Stephen Salant, PhD, professor emeritus of economics at the University of Michigan and research professor at the University of Maryland has written a paper that I believe gives voice and pays respect to the millions of Americans who import or are on the verge of importing lower-cost medication using online pharmacies. Let me be clear: this guy is a world-renowned economist. An expert in applied microeconomics, Professor Salant is most famous for his work in the economics of natural resources and industrial organization. Over the past few years, he has turned his attention to the problem of high drug prices in America and how to solve it without decreasing investment in research and development to create new life-saving drugs.
I’ll articulate the basic points of Salant’s paper, as I
understand them, and then give some commentary.
The recently signed appropriations or “omnibus” bill to fund the federal government includes an additional $94 million (Section 778) for the FDA to screen and stop drug imports at international mail facilities (IMFs). That could mean fewer people receiving their prescription medications that they have ordered from Canadian or other international pharmacies.
As I wrote a couple of weeks ago, the FDA’s coming crackdown against opioids could be a cover for greater import refusals and destruction of imported medications. This new appropriation of $94 million is a lot of money. In the case of drug importation, that money could be used for good (intercepting opioid ingredients en route to drug dealers or addicts) or evil (refusing and destroying prescribed medication en route to a patient who can’t afford the drug here).
You can read the section of the bill showing the appropriation and what it’s for at the end of this post. It states that the money is for “necessary expenses of processing opioid and other articles imported or offered for import through international mail facilities of the U.S. Postal Service.” Those “other articles” include prescription medications from pharmacies in Canada and other countries. Since the FDA considers those imports illegal, at least under most circumstances, it can refuse them and even destroy them – but must first alert the patient who ordered them giving them due process to defend their prescription order. (more…)
This week, President Trump potentially handed Big Pharma one of its greatest victories by appointing Alex Azar the new Secretary of Health and Human Services (HHS). Why? Until earlier this year, Alex Azar was the president of Eli Lilly USA and few people (companies are people?) on earth personify Big Pharma like Eli Lilly.
This matters to Americans who import lower cost medication to fill prescriptions because the FDA is an agency housed in HHS, and HHS has a lot of statutory power when it comes to importation of prescription drugs.
President Trump campaigned on making it legal for Americans to buy lower-cost medications from other countries, but Eli Lilly and Alex Azar are leading opponents of safe importation. In fact, Eli Lilly is perhaps the leader when it comes to hatching, or funding, strategic communications and lobbying campaigns to stop Americans from using safe, international online pharmacies. Its efforts through the non-profit group, Alliance for Safe Online Pharmacies—FUNDED BY ELI LILLY—have been frighteningly successful at fooling our elected officials and the public that international online pharmacies are inherently bad for Americans. They do so by conflating counterfeit drugs and even fentanyl abuse with safe international online pharmacies. As I see it, Eli Lilly’s narrative on online pharmacy and importation incorporates the most sinister aspects of fake news. Really. (more…)
This week I’m down in Washington, DC, talking to policy-makers and activists, setting off alarm bells about Big Pharma’s campaign to not only kill prescription importation legislation but also the ability for Americans to currently buy medications from Canada and elsewhere at all. I have a feeling Big Pharma knows I’m here, which is kind of cool (but also freaks me out because they are very powerful and we are not). Here’s the very quick story.
When I searched “pharmacychecker” in Google I noticed the top advertisement was placed by none other than the Pharmaceutical Researchers and Manufacturers of America (“Big Pharma”). That ad doesn’t show up in Brooklyn where I live but appears targeted in Google to the DC area. They know that our pricing information, verification work we do for patient safety, and advocacy is compelling to some public policy and healthcare advocates down here, so they pay Google to get their message on top. As if Big Pharma’s 1100 lobbyists aren’t enough!
It’s a badge of honor (but there’s no sleep til Brooklyn).
In 1976, reggae legend, Peter Tosh, released his song “Legalize It” – calling for the legalization of marijuana. In it, he sings “legalize it, don’t criticize it.” Needless to say, that’s already becoming our reality in the U.S. where, to varying degrees, many states have made pot legal. The federal government has begrudgingly accepted dissension in the ranks of states. Yes, there are rumblings that under Attorney General Jeff Sessions things are going to change. We’ll see.
To be intellectually honest, Silverman’s call to action is qualified. He seems to be saying to “legalize it,” but he’s not necessarily advising that we not “criticize it.” There are real threats from counterfeit and otherwise substandard drugs that need to be addressed in reforming the law. Dr. Aaron Kesselheim, professor of medicine at Harvard, offers his own thoughts in Silverman’s piece: “We should be able to address this safety issue…To not have the conversation and instead say there’s no way to import medicines safely is a cop-out.” (more…)
In 2001, in a Wall Street Journal article called “Survey Shows U.S. Customs Allows Illegal Foreign Medication,” then Congressman James Greenwood (R-PA) expressed his belief that Americans who import medications, even illegally, for their own use, should be able to. As president and chief executive of the Biotechnology Innovation Organization (BIO), which represents leading biopharmaceutical companies (such as Abbvie, Amgen, Celgene, and Gilead), he has changed his tune.
Flashback to 2001…
Congressman Greenwood, who chaired the House Commerce oversight committee, stuck up for cash strapped older Americans. Congressman Greenwood said:
“While we would like to stop dangerous drugs from being brought in for abuse and stop people from getting drugs that are counterfeit or bogus, we don’t want to interfere … with an older person getting a better buy.”
He was referring to Americans importing small quantities of non-controlled, prescription drugs for their own use because they cost a lot less money than at U.S. pharmacies.