Drug importation is a dangerous idea that won’t die

A federal judge just struck down a program in Maine allowing state residents to import prescription drugs from foreign countries. The reason: it’s against federal law — and justifiably so. The importation of price-controlled foreign drugs severely undermines research into future cures, hurting patients in the long run. And more immediately, foreign drugs pose a risk to Americans’ health.

For this reason nearly every Congress since the Clinton administration has decided against legalizing drug importation.

But some in Congress are pushing to open up America’s medicine cabinets to foreign drugs. Indeed, Sens. Amy Klobuchar (D-Minn.) and John McCain (R-Ariz.) have repeatedly introduced legislation to allow the importation of drugs. When Congress debates the nation’s budget later this month, Klobuchar and McCain could attach a drug-importation amendment. If they succeed, it will come at a huge cost to American patients.

On the face of it, allowing Americans to purchase prescription drugs from abroad is an appealing idea. Thanks to price controls, drugs in my home country of Canada, if they are even available on a formulary, often carry a lower price tag than their American counterparts. In the UK, meanwhile, per capita prescription drug spending is about half what it is in the United States.

Why not let Americans access cheap drugs?

While importing prescription drugs might save American patients money in the short-term, it comes with enormous long-term costs. For one, it cuts off the research funding that drug laboratories need to develop the next generation of treatments. According to researchers at Tufts, it takes drug companies roughly $2.5 billion over the course of a decade to bring just one new medicine to market.

Thousands of drugs never make it that far. According to the California Biomedical Association, only 5 in 5,000 drugs that begin clinical testing ever make it to human testing. Of those five drugs, only one will receive approval for human usage.

One of the reasons countries like Canada can impose price controls on their drugs is that much of that multi-billion-dollar investment is made back in the American market. A wave of drug importation would make pharmaceutical investment far less attractive, choking off funding for the researchers who work to develop the next generation of treatments for diseases like cancer and Alzheimer’s.

That’s a high price to pay for a discount on blood-pressure medication.

This is especially true when you consider that prescription drugs aren’t a major driver of rising health expenditures. Between 2008 and 2012, prescription drugs accounted for a mere 5 percent of the growth in U.S. health spending. Today, retail prescription drugs account for only about 10 percent of overall U.S. health spending — a statistic that isn’t expected to change in the next decade.

Safety matters, too. Drugs sold in the United States are approved by the Food and Drug Administration (FDA). The organization goes to great lengths to ensure that prescription medicines meet rigorous standards of safety and effectiveness.

None of this is true of imported drugs — even medicines arriving from places like Canada and the UK. In fact, patients have little way of knowing whether their foreign medicines are potentially deadly counterfeits.

According to the World Health Organization, as much as 10 percent of medicines on the global market are counterfeit. In parts of Asia, Africa, and Latin America, that number may be as high as 30 percent.

Many of these fake drugs carry serious health risks, including death. In 2008, for instance, a counterfeit form of the blood-thinner Heparin resulted in 81 deaths throughout the United States. In 2012, meanwhile, the FDA issued warnings that a counterfeit version of cancer drug Avastin was in distribution throughout the country.

In short, policing the flow of counterfeit drugs in the United States is already a major challenge for regulators. Legalizing drug importation will only compound the problem.

None of these concerns has dissuaded Klobuchar, who, together with McCain, has led the fight to legalize drug importation. Twice last year, the two lawmakers introduced legislation to let foreign medicines flow freely into the country.

With this latest attempt, Klobuchar and her allies may try to win over Senate Republicans by portraying drug importation as a free-trade issue. But importing price controls from foreign countries — at the expense of both medical innovation and patient safety — bears little resemblance to free trade.

It’s now up to the new Congress to continue in a long tradition and reject drug importation.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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