Drug Importation in New Hampshire: An Overview

map of New Hampshire with a bottle of poisonous Canadian pills

Synopsis:

In January 2020, the New Hampshire legislature introduced SB685, which would require the New Hampshire Department of Health and Human Services to design a wholesale importation program for prescription drugs from Canada by or on behalf of the state and obtain federal approval for the program. In June 2020, SB685 was added to HB1280, which included several other prescription drug initiatives. The bill was signed into law in July 2020.

 

Current status:

New Hamphire's legislature approved HB1280 in June 2020, and Governor Sununu signed it into law the following month.

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.

Official actions and statements

HB1280: Text of the Bill

SB685: Text of the Bill | New Hampshire State Senate hearing

Testimony opposing SB685:

Op-eds from the Experts

PSM’s President Weighs in on Importation Fueling Fentanyl Epidemic

October 10, 2017

As PSM’s Board President, Dr. Marv Shepherd, wrote in an editorial for the Washington Examiner that was published on October 10, 2017, opening the United States to unregulated, imported drugs will offer fentanyl traffickers even more access to Americans:

“The reality is that criminals throughout the illegal supply chain from China to the streets of U.S. cities are making money at the cost of American lives. We need to be taking steps to eliminate illegal fentanyl from our communities, not providing new avenues for those who want to see just the opposite happen.”

Former Assemblyman Reminds Everyone That Drug Importation Is Bad For Alaska

October 2, 2017

Paul Honeman is a former Anchorage Assemblyman representing East Anchorage. He also is a retired Anchorage Police Department Lieutenant. In this September 28, 2017 editorial in The Bristol Bay Times, he highlights the dangers posed by drug importation and reminds everyone why it is currently banned…

Dr. Shepherd at the Interchange

Separating fact from fiction about drug importation at CNN’s recent Healthcare Town Hall

September 29, 2017

CNN’s September 25, 2017 Healthcare Town Hall was an opportunity for prominent senators to share important ideas about ways to improve Americans’ lives, but it also included some erroneous statements about drug importation. PSM’s Board President, Dr. Marv Shepherd, sent this letter on September 29 to clarify those issues.

NV Sheriffs’ and Chiefs’ Association Tells Sen. Heller They Oppose Allowing Drug Importation

September 23, 2017

The Nevada Sheriffs’ and Chiefs’ Association sent a letter to Senator Heller explaining their reasons for opposing S. 469, the bill that would allow drug importation…

Texas Policy Analyst Questions Economic Impact and Safety of Drug Importation

September 22, 2017

Russell Withers, general counsel at the Texas Conservative Coalition Research Institute in Austin, believes that drug importation is “neither affordable nor safe.” In a September 20, 2017 editorial in the Austin-American Statesman , he argues that “it would hurt U.S. and Texas businesses, workers and patients’ and urges Texan congress members to oppose it.

US Will Be Exposed to Counterfeits From Weak European Drug Security Warns Expert

August 28, 2017

In early July, European authorities reported that counterfeit versions of Omnitrope, a drug containing human growth hormone, were found in France, Denmark, and Mexico. The counterfeit Omnitrope was designed to look like it was made by a large drug manufacturer, but it contained no active ingredient. Shortly thereafter, German authorities announced that a fake version of a schizophrenia drug, Xeplion, was discovered in Germany. The Xeplion was also a knock-off, mimicking packaging used in Bulgaria and Romania.

These incidents are the latest in a stream of reports about counterfeit drugs throughout Europe. The problem lies in lax security of the supply chain — distributors, middlemen and wholesalers between the drug maker and the consumer. Despite ongoing problems with the EU drug supply chain, Congress is currently considering a bill that would open the U.S. to imports from the EU and elsewhere. We can’t have a serious debate about drug importation without understanding what is going on in Europe.

Health Policy Expert: “Why Cheaper Drugs Can Kill”

August 24, 2017

Health policy expert Kenneth Thorpe weighs in on the dangers of drug importation in this August 23, 2017 editorial in U.S. News & World Report:

“…these savings could come at the cost of Americans’ lives. Legalizing drug importation would make it far easier for harmful counterfeit and contaminated medicines to enter the U.S. drug supply. At a time when illegal, counterfeit drugs already cause hundreds of American deaths every year, importation represents a reckless way to cut health care costs.”

Bioworld: Importation a cliché, not a CAPA

August 21, 2017

Mari Serebrov, the regulatory editor for biotechnology news site BioWorld, offered this opinion about drug importation on August 4, 2017.  

“On the surface, importing drugs from Canada seems like a no-brainer,” she writes, “especially when the Canadian version is virtually the same drug as the one approved by the FDA for the U.S. market – except a whole lot cheaper. But there’s the rub. How can Congress ensure that drugs imported from Canada are all that they claim to be?

While more than 40 countries have or are implementing security measures to protect their drug supply chain, Canada’s not one of them, Brian Daleiden, vice president of industry marketing at Tracelink Inc., told BioWorld. That puts importation – from Canada, at least – on a collision course with the U.S. Drug Supply Chain Security Act (DSCSA), which Congress passed in 2013 as part of the Drug Quality and Security Act.”

Physician: Sanders’ drug proposal comes with serious costs

August 21, 2017

The Daily Herald published this editorial by Dr. Terry Sellers about the shortcomings of drug importation as policy on July 25th, 2017. Sellers is a Utah-based physician specializing in addiction.

“… price is not the same as cost,” he writes, “In this case, cheaper prices will impose tremendous costs that would adversely affect the future of medicine for generations to come.” 

Former Director of the U.S. FDA’s Office of Criminal Investigations Warns Against Allowing Drug Importation

August 21, 2017

More than 60,000 Americans died from drug overdoses last year. Fentanyl, a synthetic opioid 100 times more powerful than morphine, caused one-fifth of those fatalities. Local law enforcement and health professionals are working at a feverish pace to prevent fatal overdoses, yet at the same time, some federal lawmakers have proposed legislation that would make it legal to import drugs that are not approved by the Food and Drug Administration into the United States from questionable sources. Such legislation would provide a gateway for international criminal organizations to import counterfeit prescription drugs and deadly illegal opioids, including fentanyl…