Background On Trump's Plan To Allow Imports Of Some Prescription Drugs

The Trump administration says it's trying to clear a path for Americans to import some prescription drugs from Canada. NPR's David Greene speaks with Phil Galewitz of Kaiser Health News.

DAVID GREENE, HOST:

The Trump administration says it is trying to clear a path for Americans to import some prescription drugs from Canada. This is part of a larger plan that was announced today by Health and Human Services Secretary Alex Azar.

And let's talk this through with Phil Galewitz. He's a senior correspondent with Kaiser Health News and joins me on the line. Good morning, Phil.

PHIL GALEWITZ: Hi. Good morning.

GREENE: So you were actually on this call with the secretary announcing this. So take me through exactly what he says is the plan here.

GALEWITZ: Yes. Secretary Alex Azar announced sort of a two-pronged strategy to - for the first time, which would have the federal government allow the importation of drugs from outside the United States. The first strategy would allow, basically, states to come up with pilot programs for them to import certain drugs from Canada. The exceptions for this would be biological drugs, such as insulin. Intravenous drugs and controlled substances would not be allowed onto that program.

The second program would allow drug manufacturers to basically bring in drugs that they sell abroad at cheaper prices to sell those same drugs in the United States. It's certainly unclear at this point if drug manufacturers would go for that because they've certainly been against any efforts to do drug importation in the United States.

GREENE: But presumably, I mean, the Trump administration is saying this is an effort to lower drug prices for Americans. I mean, that would be the goal here.

GALEWITZ: Yes. Drug prices in Canada have been, in many cases, 50%, 60% lower than in the United States for many years. This is why, for many years, Americans have been either driving across the border or ordering drugs over the Internet to get drugs from Canada. And even some mini towns, municipalities and school districts have been getting drugs in Canada for years for this purpose.

GREENE: Aren't there a lot of hurdles here? I mean, people have talked about this idea as something that could never actually come to being because of so many obstacles in the way.

GALEWITZ: Yes, a number of obstacles. I guess the first would be starting with Canada. The Canadian health minister recently came out and said, we don't have enough drugs in Canada to help the United States solve its problems. So there's one issue on just whether Canada has enough supply. Alex Azar, I mentioned - he has spoken to the Canadian health minister, who had raised those issues. They certainly do not seem like they've resolved any issues. Alex Azar said it'll be up to states to help get past those hurdles. So that's the first issue - is just getting Canada to maybe go along with this.

The other issue is the pharmaceutical industry - you can expect to come out. And they've already come out and said, we're against this; we're going to fight this. And whether they'll do that in court remains to be seen. That's going to be a big ballot to overcome.

And then just - even if they can get past those, just setting up a system where drugs can be imported to connect the drugs from Canada and bring them into the U.S. - how will that be done? Will it be done by mail order? Will Americans be able to go to their U.S. pharmacy and pick up these drugs from abroad? A lot of those questions remain to be answered.

GREENE: And briefly, one question that also remains to be answered is why the Trump administration sort of reversed course here. Weren't they siding with the drug industry against proposals like this before?

GALEWITZ: That's absolutely correct. Alex Azar had called this proposal a gimmick, saying this would not be something that could really work in the United States. But slowly, that policy has evolved, and the administration has looked to see if there is a way that - initially do this on a small scale with just certain drugs that had a big price hike. Last spring, President Trump came out and said, I'm for this idea. Let's try to do it - and instructed HHS to go ahead and try to set up a system. So it's been an evolving strategy by the administration, but yet, they still have a ways to go.

GREENE: Phil Galewitz is a senior correspondent with Kaiser Health News. Thanks so much, Phil.

GALEWITZ: OK. You're welcome.

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