This week the Trump administration did an about face and announced it would support importation of prescription medicines from Canada. This would presumably save U.S. citizens a lot of money. But don’t hold your breath. It is not yet legal to import drugs from Canada. There are lots of roadblocks ahead. If the pharmaceutical industry has anything to say about this, the plan will be dead on arrival (DOA). If you are confused, we don’t blame you. The headlines are misleading. We’ll do our best to provide you inside information on the new proposal.
Can You Really Import Drugs from Canada?
The reporting has been provocative:
“Trump admin opens door to allow drug importation from Canada” (CNN 7/31/19)
Newsweek (7/31/19) led its story with this sentence:
“Health and Human Services Secretary Alex Azar announced Wednesday morning that the Trump administration plans to allow Americans to legally import prescription drugs from Canada in an effort to reduce prices.”
President Trump tweeted:
“Lowering drug prices for many Americans – including our great seniors! At my direction, @HHSGov @SecAzar just released a Safe Importation Action Plan”
What You Should Know About the New Plan:
It’s called the “Safe Importation Action Plan.” It is not a done deal. At best, this is a proposal to create a regulation to allow states, wholesalers and pharmacies to import drugs from Canada. It could take months or even years to be finalized. The first step would be a pilot program, which might never become widespread.
We have seen nothing about allowing patients to personally import drugs from Canada in the administration’s plan. In other words, this is all about states saving money on their prescription drug costs for state employees or Medicaid patients. If the plan goes through, wholesalers and pharmacies will also be allowed to import drugs from Canada. Will they pass their savings on to patients?
The Big U-Turn:
For years the Food and Drug Administration has maintained that it is unsafe for Americans to import their prescription medications from any other countries, including Canada. Such practices are officially illegal, though U.S. citizens have been doing so for years without penalty. Let’s face it, having customs officials arresting senior citizens who are buying blood pressure medicines or asthma inhalers from Canada would not look good.
We have found the FDA’s policy bizarre. The agency permits generic drug companies in China, India, Thailand, Slovenia, Brazil and Mexico to ship huge quantities of prescription drugs to the U.S.
Over the last decade or so, we have learned that many generic drugs manufactured abroad were contaminated with carcinogens or other impurities. Some of the pills were just plain sub-standard. Others were made in plants that did not follow good manufacturing practices. Listen to our interview with Katherine Eban (author of Bottle of Lies) at this link to learn the gory details.
At the same time that the FDA has welcomed importation from generic drug companies with questionable track records, it has warned Americans about importing brand name medicines from Canada. We have a hard time wrapping our brains around that logic.
The Flip Flop:
It is going to be a hard pill for some FDA officials to swallow when they have to say it is OK to import drugs from Canada. Even the boss of their boss must have had some challenges with this flip flop.
Drug Prices Listed in TV Commercials?
Alex Alzar is a former drug company executive. He is currently head of Health and Human Services (HHS). That means he oversees the FDA. He has been flipping and flopping a lot lately. He was going to try to make drug companies include the list price of their medicines in TV commercials. That was supposed to shame them into lowering prices. That idea flopped when a judge ruled that plan DOA.
Next, Alex Azar wanted to do away with rebates to middlemen (pharmacy benefits managers or PBMs). The PBMs are gatekeepers between drug companies and pharmacies. Eliminating the discounts was supposed to save patients money. The administration decided that plan was a nonstarter. Reversal #2!
Read about those reversals at this link:
Importation Flip Flop?
On May 14, 2018, Alex Azar gave a speech about drug pricing.
“Many people may be familiar with proposals to give our seniors access to cheaper drugs by importing drugs from other countries, such as Canada. This, too, is a gimmick. It has been assessed multiple times by the Congressional Budget Office, and CBO has said it would have no meaningful effect.
“One of the main reasons is that Canada’s drug market is simply too small to bring down prices here. They are a lovely neighbor to the north, but they’re a small one. Canada simply doesn’t have enough drugs to sell them to us for less money, and drug companies won’t sell Canada or Europe more just to have them imported here.
“On top of that, the last four FDA commissioners have said there is no effective way to ensure drugs coming from Canada really are coming from Canada, rather than being routed from, say, a counterfeit factory in China. The United States has the safest regulatory system in the world. The last thing we need is open borders for unsafe drugs in search of savings that cannot be safely achieved.”
That was then. This is now:
On July 31, 2019, Alex Azar flipped again.
In a TV interview he said this about drug importation:
“We’re open for business.”
He also stated:
“For the first time in HHS’s history, we are open to importation. What we’re saying today is we’re open. There is a pathway. We can be convinced.”
In a tweet on the same day, Secretary Azar wrote:
“Today we are announcing a new action plan to lay the foundation for the safe importation of certain prescription drugs. This is the next important step the Administration is taking to address foreign freeloading and lower the cost of drugs for Americans.”
Will the New “Action Plan” Save You Money?
This remains to be seen. Remember, the import plan only involves wholesalers, states and pharmacies, not patients. Will these big players pass along the savings to patients? It could also be years before the plan is implemented. Really expensive biologic drugs that are prescribed for conditions such as psoriasis, rheumatoid arthritis, cancer and type 1 diabetes will probably be excluded from the list of import drugs from Canada.
Let’s not forget that PhRMA (the industry trade group) is opposed to this plan. The pharmaceutical industry spends a huge amount of money lobbying the movers and shakers in Washington. We suspect that there will be a full court press to derail the Safe Importation Action Plan.
What Can Patients Do to Save Money on Medicines Right Now?
It just so happens that a lot of Americans have been buying brand name drugs from legitimate Canadian pharmacies for years without interference. Even though it is technically illegal, the U.S. government is not arresting grandmas for buying arthritis medicines in Canada. You can read more about this process at this link.
There are scoundrels on the web, so it is essential to learn which pharmacies are truly Canadian and which might be in Croatia or China but masquerading as Canadian. We have come up with our own “action plan” that will allow you to verify actual Canadian pharmacies. Read about it in our eGuide to Saving Money on Medicines. You can find it in the Health eGuides section of our website.
What do you think about the administration’s new plan to perhaps allow pharmacies, states and wholesalers to import drugs from Canada? We would love to read your thoughts in the comment section. Have you ever purchased drugs from Canada? How well did that work? Share your experience, positive or negative.