By signaling that he would allow the importation of cheaper drugs from Canada, Donald Trump has revived hope among Americans. The pressure is huge. Some states are desperate to get Washington’s official green light.
Sky-high cost of drugs in the US
The cost of drugs is poisoning the American healthcare system, but it is a hit with the pharmaceutical industry. Drug expenditure represents only 10% of the total cost of health in the United States, but it focuses the attention of citizens and, in their wake, policies. It is indeed a good indicator of the inequity of the health system, in a country that devotes more than 16% of its gross domestic product (GDP) to health, but where 16% of the population does not do not have access to health insurance. Last December, by passing a bill providing partial coverage of seniors’ drug expenditures, the presidential administration hopes that part of the population will receive better coverage, but this bill is also another gift to a pharmaceutical industry that makes huge profits.
Today, basic medications for diseases such as asthma, high cholesterol, depression, or pain treatment can cost hundreds of dollars per month per person if they are not cared for insurance. US legislation allows pharmaceutical companies to set their prices freely, which many see as the root of the problem.
Ordering drugs from online pharmacies is something that a huge number of Americans have been doing for many years now. Canadianmedsworld.org a prescription pharmaceutical company servicing international buyers allows accessing medications at significantly cheaper prices without crossing the borders. Still, many citizens are unaware of this option and lose much money. Their drugs can be quite legitimately sent to the US if certain conditions are met. The approval of the presidential administration would popularize ordering drugs from Canadian pharmacies, but many fear that it would also exhaust its resources, leaving both domestic and neighboring shoppers short of supplies.
Canadian pharmacies vs. US prices for drugs: a real-life example
Here is an eloquent example from Colorado. Claudia Curry Hill moves painfully. She has already lost the use of her left leg. In her home in Denver, her smile disguises the feeling of rage she feels. And for her, the most difficult is yet to come. With a primary progressive multiple sclerosis, a drug could help limit the progression of the disease: Ocrevus. But she had to give it up quickly. “We are not rich, but we are not poor,” she says.
The price of Ocrevus in the United States reaches $90,000 a year, three times more than in Canada. To give up medicine that really helps you because you cannot afford it anymore is cruel.
The story of Claudia Curry Hill is not exceptional. Not having the means to buy prescription drugs is the reality of more than 45 million Americans. Claudia Curry Hill suffers from primary progressive multiple sclerosis. She must move with a walker. She stopped taking a medication that could help her curb the disease because of its high price.
In the United States, where prices are the highest in the world, laws prohibit governments from negotiating with pharmaceutical companies. While Canada remains one of the countries with the highest patented medicines, the legislation still allows for a price cap.
Claudia Curry Hill carefully follows what is happening in her own state. One solution is making its way to Colorado: importing drugs from Canada. “It’s very attractive and I have high hopes for it.”
Democrats in favor of drug import
The word “crisis” keeps coming back in several states. In Colorado, not a day goes by without lawmakers being challenged about the consequences of soaring drug prices. “People are dying. We have the responsibility to act, and that’s what we do,” says Sonya Jaquez Lewis in describing the current context. And to those in Canada who still have doubts about the seriousness of this approach, she replied that “it’s not bluffing.”
This Democrat is the first female pharmacist to sit in the Colorado House of Representatives. She has been closely involved in drafting a law recently cited by President Trump as an example. Adopted in May, the new law allows the state to develop a bulk import program for prescription drugs from Canada. It remains for him to obtain the federal seal. Colorado wanted to put all the chances on their side in order to get there. His strategy is that of small steps, to convince US federal agencies that his plan is safe.
Democrat Sonya Jaquez Lewis, a pharmacist, sits in the Colorado House of Representatives. She co-authored the state law that authorizes a bulk import program for prescription drugs from Canadian pharmacies. “We want to start slowly, it is better to start small. This is the only way to get there,” says Sonya Jaquez Lewis.
Only the importation of certain types of products for specific populations is targeted, just under twenty categories of drugs in all. Sonya Jaquez Lewis cites two examples: “A cardiovascular patient could save up to 30%. And the prison system could save at least $ 3 million a year just in hepatitis C treatments.” But cancer drugs given by infusion could not be imported from Canada. Same thing for insulin, because it has to be refrigerated.
This summer, the Trump administration strongly suggested that it would allow pilot projects developed by states, but how? It remains vague. Nevertheless, Colorado sees a unique chance.
Other states to join Colorado in Canadian drug import initiative
Discussions are being held with the other three states that have enacted legislation in recent months to import bulk drugs from the Canadian Pharmacy network: Florida, Vermont, and Maine. In addition, there are 13 states that have bills under consideration.
To those who are worried about Canada becoming the pharmacy of the United States, Ms. Curry Hill offers this answer. “I can understand the concerns of Canadians. It is sad that we have been there. But I also want them to know that we are very many suffering.” The idea of importing bulk drugs from Canada is not new. Many attempts have failed in the past. But this time, experts do not all predict the failure of American efforts.
“I’m afraid that in a year or two it will be real,” says Amir Attaran, a professor at the University of Ottawa’s Faculty of Law and Medicine. In his eyes, it is important not to underestimate what is happening. Political dynamics have changed in the United States.
Amir Attaran is surprised that Canada’s response is slow in coming, especially as drug shortages are already a problem in Canada. Ottawa still has not erected walls. “Canada has totally failed to take measures to protect its citizens, and that should be a priority for political parties.”
In the aftermath of the Trump administration’s announcement and the many concerns raised in Canada by the US plan, Prime Minister Trudeau promised to protect the supply of drugs. Health Canada, he said, is continuing work to ensure “there is enough medicine for Canadians, that we are never caught off guard with access to affordable medicines for Canadians.”
A month later, the Prime Minister still has not said when and how he plans to do it. This is “amazing and disturbing,” according to Amir Attaran. Former Liberal Minister Ujjal Dosanjh is equally concerned.
Hard to ignore the views of the former Minister of Health under Prime Minister Paul Martin. Why? In 2005, he introduced a bill to ban the massive export of prescription drugs to the United States. This approach would have allowed the federal government to establish a list of drugs that could not be exported in the event of a shortage or threat of scarcity. The bill died on the order paper when Paul Martin’s government was overthrown.
Ujjal Dosanjh also considers that the current threat is more serious than at the time. “The government should have seen things come and even summoned House MPs this summer to legislate.”
Far from Ottawa, in her Denver apartment, Claudia Curry Hill clings to what she can: the Canadian option. “We must and will keep the pressure on our legislators, I think it’s encouraging.” She leads a double fight. If her illness progresses, she has more hope of winning her political battle. She can hardly see how the discontent in Colorado and elsewhere could subside.
Canadian pharmacists remind the consumers that ordering from Canadian e-stores should meet a number of requirements: consult your doctor for diagnosis, obtain a prescription to enclose to your package for the customs, and never order more than a 90 days’ supply of medication in order for your package to make it to you in a sure and speedy way.