This guest post was submitted by state Rep. Karen Rohr (R-Mandan) and Rep. Lisa Meier (R-Bismarck).
As prescription drugs become an ever more important aspect of modern medicine, leaders of all political stripes are increasingly concerned about the out-of-pocket cost of prescription drugs, especially for seniors. Some of these suggestions, like passing most of the discount an insurer negotiates with a drug manufacturer directly to patients at the pharmacy counter, make a lot of sense and would help the sickest and most vulnerable among us. Likewise, reforming and streamlining the FDA approval processes so safe lifesaving medicines can more quickly reach patients at lower costs makes a lot of sense.
While other schemes – like importing drugs from other countries – may sound good at first blush, it does not hold up to scrutiny. As residents of a border state, North Dakotans are comfortable with the free flow of goods and people across the Canadian Border. Although generic drugs, which make up a large portion of the drug market in the United States and are generally cheaper here than in Canada, some North Dakotans travel across the border to purchase some specific name-brand prescriptions at a lower price. That’s why the opportunity to buy drugs online from a so-called ‘Canadian pharmacy’ may be appealing to those who cannot make the trip in person.
Some have even proposed allowing American pharmacies to bulk purchase from these Canadian online pharmacies for resale to Americans.
The problem is that the drugs dispensed from many online Canadian pharmacies are neither safe nor Canadian. Unlike brick and mortar pharmacies in Canada, which dispense safe drugs regulated by Canadian authorities similar to our FDA that are prescribed by Canadian physicians, the Canadian government does not have the resources to regulate online pharmacies. Many of which function offshore and simply have the word “Canadian” in their name. Purchases from so-called Canadian online pharmacies may actually be coming from China, Turkey or some other country abroad. The effectiveness of the drugs, their purity and proper handling cannot be guaranteed by either American or Canadian regulators responsible for maintaining a safe or effective drug supply.
Law enforcement entities on both sides of the border have also expressed concern about the unregulated movement of drugs through the mail, which makes it easier to get dangerous drugs like fentanyl into our country – making the opioid crisis even worse.
Bernie Sanders and even the Trump administration are toying with importation schemes. Some states have tried them and they have failed. The Illinois State Auditor report noted that a program set up by Illinois based on “approved” foreign pharmacies dramatically failed when audited. 40% of the foreign pharmacies were not compliant and the State did not monitor if prescription drugs were being filled by “approved” pharmacies. Illinoisans were subjected to drugs that at best were ineffective and at worst were tainted and dangerous.
The latest importation proposals are not likely to work either. Even if 20% of Americans were somehow legally able to purchase their prescription from legitimate Canadian pharmacies, the Canadian drugs supply would run out in about 6 months, a possibility that alarms many Canadian patient groups and would not be tolerated by Canadian politicians.
Political leaders are right to grapple with the out-of-pocket prescription drug costs being paid by Americans at the pharmacy counter. There are things that should be done, but drug importation is not part of that solution.