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Trump Administration's Prescription Drug Importation Plan Is Likely To Face Challenges

Jul 31, 2019
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The Trump administration's launching a process that could eventually allow lower-cost prescription drugs to be imported to the U.S. from other countries, including Canada. This comes as there's intense bipartisan focus on lowering the cost of prescription drugs. NPR White House correspondent Tamara Keith reports.

TAMARA KEITH, BYLINE: Don't expect to go to your pharmacy tomorrow and pick up cheap Canadian drugs. What the Department of Health and Human Services announced today is a plan to begin a lengthy rule-making process that could eventually see some pilot projects get the go-ahead. Or, as HHS Secretary Alex Azar put it in an interview on MSNBC, it's an alert to interested parties that there's a new historic open-mindedness.

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ALEX AZAR: So that they could start thinking about how they would plan for this because we want to see those plans right away as soon as the regs are ready.

KEITH: There's been a law on the books for more than 15 years that made importation possible, says Bill Pierce, who was at HHS during the George W. Bush administration.

BILL PIERCE: The law allowed for drug importation. However, it could only happen if the HHS secretary certified it as safe and that it would provide significant savings.

KEITH: But through three administrations, no HHS secretary has made such a certification. And earlier in his tenure, Azar even called the idea of importing cheaper drugs from other countries a gimmick.

RACHEL SACHS: So the fact that he has now stated his intention to encourage its use is a big change for him.

KEITH: Rachel Sachs is an associate professor of law at Washington University in St. Louis who specializes in prescription drugs. Sachs says the Trump administration has made a lot of big announcements like the one today, but there isn't much to show for it.

SACHS: They've already abandoned two of them, and the third is still in the really early stages of being proposed. So they haven't yet implemented anything that would be particularly beneficial for patients.

KEITH: When it comes to prescription drugs, the politics are a lot simpler than the policy. Voters frequently list drug prices as a top concern. Just this past weekend, Democratic presidential candidate Bernie Sanders took a busload of people to Canada to buy insulin.

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BERNIE SANDERS: People here are paying one-tenth of the price for the vitally important drug they need to stay alive.

KEITH: A Kaiser Family Foundation poll from earlier this year found 80% of those surveyed think Americans should be allowed to buy drugs imported from Canada. But Pierce says importing drugs on a large scale is a lot more challenging than it sounds. U.S. drugs are carefully tracked from manufacturer to the pharmacy counter. But drugs not originally destined for the U.S. don't have the same supply chain control.

PIERCE: Even though we trust the Canadians, we like the Canadians, we can't say that. The FDA can't tell the HHS secretary, I know where that pill's been.

KEITH: Which could also open up concerns about counterfeit drugs. And Pierce says there's another issue.

PIERCE: The Canadian government's not that interested in helping us in any way, shape or form on this because their drug supply's limited. It's specific to Canada.

KEITH: The drug industry lobbying group PhRMA raised many of these same concerns in a statement, saying this importation scheme is far too dangerous for American patients. And in the past, the industry's objections have proven potent.

Another shortcoming critics point out - the administration's planned proposal won't cover the class of drugs that includes insulin, the diabetes drug that has focused the public's attention on the high price of prescription drugs.

Tamara Keith, NPR News.

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