Report: Trump’s Promise to Rein in Drug Prices Could Prompt Consumer Drug Importation

Former FDA heads say imported medications are too risky

With prescription drug prices soaring and President Trump vowing to take action, an old idea is gaining fresh traction: allowing Americans to buy medications from foreign pharmacies at lower prices, according to a report from Kaiser Health News. A new bill in Congress to allow the practice would modify previous safety standards and would remove a barrier that had proved insurmountable in past attempts to enable progress.

In 2003, Congress came close to allowing the importation of foreign drugs through the Medicare Modernization Act, but added one precondition that has proved a nonstarter. The secretary of Health and Human Services had to guarantee that imported medications posed no additional risk to public safety and would save money.

In an open letter to Congress, four former FDA commissioners argued that consumer drug importation remains too risky to permit. “It could lead to a host of unintended consequences and undesirable effects, including serious harm stemming from the use of adulterated, substandard, or counterfeit drugs,” they wrote. The letter was signed by Robert Califf, Margaret Hamburg, Mark McClellan, and Andrew von Eschenbach, who headed the FDA at various times between 2002 through 2016.

A recent proposal from Senator Bernie Sanders (I-Vermont) and such Democrats as Cory Booker of New Jersey and Bob Casey of Pennsylvania drops that requirement. Instead, it sets up a regulatory system where Canadian pharmacies that purchase their supplies from manufacturers inspected by the FDA would be licensed to sell to customers across the border. The bill allows not only individuals but drug wholesalers and pharmacies to buy from Canada.

Approximately 45 million Americans—18% of the adult population—said last year that they did not fill a prescription because of cost, according to an analysis of data from the Commonwealth Fund by Gabriel Levitt, president of, whose company helps Americans buy medications online by vetting overseas pharmacies and comparing prices for different drugs. Data compiled by the company comparing prices offered in Canada with those in New York showed that drugs are often three times or more as costly in the U.S. as across the border.

For example, a simple Proventil asthma inhaler costs $73.19 in the U.S. vs. $21.66 in Canada. Crestor, the cholesterol-lowering drug, is $6.82 per pill in the U.S. but $2.58 in Canada. Abilify, a psychiatric medication, is $29.88 in the U.S. versus $7.58 in Canada, according to

Many previous bills to allow the importation of foreign-made drugs and allow Medicare to negotiate prices for its beneficiaries have failed in the face of $1.9 billion in congressional lobbying by the pharmaceutical industry since 2003, according to the KHN article. But Americans may be reaching a tipping point of intolerance. In polling just before the election by the Kaiser Family Foundation, 77% of Americans called drug prices “unreasonable,” and more than half favored a variety of proposals to address them.

Source: Kaiser Health News; March 22, 2017.