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Drug Importation Front and Center in 2019

Personal Drug Importation

In the first two weeks of January, the prospects for drug importation to help alleviate high drug prices in the U.S. are looking good. Before summarizing recent developments, I’ll just note that millions of Americans who can’t afford medicines and want to save money continue to use personal drug importation, despite the federal prohibitions. This includes physically traveling across the border to buy from Canadian or Mexican pharmacies, through international air travel, and ordering from international online pharmacies.

Last week, Lucia Mueller blogged about an important survey by the Campaign for Personal Prescription Importation in which 94% of respondents affirmed that cost is the #1 reason they rely on importation through international online pharmacies.

This week, the Philadelphia Inquirer reported on Americans with Medicare falling through the cracks on drugs dropped from formularies, particularly when they are prescribed off-label, facing high costs and looking internationally for relief. As reported, savings are even greater when Americans buy generic versions overseas, of drugs that are still under patent domestically.

There’s a lot of buzz in Congress, states, and the White House on the issue of drug importation right now. Hopefully, current laws will be amended this year to make importation expressly permitted instead of merely tolerated.

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HHS and FDA Drug Importation Idea: Important Takeaways

Alex Azar, Eli Lilly

Azar is proposing a discussion about allowing imports of single-source drugs to lower costs

Yesterday, Health and Human Services Secretary Alex Azar announced that he was tasking FDA Commissioner Scott Gottlieb with forming a working group to explore how drug importation could be used to lower prices. See Gottlieb’s remarks on the proposal.

The crux of the proposal is very narrow. Azar is considering allowing imports of foreign versions of off-patent medicines that only one manufacturer (also referred to as “single-source” drugs) is selling in the U.S. market. That would be a drug without any competition where the company with the marketing license jacks the price. Keep in mind that he has simply called for a working group to discuss it.

I’m getting asked a lot of questions about this proposal and realize that many people, including well-informed journalists and policy professionals, don’t really get this.

People who already import medicines, through buying them online or carrying them home from Canada to save money may also be confused!

So, to help any and all understand what HHS and the FDA are considering when it comes to drug importation, below are some important takeaways. My general take, as noted in the Washington Post, is that it’s a step in the right direction (if it goes forward), and it could help educate the public about greater potential benefits to larger scale importation.

  • This is not legalizing buying cheaper, FDA-approved meds from retail pharmacies in Canada online or otherwise.
  • Millions of Americans already benefit from importing lower-cost, safe and effective medicines for personal use. They do this despite the existing federal prohibitions and scare tactics employed by industry-funded groups to deter such purchases. To do so safely, they stick to credentialed online pharmacies, such as those verified by PharmacyChecker.com. Today, Roger Bate, who is affiliated with the American Enterprise Institute, wrote: “All the FDA has to do is allow Pharmacy Checker to do its job and tell the American people about it.”

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How are Americans importing more affordable medications?

online pharmacyIt’s widely known that Americans buy medications from Canada and other countries because the prices are much lower. What many people do not know is how people are doing this.

Even our foremost scholars on the issue of U.S. pharmaceutical prices don’t know. In an article published in the prestigious British Medical Journal (BMJ), readers are informed that:

“A modest proportion of U.S. citizens travel to Canada and Mexico to purchase lower priced prescription drugs.23

That footnote – 23 – links to a 2016 Kaiser Family Foundation Health Survey, which includes the question:

“Have you or another family member living in your household ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price, or not?”

Eight percent of respondents said that they had, which is about 20 million Americans, but the survey did not ask how they did it.

The data is far from perfect. I looked at several data sources when I wrote a report in 2015 called Online Pharmacies, Personal Drug Importation and Public Health.  In one analysis of an FDA survey in 2012, I estimated that about six million Americans were purchasing medication from outside the U.S. over the Internet. I believe that figure is somewhat inflated. (more…)

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