When Donald Trump unveiled a stunningly stark health care plan this week, one detail stuck out that would do far more harm to the U.S. drug market than good: allowing the reimportation of foreign drugs.
“Trump would expose Americans to danger through large scale reimportation of prescription drugs from overseas,” said IPI president Tom Giovanetti.
In 2013, the state of Maine attempted to defy federal law to allow Mainers, including private sector companies but also state and local governments, to import prescription drugs from foreign sources, arguing that:
- Foreign Internet pharmacies are safe.
- Mainers have been crossing the Canadian border for decades to buy prescription drugs for personal use.
- Brand name prescription drugs are cheaper in most other countries and therefore the state and Mainers will save money.
“We’ve heard these arguments before,” said Merrill Matthews in a 2013 PolicyByte.
"Of course, Maine cannot know whether foreign-based Internet pharmacies are safe; that’s the job of experts at the FDA. Former Illinois Gov. Rod Blagojevich, now in jail, also pushed for state importation and assured everyone that Internet pharmacies would be safe. But non-experts don’t know if the drugs have been mishandled or compromised. Indeed, one Canadian Internet pharmacy approved by Maine stopped shipping insulin because it failed to handle it properly."
"For generations, U.S. patients have gone to their local pharmacy confident of the quality and safety of the drugs they bought," wrote Matthews in a classic IPI publication, A Legislator’s and Consumer’s Guide to Prescription Drug Importation.
To those consumers who ask, “Aren’t imported and reimported drugs as safe as those bought in the U.S.?” Matthews responds: "Some are, others aren’t. And it is almost impossible for the average consumer to know which are which. The reason is the explosion of counterfeit drugs in many countries outside the U.S."
Fortunately, the vast majority of those counterfeits are outside of the U.S., in countries with much less drug monitoring, said Matthews. "But that would change with widespread reimportation."
"The World Health Organization estimates that roughly 6 to 8 percent of the world drug supply is counterfeit. In India, about 30 percent is counterfeit," he said. "In Pakistan, it’s about half. And in some African countries, 80 percent. Counterfeiters – who can range from foreign generic drug manufacturers to low-budget operations working out of a garage to organized crime and terrorists – are looking for ways to get their products in the U.S."
"Recognizing the growing threat to the safety of the U.S. drug system, the FDA has drastically increased its efforts to identify, locate and shut down those not following strict FDA guidelines."
"Unfortunately, it may take a tragedy before some of our politicians and patients get the message that importation is illegal and unsafe.”