There are few people more supportive than I am of prescription drug importation as one policy to help Americans access lower drug prices. But, since I accuse Big Pharma types and the FDA of ignoring reality about the safety of personal drug imports from licensed pharmacies in Canada and other countries, I won’t ignore reality! Canada is concerned about momentum on drug importation coming from the Trump administration and states, particularly Florida, citing its relatively small population and limited drug supplies. The answer is not to pull back on importation, but to expand the scope of countries in the supply network.
As reported in Reuters earlier this week, the Canadian Ambassador to the U.S. stated that she is “sympathetic to U.S. concerns regarding affordable prescription drugs.” On the other hand, she said, “Not only are we too small of a market, Canada cannot increase its domestic pharmaceutical drug supply to meet U.S. demand…” It’s not incredibly cynical of me to suggest that drug company lobbyists, who work internationally, have spoken with Canadian diplomats and said, “Look, we’re not going to increase your supply of far less expensive medicine just so Florida’s state importation plan can work and Trump can get a political win.”
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.
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.