The Trump administration this week said it would move ahead with planning to allow imports of prescription medications from Canada to lower drug costs for Americans. This is a positive — if indirect — step forward. A better solution would be to actually lower the cost of many medications sold in the U.S.
To be clear, the administration didn’t say it was allowing drug imports from Canada or other countries. Rather, Health and Human Services Secretary Alex Azar said the administration would ”explore” systems that would allow such imports. No timeline was offered for when imports could actually begin.
The department proposed two approaches — demonstration projects allowing states, drug wholesalers and pharmacies to import drugs from Canada or allowing drug makers to sell FDA-approved drugs that they currently sell in foreign countries. It did note that the second option, which essentially means that drug manufacturers would simply charge lower prices in the U.S., could lessen the need to import lower-cost drugs from Canada.
This points to the fact that importation is a long way around the simpler solution of simply lowering prices for drugs sold in the U.S. Price caps, which other countries use, or allowing major government insurance programs like Medicare to negotiate lower drug prices would be more direct solutions.
To move in that direction, all of Maine’s congressional delegation and the state Legislature are right to pursue other solutions in addition to importation.
Prescription drug costs, which have risen substantially in recent years, now account for a fifth of all health care spending in the U.S.. As a result, a quarter of Americans say they have a difficult time paying for their prescription medications and nearly one in 10 say they do not take their medication as prescribed to save money.
Earlier this year, Maine lawmakers passed a bill, sponsored by Senate President Troy Jackson, that would allow Maine to create a wholesale prescription importation program to acquire lower priced medications from Canada. Under current law, Maine would need a waiver from the federal government for such a program.
Maine lawmakers, and Gov. Janet Mills, took additional steps to lower drug prices. They enacted a law requiring additional pricing information from drug makers and pharmacy benefit managers, who negotiate drug prices with public and private insurance providers. They created a prescription drug affordability board that will set prescription drug price targets for public entities.
On the same day as the Trump administration announcement, Sen. Susan Collins spoke on the Senate floor about the need for action on drug costs. She recounted watching a couple leave a Bangor pharmacy without a prescription because they couldn’t afford the $111 co-pay. The pharmacist told her that this happened “every single day.” In recent years, her bills to increase generic drug competition and to end rules that barred pharmacists from telling customers how they can save money on prescriptions have become federal law.
Collins has also introduced measures to end patent strategies that delay similar, less expensive drugs from getting to market and to increase the transparency of prescription drug prices. Last week, she introduced legislation to combat the rising costs of insulin.
Sen. Angus King has also backed many measures to lower drug prices, including bills to allow Medicare to negotiate lower drug prices, to allow importation of lower-cost medications from other countries and to rein in drug advertising.
“The cost of prescription drugs is simply too high for too many Maine people, so we need to explore any and every possible solution that will provide real relief in a responsible way,” King told the BDN.
When she was a member of the Maine Senate, 1st District Rep. Chellie Pingree accompanied seniors on bus trips to Canada to purchase medications and she sponsored legislation creating the Maine Rx program, which sought to lower prices through rebates from drug makers. Drug manufacturers challenged the program in court, but it was mostly upheld by the U.S. Supreme Court ruling in 2003.
“The Trump administration is right to take this important step and I’m grateful to have this area of agreement,” Pingree told the Bangor Daily News about this week’s importation announcement.
Rep. Jared Golden, from Maine’s 2nd District, has introduced a bill that would penalize drug companies that raise prices by more than 10 percent within one year or more than 25 percent within three years. It would also speed up access to generic medications. He also supports the importation bill and a Medicare price negotiation bill.
“We have to attack skyrocketing drug costs to make healthcare more affordable for working Maine people,” Golden said in a press release.
With so much attention on prescription drug prices, we are cautiously optimistic that changes will be made. To be most effective, such changes should focus directly on lowering costs for Americans, not on devising ways around high drug prices.