October 14, 2019
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Maine takes step toward allowing Canadian prescription drug imports

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Senate President Troy Jackson, D-Allagash.

AUGUSTA, Maine — The Maine Senate unanimously advanced a package of bills on Tuesday aimed at reducing prescription drug prices, including a Canadian drug importation program modeled on a first-in-the-nation Vermont law that would need federal approval.

The legislative push is led by Senate President Troy Jackson, D-Allagash, and endorsed by AARP Maine. It looks to lower drug prices in the nation’s oldest state by median age, where people have often made bus trips to neighboring Canada for access to price-controlled prescription drugs that have been the subject of action in Maine over the past decade.

Four related bills passed the Senate unanimously on Tuesday and face further action in both chambers. They would begin a Canadian drug importation program subject to federal approval, hold pharmacy benefit managers to higher standards, create a board to set drug price targets for public entities, and require more data on costs of drug production, marketing and prices.

The U.S. spends more money per capita on prescription drugs than any other high-income country in the world. Americans spent $1,443 per capita on prescriptions in 2016, which was roughly twice as much as other high-income countries on average, according to a study published last year in the American Medical Association’s journal.

The main reason for this is a policy of market exclusivity, which allows drug companies to set prices protected by monopoly rights for a period of time before other producers can produce lower-cost generic versions. Those versions are the nation’s main way of lowering prices.

Brand-name drugs are generally cheaper in other high-income countries, which have price controls. In Canada, a report from The Commonwealth Fund found that residents spent 66 percent of the U.S. per-capita sum on prescription drugs in 2015.

This has led to a long-standing effort in border states to access imported drugs that the U.S. government and drug companies have said cannot always be certified as safe, although Canada and other countries have equivalent safety standards. A law that allowed Maine residents to purchase Canadian drugs by mail was overturned by a federal judge in 2015.

“All we’re talking about now is Big Pharma with their greed that is making it so that the people in the United States can’t get the same prescription drugs for the same price and that is just unconscionable,” Jackson said in a floor speech.

History hangs over the new Maine effort: The importation program would follow Vermont’s 2018 move to establish a program that the National Academy for State Health Policy said could save residents between $1 million and $5 million per year, though both programs would have to be approved by the federal government.

A pharmaceutical industry group slammed Jackson to Stateline earlier this year, deriding his “rhetoric” and saying legislators are “trying to make political points with weak legislative tools.” Observers have also told Kaiser Health News that it could be difficult to win federal backing for an importation program and savings could be narrow.

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