Drug Importation in Florida: An Overview

FL-hb19

Synopsis:

In April 2019, the Florida State Legislature passed HB19, a bill which requires Florida's Agency for Health Care Administration to establish a Canadian Prescription Drug program and an International Prescription Drug Importation Program.

Under the Medicare Modernization Act of 2003, Florida is required to submit a plan to HHS to import medicine from Canada that meets requirements set in that legislation.

Current status:

Governor De Santis signed the bill on June 11, 2019. The state is developing a plan to submit a Canadian importation plan to the Federal Health and Human Services Agency. (June 13, 2019)

How should we evaluate this program?

The program hasn't started yet, or even been designed, 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. PSM staff followed the debate in Florida and recorded promises made about safety and savings by the sponsors of the legislation.

Official actions and statements

Background / resources

Just learning about the Florida foreign drug importation proposal? Start with some of these resources that outline the safety issues.

Op-eds from the Experts

Drug Importation threatens people with chronic illnesses, says advocate.

June 12, 2019

This editorial by Guy Anthony was published in the Orlando Sentinel on June 12, 2019. Anthony, President and CEO of Black, Gifted & Whole, a nonprofit focused on issues surrounding black, queer men, warns that drug importation will open up “a market for dangerous, counterfeit drugs” that will make it harder for people to live with HIV and other complex illnesses.

Economist questions the fundamentals of importation: “It flunks a basic policy analysis.”

April 29, 2019

In this editorial published on April 26, 2019, Douglas Holtz-Eakin, economist and President of American Action Forum, questions economic truths about drug importation:

“Drug reimportation has long been the fool’s gold of health policy, and the Florida bill is no different. It flunks a basic policy analysis. But most amazing, it is drafted to raise hope, but not actually help Floridians.”

Journalist on drug importation: “There is a real risk.”

April 28, 2019

In this piece published in the Washington Free Beacon on April 25, 2019, staff writer Charles Fain Lehman explores issues around Florida’s drug importation proposal. “Critics,” he notes, “fear that the actual realities of regulatory oversight—especially in the hand of an as-yet-unnamed private vendor—will simply be too challenging to manage responsibly.”

The Bottom Line? “Importation will make it difficult to ensure that Floridians are receiving real and safe medicine.”

April 26, 2019

In this piece, which was published on the ABC affiliate WJLA’s website on April 25, 2019, political analyst Boris Epshteyn explains that “this is a risky plan that will make it difficult to ensure that Floridians are receiving real and safe medicine.”

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.’”

Oncology Practice Managers: This “drug importation proposal that could put Floridians at risk”

April 22, 2019

In this editorial, which was published in the Palm Beach Post on April 22, 2019, Michelle Flowers writes about Florida’s history of black market cancer treatments and the danger importation poses to patients. Flowers is president of the Oncology Managers of Florida.

Santa Cruz Sentinel logo

Importation “Too Good to Be True, ” Business Columnist Warns

April 19, 2019

In this editorial, which was published in The Santa Cruz Sentinel on April 18, 2019, business columnist Jeffrey Scharf argues that importation of prescription drugs is a plan that is too good to be true.

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.”

Drug importation makes law enforcement’s job harder, says former FDA-OCI director

April 11, 2019

In this editorial, which was published in The Gadsden Times on April 11, 2019, former FDA-OCI director George Karavetsos points out the real dangers of drug importation:

“Even today, Americans are being hurt and even dying because of counterfeit medications being imported into this country. Adding insult to injury, while some might point to Canada as being a safe source, counterfeit medications are transshipped through Canada from other countries in remote corners of the globe.”

Tampa Pharmacist Speaks Out Against Florida’s Drug Importation Proposal

April 3, 2019

This editorial by Dan Fucarino was published in Florida Politics on April 1, 2019. Mr Fucarino is the owner and a pharmacist at Carrollwood Compounding Center & Pharmacy.

“The monetary rewards of Canadian prescriptions are just not worth their safety risks,” he warns. “I urge Florida legislators to listen to health care experts on this issue rather than the understandable populist appeals and vote no on this dangerous legislation — and then get back to working on more productive ways to lower drug prices for Floridians. Thousands of Americans have been injured or killed by imported prescription drugs.”