President Trump’s new plan to import cheaper drugs from Canada seems like a no-brainer. But like most things in health care, it’s complicated.
The logic is simple enough: Canadians buy the same drugs, made by the same manufacturers, but they get them at a much cheaper cost. So, says Trump, let’s take their drugs.
It’s also wildly popular: 80% of Americans said in a recent survey they support importing prescription drugs, making the idea one of the most well-liked drug pricing proposals currently being considered in Washington.
But the questions abound: Can Trump do this under existing law? Can Canada keep up with American demand? And can Trump get such an ambitious plan across the finish line before the 2020 election?
And then there’s the biggest concern of all: Is the Trump administration opening Americans up to dangerous, even deadly, counterfeit drugs?
Below STAT walks through everything you need to know about President Trump’s drug pricing plan, and how it’s likely to impact your budget.
What drugs will be imported?
Not the most expensive ones, quite frankly. Existing law prevents the importation of biologic drugs, which are new, high-tech drugs made from living organisms and which often carry seven- or eight-figure price tags. Insulin, too, which costs roughly 10 times more in the U.S. than it does in Canada, couldn’t be imported under the main part of the new plan.
Under a separate part of the plan, drug makers could bring in cheaper, foreign versions of their own drugs — including biologics and insulin — but they’d have to do that voluntarily — meaning, it wouldn’t be up to the state or a pharmacy. And it isn’t clear that there’s much of an incentive for drug makers to use this pathway.
So will this plan actually save me money?
Assuming you’re in a state that participates, yes. Most drugs are cheaper in Canada than in the U.S. For example, the high cholesterol medicine Crestor costs roughly $40 for a month’s supply in Canada, versus nearly $300 in the U.S.
The Congressional Budget Office estimated a similar proposal from Sen. Bernie Sanders (I-Vt.) would save the government roughly $7 billion over 10 years.
Who can import drugs under Trump’s plan?
Pharmacies, wholesalers, and states could all import drugs under the plan, so long as they meet the Trump administration’s requirements, such as having the ability to track drugs throughout the supply chain, and reporting any patient adverse events. Drug makers, too, could bring in versions of their drugs made in international factories.
The new proposal says nothing about patients importing drugs themselves, either by crossing the border, buying drugs online, or using one of the many storefront shops around the country that help customers import drugs. Personal importation, as it’s often called, is technically illegal, but there are exceptions. For example, consumers can import a drug that treats a serious condition but isn’t sold in the U.S.
When will the drugs from Canada start rolling in?
A long time from now. Trump is proposing a regulatory proposal to start a pilot program. In plain English, that means the administration needs to issue a proposed regulation, give the public at least a month or more to comment formally on it, and then finalize the regulation. Only after all that will it start reviewing proposals for states that want to try importing — as long as states and others have started to submit them by then.
Health and Human Services declined to provide a specific timeline for implementation. “The FDA remains committed to advancing these policies as quickly as possible,” an HHS spokesperson wrote in a statement. “We expect to have additional announcements in the coming months.”
And the states, too, have to take the time to write their proposals. The first state to express interest in importing drugs, Vermont, has been working on its proposal for more than a year, and has blown through its previous pledge to submit a plan to the federal government by July 1, 2019. Florida, which recently passed a law directing the state government to come up with an importation plan, is planning to submit its own by July 2020.
This all means that it’s unlikely any importation plans will be ready before the 2020 election. If Trump loses, that’ll throw an even bigger wrench in the project.
Date: August 06, 2019