The FDA has finished draft guidance on one of two of the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
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what drugs are permissible under Pathway II and it won’t be until the draft
guidance is made public.
I’ve recently been exercising bragging rights about our new and improved drug price comparisons. Americans seeking medicine from Canada and other countries are finding better deals on generics right here at home. But the crisis of high drug prices in the U.S. persists when it comes to brand medications. Recent price research by the Journal of the American Medical Association shows that brand name drug prices have increased by 76% over just the past six years.
This week, PharmacyChecker released new price analysis
savings for 10 popular patented drugs, comparing U.S. discounted medication
prices with those available at accredited international online pharmacies. The
average discount from Canadian pharmacies is 75%. If ordering from farther abroad,
That’s right, folks. There’s no need to buy online and import from Canada, or even from India, to save money when it comes to most commonly dispensed generic drugs.
researched prices of the 40 most commonly dispensed generic drugs in the
U.S. to compare them to ones offered at accredited pharmacies in Canada. Four
of the generics are controlled drugs, which are not available to U.S. consumers
from PharmacyChecker-accredited international online pharmacies; and two of
them are not available in Canada. Out of
the 34 drugs we compared prices on, 88% were cheaper in the U.S. than in Canada
and at an average savings of 68%.
Forcing price transparency in drug ads, proposing international reference pricing for Medicare Part B, and even drug importation can all be found in President Trump’s lunchbox of policy ideas to take on the drug companies, who are “getting away with murder.”
Huh, am I dreaming?
Is Donald Trump really a Republican? Is former Eli Lilly President Alex Azar, now HHS Secretary, really advocating such radical ideas, such as importation, against his pharma friends? Scott Gottlieb, our free-market fanatic FDA Commissioner is crusading against high drug prices, too: winner of Patients for Affordable Drugs Price Fighting Hero Award!
Pinch me. Am I awake?
I am awake and I’m not fooled by this subtle, probably well planned out public relations defense against the progressive and populist tide, which includes Republicans and Democrats. Forget importation this week: 92% of Republican and 96% of Democratic voters support ending the ban on Medicare negotiating drug prices. Finally, the country is united!
Ending the ban on Medicare price negotiations could bring down prices for drugs in all of Medicare.
But Alex Azar’s proposal to reduce drug prices in Medicare
is only for Part B, half the country, and on a small group of medications.
Forcing drug companies to list prices on TV drugs ads does not bring those
prices down. And the importation
idea is good, but super limited, and it’s still just talk!
“If one was to design a program that appeared to address the need to curb high prices for drugs, without doing much in Trump’s first term, and promising nothing after 2025, it might look like the proposal.”
On the other hand—and this is where compromise begins to seep in and you can’t help but know it’s because Trump is no normal Republican—the former President of Eli Lilly USA, Alex Azar, is advocating for forcing price reductions on drugs in Medicare Part B and importing foreign versions of lower-cost medications for single source drugs; and working in an administration giving voice to drug price transparency. Who would have thought that possible two years ago?
Each week I try and share something with our blog readers to
shed further light on issues relating to online pharmacies, drug prices, drug
importation and safety. Most of these efforts are dedicated toward advocating
for Americans who can’t afford medications – and hammering home the truth that
safe international online pharmacies are a lifeline of lower drug prices. These
are policy, consumer and healthcare issues, but also political issues. I’ve
come to know that Republicans, Democrats, Independents, Libertarians, and
Democratic Socialists all agree that drug prices are out of control and the
pharmaceutical industry has too much power.
Wishing you affordable medicine and food this Thanksgiving!
When it comes to healthcare, and especially prescription drugs, 62% of Americans are concerned with costs. In the richest country in the world, it saddens me to report that accessing food — and eating more healthy foods — is a big problem, too.
This Thanksgiving it’s important to consider and stand with the millions of Americans who have to decide whether or not they will eat the food they want or take the medicine they need. Over 30% of Americans delay buying food or buy less food so that they can pay for medical and prescription drug expenses. That’s according to an annual survey about food purchasing behavior by the International Food Information Council (IFIC) conducted earlier this year.
This is not necessarily a hunger issue, although hunger in America is a problem. The IFIC study shows that 50% Americans sometimes buy less healthy food because it’s more affordable. Those less healthy diets lead to negative health outcomes, such as obesity, and more prescription drug spending!
A Commonwealth Fund survey showed 18% of Americans aged 19-64 did not fill a prescription in 2016. In my role with the non-profit organization Prescription Justice, we used that data and other survey data focused on people 65 and older to discover that 45 million Americans did not fill a prescription because of cost in 2016.
This is entirely unacceptable for America. What is worse is that even with a strong economy and unemployment at almost a 50-year low, affording medicine and healthy food is still difficult for so many families.
I hope that the work of PharmacyChecker to provide useful information on affording medicines and advocating for patients helps make it easier for Americans to afford both food and medicine – and to have a very, very Happy Thanksgiving.