The Green Mountain State's legislature became the first in the nation to approve bulk importation of cheaper prescription drugs from Canada. PhRMA calls the bill 'highly irresponsible.'
The Vermont House on Tuesday overwhelmingly passed landmark legislation to allow for the importation of prescription drugs from neighboring Canada.
The bill, S.175, passed the House 141-2 on Tuesday, a day after its unanimous approval in the Senate, and now heads to Republican Gov. Philip Scott.
No one answered the phone at Gov. Scott's office, so it's not clear if he intends to sign the legislation. Local media are reporting that Scott has not said if he approves of the bill, which his administration has suggested could create problems with the federal government.
It is against federal law for individuals to import drugs from Canada, but states have been mulling the issue for years.
President Donald Trump, during the campaign, said addressing high drug prices would be a priority of his administration. However, he appointed Health and Human Services Secretary Alex Azar, the former president of Eli Lilly, who has raised concerns that drug importation could jeopardize public health.
The drug industry has opposed efforts to import drugs from Canada, but they claim to based their opposition on public safety and quality issues related to online purchases, factors that have been largely debunked by independent analyses.
Pharmaceutical Research and Manufacturers of America (PhRMA) Director of Public Affairs Caitlin A. Carroll blasted the legislation.
"Patient safety must be our top priority, and our public policies should reinforce – not undermine – that commitment," Carroll said. "It is highly irresponsible for Vermont legislators to promote an importation scheme that would create more avenues for counterfeit drugs to enter the country in the middle of an unprecedented opioid crisis."
Carroll said Vermont lawmakers cannot guarantee the authenticity and safety of imported prescription drugs that bypass the FDA approval process, and that the Canadian government does not inspect drugs shipped to this country.
"The burden of combating illicit drugs would fall on local law enforcement officials, who lack the capacity to inspect even a small percentage of increased counterfeit drugs, but who have witnessed their impact in communities across the state," she said.
Vermont Senate President Pro Tem Tim Ashe said the state felt compelled to act in the face of rising, unchecked prescription drug price increases.
“It is outrageous that a commonly used medicine like Lipitor costs 46-times more per pill in the United States than in Canada," Ashe said. "In fact, legislative staff determined that importing just two diabetes drugs from Canada would save the state’s teacher health insurance plan more than $500,000 each year."
The bill is based on the National Academy for State Health Policy's model importation legislation that creates a wholesale importation program to purchase high-cost drugs through authorized wholesalers. The wholesalers will purchase the drugs in Canada and make them available to Vermonters through an existing supply chain that includes local pharmacies.
Across the nation, nine legislatures introduced drug importation bills this year. Utah's legislature asked the governor to develop a proposal similar to Vermont's so the legislature could re-introduce a wholesale importation bill next session.
NASHP Executive Director Trish Riley said states are getting impatient waiting for Congress to address rising drug costs.
"In the absence of federal action to control the cost of prescription drugs, states can’t wait, they need to control drug costs now for all of their citizens," Riley said. "Vermont's legislature has taken an important step in lowering prescription drug prices that we hope will serve Vermonters well and inform the federal policy debate."
The issue of high drug costs could be a factor in the upcoming mid-term elections. Despite President Trump's rhetoric, he has failed to act, and Democrats believe they can own the issue, especially if legislation such as Vermont's is challenged by the Trump administration.
Editor's note: This story was updated Wednesday, May 9, to include a comment from PhRMA.
John Commins is the news editor for HealthLeaders.