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Helping Americans Get The Truth About Prescription Drug Savings
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Helping Congress Learn More about Foreign Pharmacy Prices

A few weeks back, I wrote about the House Ways and Means Committee international drug price report, which very competently compared U.S. patented drug prices with 11 other countries. The report found that 79 drugs, ones that account for 60% of Medicare drug spending, are on average priced just under 75% lower internationally vs. the U.S. when looking at ex-factory, meaning wholesale prices.

I half-joked that the Committee was recommending looking abroad for lower drug prices. They were not focusing on drug importation. However, the Committee held a hearing yesterday in which foreign drug prices were central to the debate. The focus of the hearing was a bill, H.R. 3, Lower Drug Costs Now Act, which seeks to lower drug prices in Medicare by empowering Medicare to negotiate with drug companies prices on certain, generally very expensive drugs. There’s a backstop in the bill if the drug companies won’t negotiate in which drugs would be priced at 120% of the average price of six high-income countries. That’s called international reference pricing. The bottom line here is that Congress is now shining a bright light on how much more expensive the “same” drugs are in the U.S. vs. abroad.

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FDA Drafts Guidance to Allow Lower-Cost Foreign Drug Imports From Any Country

The FDA has finished draft guidance on one of two of the Trump administration’s drug importation policy ideas, referred to as Pathway II. The title of this post may seem like a joke for those of you who follow the issue of drug importation in America, but it is real. As a reminder, in August 2019 the administration took its support for drug importation a step further by stating its willingness to support state drug importation programs, Pathway I, and a new idea to give drug companies greater flexibility with their global drug supplies to offer better prices in the U.S, called Pathway II.

Earlier this week, the guidance on Pathway II was sent to the White House Office of Management and Budget (OMB), although I believe it’s not public yet. I found out about the submission to OMB here (BioCentury). It doesn’t relate – at least not directly – to personal drug importation, but it frees the hands of drug companies to sell their own foreign versions of FDA-approved drugs at lower prices in the U.S. market. Its indirect relation to personal drug importation is noted at the end of this post.

Some of this is guesswork. It’s not entirely clear to me what drugs are permissible under Pathway II and it won’t be until the draft guidance is made public.

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Trump’s Campaign Website’s Only Drug Prices Policy Was Importation

If you care about and follow the issue of drug prices, then this week was bizarre on the political scene. In a press conference with Rep. Adam Schiff (D-CA) at her side, Speaker of the House Nancy Pelosi (D-CA) was imploring the media not to focus only on impeachment but on drug prices, noting that she believes Congress and President Trump can continue to work together despite the friction.

Yesterday, Trump was courting seniors in Florida, extolling drug price reductions under his watch that kind of, you know, never really happened and promising to save Medicare from “socialism” (go figure, Medicare is already a huge government program). Bizarrely, he implied that Big Pharma might have something to do with the impeachment inquiry against him. Maybe his Secretary of Health and Human Services, former Eli Lilly Pres. Alex Azar, is in on the “coup”… just joking. 

In the haze of the political circus, something fundamental keeps getting lost. During Trump’s 2016 campaign, the only policy he put forward on his website to bring down drug prices was drug importation. See below screenshot:

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House Ways and Means Report Recommends Looking Abroad for Lower Drug Prices… Kind of…

A report (“A Painful Pill to Swallow: U.S. vs. International Prescription Drug Prices”) was released this week by the Congressional House Ways and Means Committee, showing that brand name drug prices are much lower – by about 75% on average – in other high-income countries. Who knew? Well, our analysis from this past summer showed that the average savings on popular brand drugs filled through online orders with Canadian pharmacies was 75%. When including pharmacies in other countries, the savings jumped to 90%. Those include pharmacies located in middle income countries, such as Turkey. For the record, these are comparisons among PharmacyChecker-accredited online pharmacies.

The committee’s report looked at prices of 79 brand name drugs in the following countries: Australia, Canada (specifically Ontario), Denmark, France, Germany, Japan, Netherlands, Portugal, Sweden, Switzerland, and the United Kingdom. I highly recommend reading this report if you want to learn about international drug price differentials and better understand how Americans are getting ripped off.

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Immigrants Buying Meds on the Street: A Problem of High Drug Prices and Fears of Deportation

A lot of media coverage about counterfeit drug threats in the U.S. are spurred by the media relations efforts of organizations funded by pharmaceutical companies, such as the Alliance for Safe Online Pharmacies and Partnership for Safe Medicines. As I see it, their public education efforts conflate safe online sales of medicines imported by consumers in the U.S. with counterfeit drug sales and other forms of drug sales, ones that clearly harm patients. One such article that did not fall prey to the propaganda was published in Kaiser Health News’ California Healthline detailing street market sales of prescription drugs, including cases that involve counterfeit drugs and the dangers they pose. Journalists who are looking closely, checking the funding of organizations disseminating information about prescription drug importation, can help stop the propaganda of the pharmaceutical industry.

The Kaiser story, written by John M. Glionna, focuses on Latino immigrant communities in which people can’t afford medication or, due to their immigration status, are fearful of deportation if they go to federally-funded clinics for medical treatments. Eight people were arrested and charged with illegal street sales of prescription drugs, including injectables and controlled drugs. Glionna describes the LA County authorities report:

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A Bittersweet Day: PharmacyChecker vs. Big Pharma

As I wrote a few weeks back, PharmacyChecker filed an antitrust lawsuit against five organizations that we believe are largely funded or backed by pharmaceutical companies. We allege that these organizations have conspired to illegally suppress competition in the areas of online pharmacy verification services and drug price comparisons on the Internet. The organizations are the National Association of Boards of Pharmacy (NABP), Alliance for Safe Online Pharmacies (ASOP), Partnership for Safe Medicines (PSM), LegitScript, and the Center for Safe Internet Pharmacies (CSIP).

As part of that suit, we filed a motion for preliminary injunction to immediately stop the NABP from including PharmacyChecker.com and this blogsite on its “Not Recommended Sites” list. That list was created to ostensibly identify rogue online pharmacies but has included safe international online pharmacies from its very inception. More recently NABP’s oversight has been expanded, apparently, to also include sites—such as this blog—that help consumers avoid rogue online pharmacies and find affordable drug prices!

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