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Top Economist Says the FDA Should be Identifying Safe Foreign Pharmacies to Solve High Drug Prices in America

Economics

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.  

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Omnibus Bill Empowers FDA to Confiscate Imported Drugs

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…)

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2019 Budget Bill Bumps up Part D Discounts by One Year

Celebrate Part D donut holeDue to a little provision in the 2019 budget bill passed by Congress today, fewer Medicare enrollees may need to look online to international pharmacies for lower costs. That’s because the Part D discounts mandated under Obamacare are being phased in a year earlier. These are discounts provided to enrollees who fall into the Medicare Part D coverage gap “the “donut hole”.

Without the new provision, people in the donut hole would be responsible for around 50% of the cost of their medication until 2020, when they would only need to cover 30%. Now they will only need to cover 30% in 2019 – a year early.

This is a small win but perhaps it was a consolation prize. Regardless, some drug price relief is always welcome. It’s the drug companies who are forced to cover these discounts so they’re probably none too happy about this. On the other hand, maybe there was a backroom deal. The Creating and Restoring Equal Access to Equivalent Samples Act (CREATES), which would have helped lower-cost generics come to market faster, was slated to be a part of this bill. CREATES had massive support from groups on the left and the right, but it was knocked out of the final bill.

I’m glad that older Americans get a small discount next year on prescription drugs, but I have the feeling we got thrown a bone.

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Alex Azar is the Wrong Pick to Lead HHS

Last month, I published an op-ed in The Guardian in opposition to Alex Azar for Secretary of Health and Human Services. In advance of the Senate Finance Committee Hearing tomorrow over his nomination, I’m publishing my article in its entirety below. 

Recently, the president announced Alex Azar as his nominee to lead the US Department of Health and Human Services, saying: “He will be a star for better healthcare and lower drug prices!” People like me – experts in drug policy and advocates for lowering drug costs for American patients – know that nothing could be farther from the truth.

On average, Americans pay twice as much for life-saving drugs as consumers in other developed countries. It doesn’t have to be this way, but unfortunately, Azar might think so.

On Wednesday, Azar appeared before the Senate Health, Education, Labor and Pensions committee. While he stated his commitment to lowering drug prices, he declined to support the two solutions that would have the greatest impact on patients. In fact, he and his company have vigorously opposed policies that would make healthcare more affordable for the rest of us. (more…)

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Eli Lilly’s and Alex Azar’s Position on Importation is a Canard

Alex AzarThis 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…)

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PhRMA Targets PharmacyChecker on Google Ads

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).

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