Pharmaceutical lobbyists have spent a lot of time publishing arguments against the personal importation of prescription drugs lately. The profusion of anti-importation articles suggests that the idea is no longer being batted around as a hypothetical idea, but is being seriously considered as a solution to high US drug prices. After all, lobbyists don’t complain or advocate against things that aren’t likely to happen. The pharma lobby has a not-so-big bag of excuses it pulls out to oppose importation. The talking points are clear and well worn. It’s almost as if they keep them on slips of paper in a hat and pull one or two out whenever they feel they need to. Here’s the top five.
Safety issues (including the risk counterfeited and/or adulterated drugs) preclude importing finished pharmaceuticals from other countries. Doing so could compromise the US drug supply.
Ordering drugs from licensed pharmacies in Canada is safe. Canada has safety standards for pharmacies and pharmaceuticals which are the equivalent of those in the United States. Legitimate Canadian online pharmacies are licensed by the College of Pharmacists in the province they are located in. They have licensed pharmacists on staff who can be consulted; they also require a prescription from a medical practitioner licensed to practice in the patient’s area of residence.
Third party organizations like the Canadian International Pharmacy Association (CIPA) and Pharmacy Checker play a part in confirming the legitimacy of online pharmacies. They inspect pharmacies to make sure they not only comply with local regulations but also their own, often more stringent, regulations too.
There have been no stories of large numbers of Canadians becoming sick or dropping dead from their medications. In fact, the medications that Canadians get are the same as the products marketed in the US. They are regulated in a similar fashion to the US. Counterfeited and adulterated medications from rogue “pharmacies” are a concern but by following a few simple tips you can avoid them:
- When using an online pharmacy, always look to see if they are members of CIPA or Pharmacy Checker. If they display the badges of those organizations, go directly to the organization and confirm they are actually members. Rogue websites will often steal these badges. CIPA approved pharmacies currently have a perfect safety record.
- They must require a prescription for prescription medications. If every pharmacy you’ve visited requires a prescription for a particular medication but the one you’re currently looking at doesn’t it is a cause for concern. There are cases where a drug which may be a prescription drug in the US and is over the counter elsewhere but this is not common. Further, any pharmacy that offers to prescribe a drug for you should be avoided.
- Legitimate pharmacies will have licensed pharmacists on staff available to answer any questions you may have about the drugs your taking.
- Legitimate pharmacies are licensed by the pharmaceutical regulator in their area. For example, CanadaDrugs is licensed by the College of Pharmacists of Manitoba. Some websites are brokers and do not actually provide pharmacy services themselves. In this case the pharmacies they do business with must be licensed and provide pharmaceutical counselling services.
Prescription importation will export high US drug prices to other countries.
This one is a bit of a head scratcher. This excuse often makes it seem they want to protect the lower prices in other countries. Altruistic as that is, it is designed to make Americans think twice about ordering medications from other countries. It’s something like this: Americans are kind people and would not want to do anything that would put people in other countries in the same position they are when it comes to high drug prices. Pharma lobbyists argue importation would rapidly deplete stocks of drugs in places like Canada. Plus drug companies might hike prices there or delay introducing new products as a sort of retaliation for providing a work around to high US drug prices.
The problem is that the argument assumes Canada would become the pharmacy of the US. This is unlikely. Considering the majority of Americans take one or more prescription drugs, only a small proportion of Americans ever make use of importation. For most people they have coverage through their health insurance or government coverage to make personal importation financially unnecessary. Importation is a safety valve for those whose personal circumstances mean their prescription drug costs can be helped by ordering from Canada.
Prescription importation will affect new drug research and development.
This is one of the most cited excuses. Pharma says that allowing prescription importation will cause R&D funds to be reduced as there won’t be as much money coming in to fund it. It’s an assertion that was recently debunked by Health Affairs. The top 15 pharmaceutical firms combined raked in over $500 billion in revenue in 2016. They spent 17% of that revenue on R&D while spending 26% on sales and marketing.
You don’t pay the full amount anyways. The majority is covered by insurance/the government.
This is a straw man that easily blows down. Insurance companies and governments do not have money of their own; they must get it from somewhere. That “somewhere” is your pocket. Insurance companies make money by charging premiums, copays and coinsurance. Governments cover their expenses through taxes and debt (which must be serviced by more taxes). Many government medical programs (like Medicare) also charge premiums and copays on their services. So you pay several times, through copays, premiums and taxes.
As drug prices rise insurance have to find a way to compensate for increased costs. They are not endless wells. To compensate for their higher costs they will charge their customers higher premiums and copays. People who use personal prescription importation often do so because they find that online prices for their medications is lower than their premiums and copays.
Importation will import government prices controls.
Drug prices in Canada are a combination of government regulation and mass negotiation. It’s negotiation that provides the true savings. Provinces band together in massive buying groups that ensure they get the best possible deal from drug companies. US States and the federal government could band together in the same way to negotiate savings, but they do not. It’s unlikely that allowing personal prescription importation would do much to lower prices in the US as long as insurance companies and the government continue to pay for them. And it’s very unlikely that Congress, having opened prescription importation to the public, would then proceed to mass price controls.
Allowing personal prescription importation IS the alternative to mass price controls. People are angry about high drug prices. Many people are clamoring for the government to exercise patent march-in rights and start manufacturing and selling prescription drugs at lower prices. This would amount to price controls far than importation would. Importation is a free enterprise idea.
So there are five of the most common pharma anti-importation talking points. They will likely be walked out numerous times in the months ahead as healthcare undergoes big changes. You can add your voice to the growing chorus of people demanding change. You can add your voice by joining the Campaign for Personal Prescription Importation.