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Medicine United States Businesses Canada

Trump Administration Plans To Allow Imports Of Some Prescription Drugs From Canada (npr.org) 267

The Trump administration is outlining two possible ways certain drugs that were intended for foreign markets could be imported to the U.S. -- a move that would clear the way to import some prescription drugs from Canada. From a report: "Today's announcement outlines the pathways the Administration intends to explore to allow safe importation of certain prescription drugs to lower prices and reduce out of pocket costs for American patients," Health and Human Services Secretary Alex Azar said in a statement about the plan. "This is the next important step in the Administration's work to end foreign freeloading and put American patients first." The Department of Health and Human Services outlined two "pathways" for importing the drugs to the U.S.

In one initiative, the Food and Drug Administration and HHS will rely on their rulemaking authority to use existing federal law to set up pilot projects from states or wholesalers "outlining how they would import certain drugs from Canada that are versions of FDA-approved drugs that are manufactured consistent with the FDA approval." Separately, the FDA will work on safety guidelines for drug manufacturers who want to import any drugs they sell in foreign countries to the U.S. market.

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Trump Administration Plans To Allow Imports Of Some Prescription Drugs From Canada

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  • Great move (Score:5, Insightful)

    by nospam007 ( 722110 ) * on Wednesday July 31, 2019 @02:52PM (#59018970)

    'Allowing' something that people are already doing anyway because they don't want to die?

    • Re: (Score:2, Troll)

      by jwhyche ( 6192 )

      Yeah, so they don't go to prison or whatever happens if you get caught smuggling prescription drugs in to the country.

      Oh wait, I forgot, "Trump badddd .... Trump Badd......"

      • Re: (Score:2, Flamebait)

        by jellomizer ( 103300 )

        Remember a broken clock is right twice a day.

        It is possible for someone you find morally detestable to actually do something that seems like a good and decent idea.

      • Re: (Score:2, Insightful)

        by gtall ( 79522 )

        As always with Trump, watch out for the fine print. There's a money making scheme for he and his grifter family in there somewhere.

      • by Dunbal ( 464142 ) *
        Pretty sure people are allowed a small quantity for personal use. Worst that can happen is they confiscate it and give you a fine. Smuggling usually involves commercial quantities. Insulin is not usually a "controlled substance" that gets you jail time.
        • Pretty sure people are allowed a small quantity for personal use. Worst that can happen is they confiscate it and give you a fine. Smuggling usually involves commercial quantities. Insulin is not usually a "controlled substance" that gets you jail time.

          It's always been 6 months worth of prescription drugs for your own use. Why don't you dummies know your own rights? Oh, right, you managed to elect the driver of the clown car as your leader. Just as stupid as the UK and Brexit. I guess this is how the Anglo-American empire ends. Maybe time to learn some mandarin ...

          • by Dunbal ( 464142 ) *
            Heh, I live in Costa Rica and here it's 30 months, and anything controlled (opioids, benzos, etc) requires a copy of a prescription from a doctor. I know my rights. Just not the situation between USA and Canada.
      • If you have a prescription you can bring 6 months supply over the border. If you don't, see a Canadian doctor, get your prescription, bring 6 months supply over the border.

        There may be exceptions for certain drugs, but for most, a copy of your prescription is all it takes.

        There's been some rumbling around the idea of rolling back patent protection to 17 years. The drug companies gave the Canadian government certain commitments in return for it being extended to 20 years, but never lived up to their end

      • Yeah, so they don't go to prison or whatever happens if you get caught smuggling prescription drugs in to the country.

        Oh wait, I forgot, "Trump badddd .... Trump Badd......"

        This precisely is the direct benefit to the consumer. On a broader scale, this means drug companies may not be able to rely on huge markups they enjoy today due to the limited competition. To those who voted this "troll", shame on you.

        • by jwhyche ( 6192 )

          Don't sweat it. One of the benefits of literally having karma go burn. It also just goes to prove my point that even when Trump does something good, they are people so blinded by TDS that they refuse to admit it.

    • by lgw ( 121541 )

      'Allowing' something that people are already doing anyway because they don't want to die?

      Sounds like a good thing to me, in general.

      What I find baffling about this is: isn't the price difference because of IP law? Effectively the same drugs as you get in the US, but cheaper because of patent costs? Couldn't a president instead just ... fix the patent law in the US?

      OK, maybe is does make sense as Trump has the power to do this and not that, but it's still a sign that our government is fundamentally broken in some way. Don't get me wrong, I'm generally suportive of drug research being highly p

      • by I75BJC ( 4590021 )
        Patent Law is fixable by the US Congress (passing a bill). The POTUS can't do this by himself. Obamacare made sweetheart deals for supporters of Obama -- a la, the EpiPen. US FDA requires a lot more testing and a higher standard than other Western/First World nations. The USA pays that extra cost. The rise of Rx costs is, regrettably, complex and complicated. Too bad, the POTUS can't fix it with the swipe of his pen. (I would like cheaper and more plenteous RXs.)
        • The epipen is not needed. Kids have been taught to self inject insulin long before insulin pens were available. Some first responders have shifted to prefilled syringes- huge cost savings.

          You can also convert an insulin pen into an epinephrine injector and a used insulin cartridge into an epinephrine cartridge. Just make sure you remove all traces of insulin from the cartridge (boiling the cartridge and the rubber stopper works, and sterilizes everything).

      • by Cyberax ( 705495 )
        Patents for most prescription drugs have expired long ago.
      • Re:Great move (Score:5, Insightful)

        by jeff4747 ( 256583 ) on Wednesday July 31, 2019 @03:46PM (#59019404)

        What I find baffling about this is: isn't the price difference because of IP law?

        No, the price difference is due to Canada negotiating prices with drug manufacturers. With so many potential patients, they've got a decent negotiating position.

        The closest US equivalent in terms of patients (Medicare) is legally forbidden to negotiate drug prices. Private insurance plans are too small to have much leverage in negotiations.

        So the drug companies do the capitalist thing and charge a lot more in the US.

        • by MobyDisk ( 75490 )

          I hear this story over and over and it sounds like the kind of thing that just gets repeated so often is is assumed to be true. I just looked this up, and two government watchdogs claim that the government negotiating [crfb.org] for drug prices does not reduce the prices. [marketwatch.com] That second link claims that the rule preventing the negotiations is because it is economically more efficient to have the individual insurers negotiating the prices.

          (Excerpt from the second link above)

          ...the Congressional Budget Office concluded that they would have a negligible effect on public spending, because the agency judged that the government would be unlikely to get a better deal than the private plans.

          This seems consistent with macro-economics

          • Re:Great move (Score:5, Informative)

            by ljw1004 ( 764174 ) on Wednesday July 31, 2019 @05:09PM (#59019936)

            I'm also trying to understand how the government would make such negotiations. If a company owns the patent to a drug, and there is no alternative, then how is there a negotiation? Would the Canadian government really say "Canadians won't have heart medication this year, because we wanted the drug to be cheaper!" That seems unlikely.

            Yes, that's exactly how it works in the UK. The government says "You the drug company are asking us to spend $50k to get six additional quality-of-life-adjusted months per patient. The second-best medication costs $2k to get four additional months. We judge your medication to be not worth it, and we'll instead only be offering the second-best medication on the NHS."

            It's exactly as your link says. "...estimates that giving the Secretary authority only to negotiate prices will not generate significant savings unless the Secretary can also remove certain drugs from coverage or otherwise legally require reductions in prices." Your second link repeats this.

            So yes, if you give government the power to negotiate prices (with teeth), then you do indeed get cheaper medicine.

            • All the governments that negotiated prices for drugs for their universal health care plans pay less than the USA . Canada pays far higher costs than the other countries because of the relatively small population. -And it's still less than the USA.

              The lobbyists for the drug makers and insurance industries are divide-and-conquer pricing the USA rather than the government going single payer health care and using the bulk purchasing power to the citizens benefit.

              You want the benefit of single payer prices,

          • Re:Great move (Score:5, Informative)

            by jeff4747 ( 256583 ) on Wednesday July 31, 2019 @05:21PM (#59020018)

            You forgot a very important thing when claiming negotiation can't lower prices:

            The Congressional Budget Office (CBO) estimates that giving the Secretary authority only to negotiate prices will not generate significant savings unless the Secretary can also remove certain drugs from coverage or otherwise legally require reductions in prices.

            Those links assume the government can't refuse to cover a drug. Which means they assume the government isn't actually negotiating.

            The reason the drugs are cheaper elsewhere is governments do indeed say "no".

            If having a single purchaser of all goods made things that much cheaper, then we would want there to be only one grocery store.

            Retail products and medical products are inherently different. If I don't like the price for apples, I can simply not buy apples. If I don't like the price for my blood pressure medication, my alternative is dying so I still have to pay it.

            As a result, medical care in general can't be an efficient market - the purchasers do not have a realistic alternative, nor sufficient knowledge to properly evaluate the effectiveness of a particular drug/procedure.

            Also, a single grocery store could indeed negotiate the lowest prices from suppliers - see: Wal-Mart. However, if there was actually only a single grocery store, they'd probably abuse that monopoly such that their customers were worse off - see: Wal-Mart.

            I'm also trying to understand how the government would make such negotiations. If a company owns the patent to a drug, and there is no alternative, then how is there a negotiation?

            Drug maker: We wanna charge $10,000 per year.
            Government: We'll pay $100.

            If neither moves, the drug just isn't covered. Anyone who wants to buy it from the drug manufacturer at a higher price can still get it, but that's a much, much smaller pool of people compared to all covered individuals. So usually the government moves up some and the drug maker moves down some and they arrive at a price.

            They would probably choose an alternative drug. But then... isn't that something the doctor and patient should decide on a case-by-case basis?

            Guess what thing no doctor or patient ever get to decide on a case-by-case basis.

            Insurance, be it public or private, will have a formulary and rules for how doctors can prescribe. There will be rules for when a doctor can use an alternative, but usually that requires jumping through a lot of hoops (such as taking the "wrong" drug until it harms the patient) as a device to drive doctors and patients to the cheapest drugs.

            That's how it works in the US

            No, that's not at all how it works in the US. Cigna gets to decide what blood pressure drugs I can take, and require I take cheaper drugs until my doctor can document enough harmful side-effects to "move up" to a different drug. (Theoretically, I could pay retail, but the drug manufacturers really like high prices for drugs that directly keep you alive)

            Your doctor usually doesn't talk about this, because there's nothing either of you can do about it. They'll just start with prescribing the cheap drug and move on from there. Especially since it's extremely unlikely you will know anything about the effectiveness of the various options.

          • Re:Great move (Score:5, Informative)

            by tlhIngan ( 30335 ) <[ten.frow] [ta] [todhsals]> on Wednesday July 31, 2019 @05:25PM (#59020036)

            It's because of purchasing power.

            In Canada, each province negotiates with drug companies to supply drugs. Each province basically controls the drugs into it, and coverage for non-generics is very sparse. If you have a generic drug, the government will either buy it from you, or your competitor.

            In the US, it's actually pharmacies doing the buying, and the only one with any purchasing power are the chains, but even then they don't usually have a huge chunk of the population to bounce people off of.

            You have to remember it's generic drugs that are cheaper - name brands are still fairly pricey because it's a negotiation thing. In BC, there is a group called Therapeutics Initiative that tests drugs - drugs that don't provide much benefit aren't carried or prescribed. It's a clinical trial from hell - basically your drug must offer benefits to justify the cost - if you want to offer your $10,000/month drug, it better have huge benefits over a worse performing $20/month drug. If it doesn't, then the government won't likely carry it unless you drop the price significantly.

      • Canada harmonized drug patent law with the USA decades ago. As part of the agreement, drug companies have were supposed to maintain a certain level of investment. Instead, the American drug companies shifted their North American production offshore. They now supply the North American market in large part from India.

        The high cost to American consumers is because of the American insurance industry. Canadian provinces negotiate supply contracts in bulk, and soon it will be the provinces sharing price data wi

    • by hAckz0r ( 989977 )

      The last time I ordered some life saving medication, from Canada, it was actually shipped to me from a Texas warehouse. It had not even arrived in Canada yet. Ok, so I'm alive. That's great. But if I actually wanted to be cured of my disease, you can't even buy that here. The WHO says the drug indispensable, and a "must have" for their inventory. In the US its just indispensable, in that you are not permitted to stock, sell, or dispense it. No, It's not illegal, but you can't import it for sale either. Go f

    • It's a stupid move that is not going to work. All this is going to do is cause drug shortages in Canada which will lead the Canadian government to ban exports to the US to ensure there are sufficient drug supplies so that Canadians' lives are not put at risk.

      If you want to fix your insanely high drug prices do what Canada does: negotiate with the drug companies as a nation instead of letting them set their own prices. Trump keeps saying he is such an amazing negotiator and always gets the best deals so I
      • More FUD. Take the current debate on insulin. Novolin Toronto ge insulin is made by Novo Nordisk S/A of Denmark. If Americans come to Canada in hordes, that just means that Novo Nordisk will sell less to the USA and more to Canada. It's a wash for them in terms of units sold to foreign markets.

        Fix your stupid health insurance scam. Single payer has been shown for 30 years to cover all Americans for less than your current model does, or the previous one where 1/3 of the population had no coverage.

        • More FUD.....If Americans come to Canada in hordes, that just means that Novo Nordisk will sell less to the USA and more to Canada. It's a wash for them in terms of units sold to foreign markets

          I used to think so but a few years ago when I tried to get a medication my doctor had prescribed I was told it was unavailable "Canada-wide" at the moment because the drug companies had failed to supply enough. They may sell the same number of units overall but if they sell them in the US for $100 and in Canada for $5 they will make far more profit than if all the units are sold to Canada. This is why they have threatened - an apparently carried through on it - to limit the supply of medication to Canada t

      • by dryeo ( 100693 )

        Actually Canadian Provinces negotiate separately. It's why we have such expensive drugs, even if they do seem cheap compared to the States.

  • by rickb928 ( 945187 ) on Wednesday July 31, 2019 @02:54PM (#59018990) Homepage Journal

    Watch this raise prices in Canada...

    • Re:Huh (Score:5, Insightful)

      by dskoll ( 99328 ) on Wednesday July 31, 2019 @03:02PM (#59019044) Homepage

      Drug prices in Canada are regulated. What could happen is drug shortages, which is why Canada should charge export fees and/or limit the amount of drugs that can be exported.

      • Re: (Score:2, Informative)

        Drug prices in Canada are regulated.

        Drug prices in Canada are negotiated, between the government and the pharmaceutical companies.

        If the drugs are flowing back across the border, and depressing prices in America, then the companies have much less incentive to give Canadians a good deal.

        So prices in Canada will likely go up.

        This isn't entirely unreasonable. Drug companies make most of their profit in America, so Americans are paying for most pharmaceutical R&D, while Canadians get a free ride.

        • by dskoll ( 99328 )

          Some drug prices in Canada are actually regulated [pmprb-cepmb.gc.ca].

          It's not that Canadians are getting a free ride. It's that Americans are being screwed over twice, first by the pharmaceutical companies, and second by the politicians the pharmaceutical companies 0wn.

        • by ravrazor ( 69324 )
          Insulin is one of the most needed drugs in the world, after its discovery, the patent was sold to the University of Toronto for $1 by Fred Banting...most Americans would certainly be paying more for many drugs if wasn't for Canadian research, but also the Canadian opinion that drugs are worth more than just getting shareholders of some giant pharmacorp rich.
      • The insulin at the heart of this debate is made by Novo Nordisk S/A, a Danish country. If they sell more to Canada it's because they're selling less to the US., They'll just ship the stuff that was going to the USA to Canada. Same total volume of shipments.
    • Or the government will revoke the licenses of those physicians that can write prescriptions in both countries. I can only speak for my home province of Ontario, but if you want to buy a prescription drug here it has to be prescribed by a physician. You can't walk into a pharmacy and ask for a three month's supply of Crestor (cholesterol medication). And to do that you need to be a doctor licensed in Ontario to write that prescription. There are a limited number of doctors in the US who have that privile

  • by dskoll ( 99328 ) on Wednesday July 31, 2019 @03:01PM (#59019038) Homepage

    Canada should charge an export fee for drugs to the US. Make Americans pay (say) 50% of what they'd pay locally instead of 10%. That's called a win-win situation.

    • Or perhaps they could simply manufacture more pills, you know, as an alternative to choking off supply.
      • Why would the supply/pricepoint they've negotiated with suppliers be sufficient to fulfill the needs of both Canada and the United States?
        • by I75BJC ( 4590021 )
          The "Name Brand" drugs are from USA manufacturers. They are either produced worldwide in the manufacturer's factories or under contract; the IP is owned by the developer/manufacturer of the specific drug. There really aren't separate developers/manufacturers in each country. That's why the market is crazy in the USA!

          Don't worry; as you get older and are prescribed more Rxs, you will come to understand just how screwed up the situation is. The USA Federal Government (regulations and cronyism) seem to
      • by dskoll ( 99328 )

        The government regulates prices. It doesn't have the power to "simply manufacture more pills".

      • The Canadians buy the pills from the US. For the Drug Company to sell to Canada, they normally agree to the prices to align with regulations. The drug companies agree to these prices because they are still making a profit.

        In essence America has outsourced its regulation to Canada.

        • Very true. But Canada also allows more generic drugs due to differences in the patent system. Brand name drugs in Canada sell at a reduced price in order to be competitive with generic drugs. Those generic drugs are probably still illegal in the US (or at least they can not be sold) - but the brand name drugs, sold in Canada at a reduced price, will now be allowed. So drug companies are competing against themselves..

          I see people importing brand name drugs. But not any drug, there will be a focus on

  • He rants against "socialists and regulators" but then becomes one via price limits, import restrictions, tariffs, etc. GOP's spine is in Pretzelville.

    • Depends on how he does it, this is really a good move.

      Legislation is just difficult especially in high contentious issues. Here's a way to basically give the American people lower prices, while not appearing to force down a whole bunch of regulation or anything.

      Just 'open' the market.

      If American drug companies give better deals to Canada... then why can't Americans get those same deals?

      If America is not producing the generics it needs to keep prices low, then bring those generics from abroad.

      • by dryeo ( 100693 )

        We only negotiate for so many drugs. If we sell them to you, we won't have them so something will give, perhaps export bans or just refusing to write Americans large prescriptions and only honouring prescriptions written by Canadian Doctors. Possibly different Provinces will do it differently. Healthcare is a Provincial responsibility though the feds are in charge of the borders..
        You could do as we do, negotiate as a group instead of individually.

  • "the FDA will work on safety guidelines for drug manufacturers who want to import any drugs they sell in foreign countries to the U.S. market." And exactly which drug manufacturers will want to import drugs that will end up lowering their profit???
    • You have a product that cost $0.10 to make. You sell 100 units at $100.00 that is $9,990.00 profit.
      If you sell 2000 units at $10.00 that is $19,800.00 profit.

      Drug Companies have been Raping the US in prices, because each drug due to patients are a mini monopoly and being that people need some of these drugs for survival, they will pay whatever the price.

      Normally these are cases where Supply and Demand go haywire, and we need the government to go in and intervene, to set limits. The US hasn't had real leader

  • Knowing how close this administration is with (any given) industry, it's very likely that the actual regulation that gets implemented is so convoluted, slow, or expensive so as to nullify any benefit of importation from Canada.

    All this to fend off the real solution, which is a modium of price regulation on US drug companies.

    I won't say they shouldn't make a profit, just that the x,000% markups on things like insulin is literally killing people, much more than the public interest or shareholder returns.

    • by ahodgson ( 74077 )

      I seriously don't get the thing with high insulin prices. It can't be patented, so why isn't someone, anyone, making generic insulin and selling it cheap?

      • My guess: there's no incentive to compete on cost. Everyone bills it to insurance anyway, so the price is invisible to the consumer.

        For just about anything in the marketplace, follow the incentives.

      • by satsuke ( 263225 )

        But specific formulations _are_ patented or restricted.

        From what I have read, it usually boils down to either making very minor changes to the formulation, making the derivative protected, and/or industry chicanery like having the generic manufactured by the same company as the protected drug, or a pharmacitical company paying generic manufactuers _not_ to enter the market.

        e.g. on that last one, the generic drug-maker can either enter the market and drive down the cost, or get a kickback (sorry, incentive)

        • by gtall ( 79522 )

          That and there's the incest problem in the drug industry, some of those drug companies own other parts of the drug delivery chain. They've simply integrated the possibility of competition out of the market.

      • by Cyberax ( 705495 )
        Because it takes a lot of money to get an FDA certification. And if you try to wage a price war, any established company can outlast you.
      • so why isn't someone, anyone, making generic insulin and selling it cheap?

        Because you make more money selling it expensive. Just like all things where you die without it.

    • My wife's diabetic. Fortunately we have good health insurance through my job, but - the insulin price increases over the past few years (400-500% in some cases) have been ludicrous. And we're not talking about some new types of insulin... just the same short- and long-acting varieties which have been on the market for a long time.

      On a side note - the HHS statement seems somewhat bizarre. How the heck does allowing American patients to buy foreign drugs address "foreign freeloading" in any way, shape, or for

      • by sjames ( 1099 )

        What's REALLY telling is calling it "foreign freeloading". It's no more freeloading than if the only restaurant in town wants $100 for a run of the mill hamburger and I decide to buy some ground beef and make my own burger. Am I "freeloading"? How about if I point that possibility out to the restaurant and they agree to sell me the burger for $7 instead? Is THAT freeloading?

        The truth is, we have an awful lot of unhealthy markets here in the U.S.

      • Novolin Toronto and Novolin NPH: 5x300 units cartridge, $39.14 + $8.63 pharmacist professional fee = $47.77 Canadian ($36.27 USD). The price has only gone up by about $7 in 3 decades. Test strips - same price they were 30 years ago - $87.44 per hundred. Glucometer - was $500, now manufacturers give them away so you buy their brand test strips. Same with insulin pens. Pen tips $34.73 per 100, compared to $25 per hundred for syringes 3 decades ago.

        Welcome to Canada. Under US law, you can bring home 6 month

        • by dryeo ( 100693 )

          Wouldn't there also be a cost for a prescription? Or is insulin over the counter? I believe here in BC, you need a prescription from a BC licensed Doctor, so, last I checked, $38 for a Doctor visit, American cash at likely at par.

  • by kbahey ( 102895 ) on Wednesday July 31, 2019 @03:09PM (#59019092) Homepage

    So, "Socialized medicine" is bad if you have the policies/laws in your own country, but benefiting from socialist policies of other countries is perfectly fine (in this case government negotiates the prices with pharma companies) ...

    What next: death committees like Canada does them [/sarcasm]

    • by ahodgson ( 74077 )

      Pharmaceuticals for the most part aren't part of or covered by Canada's socialized medicine.

      • by kbahey ( 102895 )

        I know they are not.

        But the point is this: the government negotiates prices with big pharma and generics manufacturers.
        The result is that drugs are affordable.
        And that is true whether you have an employer who covers them, or you are on your own.

  • American healthcare (Score:3, Interesting)

    by fluffernutter ( 1411889 ) on Wednesday July 31, 2019 @03:13PM (#59019128)
    So the master of deal making can't make a better deal than Canada so he has to allow everyone to cheat the system. How about if he fixes American healthcare?
    • by dcollins117 ( 1267462 ) on Wednesday July 31, 2019 @04:41PM (#59019746)

      How about if he fixes American healthcare?

      It's an unbelievably complex subject. Nobody knew health care could be so complicated.

  • .... to buy stuff made in the USA?

    I'm trying to understand how this fits with his "America First" philosophy.

  • This is not about importing medication from one particular country. We need the same right to import from the world market in general as we do when we import electronics.

    Trump has then opportunity to become the first Republican to support a free market in medicine.

  • The only way to get the prices down, is competition.

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