Challenges lie ahead for importation champions and the future of the drug pricing fight.
This article first appeared May 18, 2018 on Kaiser Health News.
This week, Vermont passed a first-in-the-nation law that would facilitate the state’s importation of prescription drugs wholesale from Canada. It represents the state’s effort to tackle head-on the issue of constantly climbing drug prices.
Other states, including Louisiana and Utah, have debated similar legislation and are watching Vermont’s progress closely.
After all, the issue of drug importation polls well across the political spectrum and has been endorsed by politicians ranging from candidate Donald Trump, before he became president, to liberal firebrand Sen. Bernie Sanders (I-Vt.).
So how much impact might a state law like this actually have?
Trump has since stepped back from his campaign position, and the White House did not include drug importation in its proposal last week to bring down drug prices.
And cautions abound that importation may not actually save that much money as questions swirl about whether the policy undermines drug safety standards.
Kaiser Health News breaks down the challenges that lie ahead for importation champions, and what it shows about the future of the drug pricing fight.
States need federal approval to launch any kind of importation program.
Just having a law like Vermont’s on the books is not enough to legalize importation. The next step is for the state to craft a proposal outlining how its initiative would save money without jeopardizing public health. The proposal, in turn, is then subject to approval by the federal Department of Health and Human Services.
HHS has had yea-or-nay power over state importation programs since at least 2003, because of a provision included in the law creating Medicare Part D. But it’s never actually approved such a plan. And — despite mounting political pressure — there’s little reason to think it will do so now.
In the past weeks, HHS Secretary Alex Azar has come out strongly against importation, calling it a “gimmick” that wouldn’t meaningfully bring down prices.
He also has argued that the U.S. government cannot adequately certify the safety of imported drugs.
HHS declined to comment beyond Azar’s public remarks.
Importation backers — including the National Academy for State Health Policy (NASHP), which helped craft Vermont’s bill and has worked with state lawmakers — hope he’ll reverse these positions. But few are optimistic that this will happen.
Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.