In the face of surging prescription drug prices, some US states are proposing to import medicines in bulk from Canada, where many drugs are cheaper thanks to government price controls.



Vermont lawmakers are considering legislation to create an agency which would buy popular prescription medicines in bulk from Canada, and then distribute to pharmacies in the state. Utah, Oklahoma and West Virginia have proposed similar measures.

The state senator Ginny Lyons, who sponsored the Vermont bill, said that without government price controls, “pharmaceutical companies are getting away with murder,” in the US.

“People are making choices between food and prescription drugs. We can’t allow that to continue, so we’re trying to take matters into our own hands,” she said.

Lyons acknowledged the bill is a “first step” to rein in spending, but hopes it will spur Congress to act. The federal government would need to approve any bulk importing program.

“When a lot of little fish get together, it has meaning for the members of Congress.”

The desperate move comes as the cost of pharmaceuticals is expected to grow faster than other US healthcare spending in the next decade.

Meanwhile, unpredictable – and sometimes dramatic – increases in drug costs make it nearly impossible for states to budget year-to-year.

Medicaid, the public health program that insures 70 million poor and disabled Americans, is jointly run by the state and federal governments. But states have a limited number of tools legally available to negotiate drug prices with manufacturers.

As a result, mid-year drug approvals and steep price hikes can throw a state’s entire health budget off course.

For example, between 2014 and 2015 Medicaid drug spending increased by $3.7bn or 13% year-over-year. That jump was largely attributed to two new hepatitis C drugs which each cost more than $80,000 per treatment.

One of those hepatitis C drugs, called Sovaldi, is a good example of how prices can vary between countries. In the US, a course of Sovaldi lasts 12 weeks and costs $90,000 US retail.

American insurers typically negotiate a discount of 41%, according to a Bloomberg News analysis. That puts the cost of the drug at $17,700 a month in the US.

But in the United Kingdom, that drug costs $16,770 a month, and in Canada $14,493.

For an even more dramatic example, consider Gleevec, a leukemia drug. It costs $10,122 in the US, $2,645 in the UK, and $2,420 in Canada.

“Our Medicaid drug prices, particularly for specialty drugs, are way over the top,” said Lyons. “So, we’re trying to identify those drugs where the cost has escalated in the past few years, or the payment per dose is very high as compared with Canada.”

The United States has the most expensive health system in the world; Americans pay on average three times more than British people for top-selling prescription drugs.

Prescription drugs are be no means cheap in Canada: surveys suggest it is one of the most expensive countries in the world after the US, and a recent study found that nearly 1 million Canadians a year sacrifice groceries or heating to afford pharmaceuticals.

Canadian drug policy experts warned that importing drugs from Canada is unlikely to provide nationwide relief in America.



Dr Joel Lexchin, a former emergency department physician and drug policy expert from York University in Toronto, Canada, said that it’s “fine for an individual” to drive up to Canada and buy drugs, but that the US government needs to tackle drug pricing for a sustainable solution.

“Even if the US bought every pill in Canada, you have almost 10 times the population. This is not going to solve the problem of drug prices in the United States,” said Lexchin. “The solution is for the US to start regulating its own prices. And you can do that.”

Officials at Health Canada said they were aware of the proposals but said it was too early to comment.

Pharmaceutical lobbyists vehemently oppose importing drugs from Canada, and have argued the drugs are not safe. The industry spent $277m on attempts to influence members of Congress in 2017 alone.