The History of Personal Importation Bills

Americans pay more for prescription medicine than any other people in the world. Over the last decade alone, prices for insulin have tripled. In fact, retail prescription medicines have experienced a double-digit price increase in the last three years alone. This has put many patients in a difficult financial situation. Some of whom have to choose between paying their mortgages and buying critical prescription medicine.

Many citizens especially seniors on a fixed income find it hard to keep up with the ever-rising pharmaceutical costs. If the efforts to allow for the importation of prescription drugs sail through, people may finally get a price break.

Our Northern Neighbors

Canadians are used to paying higher prices for a majority of identical products sold in the US. But there are many reasons why these goods are more expensive in Canada than in the US. The lower purchasing power, higher cost of doing business, and tariffs are some of the reasons. Ironically, prescription drugs don’t follow this pattern. US citizens pay way more for prescription medicine than their northern counterparts. For instance, in Canada, a 90-day supply of Celebrex (an anti-inflammatory medication) cost about $220. The same drug cost more than $1000 in the US. This disparity is not unique.

The prices charged for drugs in Canada and other high-income countries are usually 50% less than what the US patients pay. Not surprisingly, the US consumers are dissatisfied with this inequality. That is why millions of Americans are already buying their prescription drugs from international prescription referral services.

Efforts to Normalize Prices Through Importation Bills

While we have made significant progress in developing novel drugs, access to medication for treating chronic conditions such as cancer remain prohibitively expensive. This becomes a bigger problem when patients have to depend on these drugs for the rest of their lives.

Despite heavy spending by the government on medical research, Americans still pay much higher for medication when compared with other nations including the UK, where the government has more say on prices for medicine. A study commissioned by the National Institutes of Health and the Department of Defense found out that a prostate cancer drug costs two times more in the US than in Canada and Japan.

The current pricing system is a result of intensive lobbying by the pharmaceutical industry. Pharma corporations, most of whom are famous for being top spenders on campaigns, contributed to the sail-through of the Bayh-Dole Act, a pro-corporate law that allows the government to surrender the results of government-funded medical research to for-profit patenting.

The 2003 Medicare Modernization Act prohibits the government from negotiating with pharmaceutical companies for fair pricing. Instead, the law left the negotiation to large private insurance firms. In other countries such as UK and Canada, with complex healthcare systems as the US, the government plays a major role in drug pricing.

With that being said, there have been several efforts to lower cost through personal importation of prescription drugs. At the national level, the Medicare Modernization Act (passed in 2003) included a provision that allowed importation of medicines if they are safe and inexpensive. However, this is yet to be implemented; several legislative attempts to implement this have stalled.

While the legislative attempt to allow drug importation did not gain significant traction at federal or state level, there has been widening concern about costly prescription drugs.

In recent years, several legislators have proposed changes to the drug importation act to allow individuals and drug suppliers to import medicine from Canada and other developed countries.

During the early years of President Obama’s term in office, Senators Olympia Snowe (R-ME) and Byron Dorgan (D-N.D.) introduced a bipartisan legislation that allowed consumers to import low cost, FDA-approved drugs from other countries with similar health system as the US. Both Sen. John McCain and President-Elect Obama supported the Dorgan-Snowe bill. The bill would have saved Americans up to $50 for the next ten years.

In early 2017, members of both the Senate and the House took a stab at resolving high drug prices through the Affordable and Safe Prescription Drug Importation Act. Several senators who included Bernie Sanders, Bob Casey, Angus King, Martin Heinrich, Cory Booker alongside Representatives Lloyd Doggett and Elijah Cummings drum up support for the removal restrictions that prohibit individuals, pharmacies, and wholesalers from importing drugs from Canada. While supporting the bill, the legislators cited President Trump’s commitment to bringing down the cost of drugs.

To support the bill, Senator Sanders cited a survey by the Commonwealth Fund that shows that 20% of Americans aged 19 – 64 years do not fill a prescription because of prohibitive cost.

With over 19 million Americans already importing prescription drugs for price reasons, it’s a clear sign of citizens’ support of the bill. A poll shows that 70% of Americans support the legalization of drug importation.

Some states are already pushing for federal intervention to resolve the ever-climbing prescription medicine prices. For instance, Utah is already considering importing cheaper prescription drugs from Canada. Other states such as West Virginia, Vermont and Oklahoma are following similar paths.

Early in the year, the Trump administration release a 30-page memo on drug pricing, but it seems the federal governments have been slow in acting on the issue.

The Challenge

With much support from the public, the importation bill has become a powerful political proposal. After all, drug pricing system itself is a product of political mess. However, the big pharma lobbyists are trying to put roadblocks on the progress towards importation of cheaper drugs. Already, the final version of the opioid bill seek to grant FDA new powers to curb drug imports, and it also contains a provision that prevents citizens who are just trying to access cheaper and much-needed prescription drugs from other countries.

One contention about drug importation has been safety concerns. In a letter to Congress, four past FDA commissioners argued that the drug purchases from overseas might be unsafe, substandard, or fake. However, this is a well-honed pharma industry scare tactic usually used to taint imports. A bipartisan 2016 report by the Senate Special Committee on Aging revealed that drug-safety standards in the US and Canada were quite similar. The equivalent of FDA, Health Canada, carries out strict inspections and applies the World Health Organization’s standards to ensure the safety of drugs.