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
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
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.
This week, Senator Chuck Grassley (R-IA) sent a letter to the Secretary of Health and Human Services and FDA Commissioner declaring support for the Trump administration’s drug importation plan but warning about the need to up our game inspecting foreign drug manufacturing establishments. Grassley cautioned that the U.S. must ensure new imports are properly tracked and traced within the supply chain. While there are some details in Grassley’s recently stated position that are a bit blurry, the essence of what the senator is saying is very good. We can use global trade to force down prices on prescription drugs in the U.S. while continuing to work on and improve the safety of our already-existing global pharmaceutical supply.
Senator Grassley has vociferously supported drug importation
for a long time. As reported
in The Hill in 2012, he was intensely critical of President Obama for going
back on his 2008 campaign promise to support dug importation:
This week, the Trump administration formally announced support for not only state prescription drug importation programs, but also HHS Secretary Alex Azar’s own importation plan. Until this week, it was known that Trump had instructed Secretary Azar to work with Republican Governor Ron DeSantis of Florida to help implement its new law to permit wholesale drug importation from Canada for public payers, which also includes importation from other countries for the private market. Now, there is real movement.
Before diving into Trump’s drug importation plan more fully, please take note that this plan actually allows for the importation of what the FDA has called “foreign unapproved drugs,” ones that they have said they don’t want Americans ordering online and importing for their own use. These drugs, as explained below, are safe and effective foreign brand versions of the same drugs sold here. This recognition of equivalent brand drug safety is a step in the right direction.
It’s true that while small-scale importation from Canada is
feasible, larger scale importation is not.
The future lies in pharmaceutical international trade beyond just Canada to include countries such as Japan and those in the European Union. Expanding importation programs to include the EU and Japan was recommended by Jane Horvath in a wonderfully written op-ed in Stat News earlier this week. Ms. Horvath is the leading healthcare policy expert working with the National Academy for State Health Policy and the states on drug importation programs.
Trump supports prescription drug importation, and he’s not alone. An article by Kaiser Health News reporter Phil Galewitz headlined Trump’s support for drug importation to fight high drug prices at the state level. His article delves into the history of earlier state importation attempts, which were personal drug importation not wholesale drug importation programs. But the coolest thing I took from it was that the three states that passed prescription drug importation laws have governors across the political spectrum. None are traditional right-wing Republicans or super left Democrats. What does that look like?
In Florida, you have Governor Ron DeSantis, fashioning
himself in the mold of a Trumpist Republican.
In Vermont, you have Governor Phil Scott, who can best be
described with a phrase practically unheard of these days: Liberal
Finally, newly elected Governor Jared Polis from Colorado is
a moderate Democrat.
While the state importation bill failed to advance in Utah, its vociferous champion in the state assembly is a very conservative Republican, Norm Thurston (Provo).