Caring about people: Trump administration issues plan to allow imports of cheaper prescription drugs

Peter Sullivan
The HIll
Wed, 31 Jul 2019 18:20 UTC

© Leah Millis / Reuters

President Donald Trump

The Trump administration on Wednesday announced a plan for allowing the importation of cheaper prescription drugs from other countries, a key step in President Trump's efforts to lower drug prices.

The Department of Health and Human Services issued a plan outlining the steps it will take, including issuing a regulation to allow for states and pharmacies to submit drug importation pilot programs for approval.

The move is preliminary and leaves several steps remaining before patients will actually get access to cheaper imported drugs, but it represents an important change in position, showing that the federal government is open to drug importation for the first time ever.

"The door was closed," Secretary of Health and Human Services Alex Azar told reporters. "What we are saying is, 'We are open. There is a pathway. We can be convinced.'"

The move is a break from what has been the more traditional Republican position opposing drug importation, warning of safety concerns.

Trump has railed against high drug prices and is eager to show signs of progress in the fight to lower costs as the 2020 election nears. Drug prices consistently poll as a top issue for voters.

The move is a change in position for Azar, who last year warned that drug importation was a "gimmick" that would not work.

Drug importation is an idea usually more associated with Democrats. Sen. Bernie Sanders (I-Vt.) has been a leading champion of the idea.

Azar said that new technologies have allowed importation to be done more safely than in the past and added that Trump, who is a major proponent of drug importation, is always "challenging" him to "find more solutions."

"He is always pushing me, challenging me to find more solutions to help the American patient," Azar said of Trump.

Azar acknowledged that there are "complex operational questions to be answered" about drug importation.

Officials did not give a timeline for when the plan would go into effect.

Azar said any proposals would be reviewed to ensure the imported drugs would be safe.

The pharmaceutical industry, a powerful force in Washington, opposes the plan, warning it is unsafe.

Comment: Unsafe for their obscene profits, that is.

"In the words of Secretary Azar just last year, drug importation is a 'gimmick' and 'the last thing we need is open borders for unsafe drugs,'" said Steve Ubl, CEO of the Pharmaceutical Research and Manufacturers of America. "Rather than surrender the safety of Americans by importing failed polices from single-payer countries, we should work on solutions here at home that would lower patient out-of-pocket costs at the pharmacy counter."

Azar said the administration did not consult them.

"We haven't spoken about this plan with the pharmaceutical industry," he said.

Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate's health committee, gave some praise to the idea, saying "I welcome it," though he cautioned that the plan would need to ensure safety.

Democratic lawmakers were largely silent on the proposal.

Comment: Trump has consistently advocated for lower drug costs.and more transparency on prices. From a year ago:

And in October 2018 President Donald Trump signed into a law bill lifting practices that prevent pharmacists from allowing them to explain to their customers how to save money on their prescription drugs.

Earlier The Hill also reported:

President Trump has long highlighted Europe's drug market, arguing that Americans in comparison pay far too much for prescription drugs.

"I've seen it for years, and I never understood," Trump said in October. "Same company, same box, same pill, made in the exact same location. And you'll go to some countries, and it would be 20 percent the cost of what we pay, and in some cases much less than that."

The president is pushing an ambitious proposal that would tie certain Medicare drug prices to lower prices in other countries.

It's a plan that has found support from across the aisle. Sen. Bernie Sanders (I-Vt.), a 2020 presidential candidate, has also compared the U.S. drug market unfavorably with Europe and has an even broader bill to lower U.S. prices in line with those in other countries.

But health industry experts caution there are critical differences between the two markets that complicate comparisons.

The United States spent $1,011 per person on drugs in 2015, according to the Commonwealth Fund, far higher than other countries. By comparison, Switzerland spent $783, the United Kingdom spent $497, and Sweden spent just $351.

"Prices are higher in the United States than in these other countries," said Rachel Sachs, a drug pricing expert at Washington University in St. Louis. "The general reason is that other countries negotiate for these prices and we really don't."

Examples abound of individual drugs costing more in the U.S. The cholesterol drug Crestor costs $86 in the United States and $20 in Norway, according to the Commonwealth Fund. The insulin drug Lantus costs $186 in the United States and $60 in Germany.

Other countries have a range of centralized government systems that negotiate in some way on drug prices and drive the prices down. They also often use systems that evaluate how effective a drug is compared to what is already on the market to determine what price is justified.

The United States largely does not have these controls.