To Lower Drug Prices in Florida, Lawmakers Look To Canada. But Not Everybody's Sold

Apr 7, 2019

Floridians spend a lot on prescription drugs -- more than $30 billion last year, according to the Kaiser Family Foundation. Now at least some Florida lawmakers say they have a way to save consumers money on drugs: get them for less from Canada.

In his first weeks in office, Gov. Ron DeSantis proposed the idea of the state importing drugs from Canada. State lawmakers quickly took up the idea. They say that could save Floridians up to 80 percent on what they currently pay for drugs.

Health News Florida reporter Julio Ochoa said Friday on The Florida Roundup that many consumers are eager for any measures that would lower their drug prices.

But the plan doesn't sit well with everyone. Many say they see the idea to import drugs from abroad as a convoluted solution to a larger problem being caused by those making money off the prescription drug market. Many of the drugs being sold in Canada are actually made in the United States and then exported -- so they’d be re-imported into the U.S. under this new plan.

“We hear it all the time from people who can’t afford their medications. The fact that the cost can increase so much in such a short period of time -- it just feels like drug companies are putting the squeeze on patients,” Ochoa said. “To them it seems very unfair that they would have to go to another country in order to get cheaper drugs when many of them are made here.”

According to national data, the U.S. spends about $333 billion annually on prescription drugs, or about $10,739 per person. U.S. drug prices are between 30 to 190 percent more than in other developed countries.

The bill currently making its way through the state Senate, sponsored by Republican Sen. Aaron Bean of Jacksonville, would establish a vendor to administer the import program in Florida, identifying and contracting with eligible Canadian suppliers.

The House version, sponsored by Republican Rep. Tom Leek of Ormond Beach, goes even further. It would allow private citizens to import drugs through distributors, pharmacies and pharmacists registered with the state.

Florida isn’t alone in looking for cheaper drugs. A dozen states also are considering similar efforts and Vermont approved importing prescription drugs from Canada last year.

But any efforts passed on the state level would have to be approved by the federal Department of Health and Human Services (HHS). And past HHS secretaries have signaled importation is a non-starter.

The plans would ensure that all imported drugs meet strict standards for safety and effectiveness.

So why are drugs from Canada so affordable? Canada imposes caps on how much pharmaceutical companies are allowed to charge for medicines, which keeps costs down, Ochoa said.

“Our federal government could do that same thing,” Ochoa said. “They could say ‘you cannot overcharge or increase the cost beyond a reasonable amount.’ But they have failed to do that, and they are not trying to do that, I haven’t seen any proposals.”

Opponents of the plan have raised concerns about the potential for counterfeit drugs coming into the U.S., which they say could have huge health implications.

But Ochoa said it’s lobbyists from the drug companies that have been among the most vocally opposed to the importation proposals.

“You see drug lobbyists showing up to subcommittee meetings in Tallahassee and standing up against this,” he said. “They’re lining up to voice concern with this plan and raise red flags about counterfeit drugs and safety issues, but really I think there’s a lot of money on the line for them.”

Alison Kodjak, Health Policy Correspondent at NPR, said Friday on The Florida Roundup that it’s not just issues of safety at play. Politics are also involved, she said. Namely, these state-level proposals are setting up a potential conflict between states and the federal government. 

Politicians at all levels are hearing from an increasingly angry electorate about the rising cost of drugs.

“The more states that start asking for this, that’s votes. If enough people say that’s what they want, HHS will at least feel pressure to consider,” she said.

She agreed the idea of citizens, governments or insurance companies buying American-made products from another country is one of more “convoluted” solutions to the current problem. “But it’s another way of putting pressure on politicians, drug companies and insurance companies to figure out a solution to this problem that’s been getting worse over the years.”

When DeSantis proposed the importation plan in February, he said he planned to work with the Trump administration, and that Trump had been "supportive" and "enthusiastic." 

But soon after, the White House gave a tepid response, saying it looked forward to "educating" DeSantis on existing policy options to reduce costly drug prices for American families.

Meanwhile, on Capitol Hill, another lawmaker from Florida has a different plan. Sen. Rick Scott thinks more price transparency would allow patients to shop for better drug prices.

In late March, Scott introduced the Transparent Drug Pricing Act, which would require insurance companies to release the cost of prescription drugs before enrollment, allowing patients to compare plan costs to get the cheapest prices on drugs. Pharmacies would also be required to inform patients of out-of-pocket costs. 

And the plan would also require drug companies to charge no more than what consumers are charged in countries such as the U.K., Canada or Germany.

Kodjak said this price cap proposal is “pretty unusual for a free market Republican.”

“What they have in those countries are national healthcare systems,” she said. “Those country’s governments negotiate for the whole country drug prices, so they can walk away if they don’t like what the drug company wants to charge.”