

Planning documents

Op-eds from the Experts

Economic Policy Researcher Finds Fault with Federal Drug Importation Plans

August 30, 2019

This editorial by Liam Sigaud was published by Inside Sources on August 27, 2019. Mr. Sigaud is an economic policy researcher who writes for the American Consumer Institute, a nonprofit educational and research organization.

Cancer Center Pharmacist in Iowa Worries Drug Importation Will Harm His Patients

August 27, 2019

This editorial by Dana McDougall was published in The Waterloo Cedar Falls Courier on August 26, 2019. Mr. McDougall, Pharm.D., BCPS, is a pharmacist with the Covenant Cancer Treatment Center in Waterloo, Iowa.

Drug Distribution Experts Warn That State Plans To Import Foreign Drugs Will Undermine Safety

July 11, 2019

This editorial by Adam Fein and Dirk Rodgers was published in Stat News on July 11, 2019. In it, Fein and Rodgers warn that plans by states to create drug importation programs will open new pathways for counterfeit drugs to enter the U.S. drug supply chain…

“Canada cannot act as a drugstore for the United States,” says academic

June 19, 2019

In this editorial, which was published by the Fraser Institute on June 13, 2019, economist Dr. Kristina Acri argues against importation, concluding: “Diverting drugs meant for Canadian patients to the U.S. through state importation schemes will create shortages for Canadian patients and increase pressure on potentially unscrupulous suppliers to source drugs from wherever they can, opening the door to counterfeiters.”

Joni Inman of Front Range Pharmalogic Describes Canadian Drug Importation as a ‘Dangerous Myth’

May 22, 2019

Dozens of the most highly qualified law enforcement officials and former, senior staff at the U.S. Food & Drug Administration have conducted in-depth analyses that show Canadian drug importation will lead to a massive increase in counterfeit drugs entering the U.S.

The case against importation: “There are simply too many channels for fake drugs to enter any importation scheme”

April 23, 2019

In this piece, which was published in the Inside Sources on April 22, 2019, Michael Graham reviews the case against drug importation: “As Scott Gottlieb said in 2016 before becoming President Trump’s FDA chief…’There are simply too many channels for fake drugs to enter any importation scheme to forgo some meaningful controls.’”

Canadian law enforcement: Smugglers will exploit importation to traffic counterfeit medicine

April 17, 2019

In this editorial, which was published in Colorado Politics on April 17, 2019, Don Bell, a 30-year veteran of Canadian law enforcement and border protection, warns that Canadian drug importation will open the U.S. to counterfeit medicine and exacerbate drug shortages in Canada.

The Wall Street Journal’s Editorial Board Comes Out Against Drug Importation

April 15, 2019

The editorial board of the The Wall Street Journal published this editorial on April 15, 2019. In it, they write:

“The argument that drug importation threatens the integrity of the drug supply is often dismissed because pharmaceutical lobbyists make it. But keeping the drug supply free from contaminated or counterfeit products is not easy, and the World Health Organization has warned that 1 in 10 medical products in the developing world are phony. It isn’t clear who is liable if counterfeits are found in Florida, but you can bet it won’t be the politicians.”

Amelia Arnold, pharmacy operations manager for Community Pharmacies, Augusta, ME

Maine Pharmacist to Colorado: We found that importation doesn’t deliver quality or savings

March 29, 2019

In this March 28, 2019 editorial for the La Junta Tribune-Democrat, Maine pharmacist Amelia Arnold explains her state’s experience with drug importation: “It is a concept that makes big promises in terms of quality and cost savings that it cannot, and will not, deliver on for the people of Colorado.”

Sheriff of Larimer County, Colorado: Importing prescription drugs could be dangerous

March 23, 2019

These dangerous drugs get trafficked into Colorado and present a clear and present danger to unsuspecting citizens, who can die from simply ingesting what they think are safe medications. Importing foreign drugs would open a loophole, which increases the chance these dangerous counterfeits enter America unbeknownst to us all.