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FDA’s Misplaced Advice to Patients in CanaRx Import Warning

Last week, in a warning letter and press release, the FDA went to great lengths to demonize what appears to be an exceedingly safe personal prescription drug importation program offered by a Canadian company called CanaRx Services, Inc. I believe the agency crossed the line with bad advice to patients. In a nutshell, about 500 U.S. cities, companies, and other organizations use CanaRx to offer their employees and retirees a lower-cost international pharmacy option. The prescription medicines are mailed from licensed pharmacies in Canada, Australia and the United Kingdom to U.S. consumers. CanaRx’s programs have been in effect for almost 20 years and helped taxpayers and patients save $250 million, according to the company.

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Nocturnal Reflections on Trump’s Blurry Overtures on Drug Prices

Night owl drug prices

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!

Jamie Love from Knowledge Ecology International’s comment on Trump’s Medicare Part B proposal is caustic yet correct in describing the Trump administration’s policy and general approach:

“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?

Not me. Am I dreaming?

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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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