The pharma-funded and industry opponents of drug importation from Canada just love to talk about how “even the Canadian government opposes importation.” For a quick clarification, Canada has not minded or stopped its pharmacies from safely dispensing medicines by mail to Americans. That’s personal drug importation. When I write that Canada opposes importation, I mean the wholesale drug importation currently proposed by the Trump administration.
Hey, if Canada doesn’t want this new policy, then what the hell can we do? As I see it, Pharma-funded groups, like the Partnership for Safe Medicines and Alliance for Safe Online Pharmacies, have—almost gleefully— pointed out to the U.S. FDA that Canada is opposed to the implementation of Section 804 to allow registered wholesalers in the U.S. to import drugs from Canada. This is mainly due to Canada’s fear of drug shortages. Drug manufacturers supply Canada to meet the needs of its much smaller population. If Canadian wholesale drug exports increase substantially under the new Trump administration policy then it could exacerbate supply problems in Canada.
There’s a lesson to be learned from Canada here, however, and it’s not the one about shortages and other things Big Pharma wants you to think about. You’ll find this lesson in public comments Canada submitted to the FDA. The gist: unlike the U.S., Canada make their citizens’ access to affordable medicine a priority. Take it from Canada:
“Rising drug prices and growth in the number of high-cost medicines now available on the market is a challenge faced by all governments. In response, Canada has put in place a number of domestic measures to address increasing drug prices. Ensuring that Canadians have secure and affordable access to the medicines they need is a top priority of the Government of Canada.”
The public comments then enumerate various policies that are used by governments in many countries to ensure drug prices are more affordable for their citizens. Such policies include international price referencing, negotiating bulk discounts, competitive bidding and value-based pricing. In terms of Canada’s own policies, a mix of the aforementioned strategies are employed. Most notably, Canada has the Patented Medicine Price Review Board, which ensures that brand name drug prices are reasonable. That explains why Americans personally import medicines from Canada.
Canada’s tone in the conclusion of it its public comments about drug importation borders on condensation:
“Canadian officials would be pleased to meet with U.S. counterparts to share information on Canada’s approach to ensuring that Canadians have access to the safe and affordable drugs they need.”
I’m all in.
I might add that the U.S. could teach Canada a thing or two about lower generic drug prices. Our far more competitive market for generic drugs and the fact that Canada’s policy interventions on drug prices focus on patented, not generic drugs, means that most generic drugs actually cost a lot less in America!
It may come as no surprise that Canada, in its comments, doesn’t even dignify our debate on whether imports of Canadian drugs are safe. As former FDA Commissioner Scott Gottlieb, MD, stated “Canadians have safe drugs.”
For decades, Americans have purchased and imported medicines from Canadian pharmacies for their own use and saved lots of money. Limited wholesale importation from Canada could help some states lower their drug bills, but largescale wholesale drug importation from Canada into the U.S. would not be sustainable. Others, such as Horvath Health Policy, recommend expanding wholesale importation beyond Canada, to the European Union, Japan and the UK. For that to happen legislative reforms would be necessary, but clearly a more global approach would be sustainable and force drug prices lower in the U.S. over time. In fact, one world famous economist, Stephen Salant, believes that importation is the best way to lower drug prices and maintain pharmaceutical innovation.
In the meantime, Americans rely on personal importation from Canada and other countries when they cannot afford medicine domestically or they are fed up with the much higher prices. Can you blame them?Tagged with: Horvath Health Policy, Scott Gottlieb, Stephen Salant