Op-ed: PhRMA on Colorado’s prescription drug importation program

Nick McGee is a Senior Director of Public Affairs at the Pharmaceutical Research and Manufacturers of America (PhRMA). In this op-ed, he explains PhRMA’s position on Colorado’s efforts to import prescription drugs from Canada.


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Public polling shows that addressing the COVID-19 pandemic and bringing the economy back were top issues in the 2020 election. The same polling shows that when it comes to health care beyond the current pandemic, there were bipartisan concerns—largely centered on health insurance coverage, including protections for those with pre-existing conditions, as well as affordability of out-of-pocket costs.

Most people are concerned with the deterioration of their coverage and the corresponding rise in out-of-pocket costs for health care, like deductibles and co-insurance for hospital services and prescription drugs. Put simply, people want to make health care more affordable and predictable.

We should be focused on the affordability challenges that are the root causes of issues facing patients and push substantive solutions that would help Coloradans now.

Instead, the state of Colorado continues to pursue a dangerous importation scheme that threatens public health in the midst of a global pandemic. This should be alarming to everyone.

Importing unapproved medicines, from Canada or other countries, poses a serious risk to public health. Medicines that enter the United States through importation will not be subject to the FDA’s gold standard review and approval and would open our closed supply chain. As a result, counterfeit, substandard or diverted, repackaged and adulterated drugs could be introduced into the secure drug supply chain in Colorado.

The Canadian government has said it cannot and will not guarantee the safety of medicines imported to the United States through Canada that are not intended for Canadian patients. And, late last year, Canada made it clear it won’t allow the export of medicines approved for Canadians that are in threat of a shortage showing again that this type of program is unworkable.

Secretaries of the U.S. Department Health and Human Services under both political parties have consistently declined to certify importation for nearly two decades. Even in 2020, despite claims to the contrary, the Secretary was no more able to certify than his predecessors and questionably circumvented the statute by punting the responsibility to state governments.

As a result, the federal government has put the sole responsibility to guarantee safety and consumer savings with the state of Colorado. Colorado is already spending millions of tax dollars on its program, despite not having any data to support whether it is feasible, safe or even effective in lowering medicine costs for patients.

At the same time, Colorado lawmakers are proposing an equally harmful policy that would set up a government price-setting board. This board, made up of unelected bureaucrats, would have the authority to determine the value of critical medicines.

This board, which has been billed as a panel of “experts” that will make medicines more affordable, would actually give bureaucrats the authority to arbitrarily decide what medicines are worth and whether patients have access to them. A policy like this could lead to discrimination against seniors, those with a disability and the chronically ill and makes it more difficult for people to access the medicines they need.

What’s worse is that there is no guarantee that this proposal or importation will give meaningful savings to patients who want lower out-of-pocket costs.

We can do better.

There are solutions that would deliver real savings to Coloradans at the pharmacy without jeopardizing their safety or their access to medicines.

For one thing, retail prescription drug prices declined in 2019, yet patients often don’t reap the benefits from lower prices because of our broken insurance system. Commercially insured patients with a deductible have seen their out-of-pocket costs for brand medicines increase 50 percent since 2014.

At the same time, manufacturers rebate up to 40 percent of a medicine’s sticker price back to health insurers, PBMs, the government and other entities. In 2019, these rebates and savings totaled $175 billion. In Colorado, the amount of rebates received by these same entities increased from $850 million in 2016 to $1.12 billion in 2018.

Colorado leaders can solve this problem for patients and help them save money by requiring health insurance companies and PBMs to share these massive rebates and savings with Coloradans directly at the pharmacy counter. Doing this could save some Coloradans more than $1,000 every year.

Colorado lawmakers should be focused on solutions, like this, that would bring patients immediate relief without jeopardizing public health or threatening access to the medicines they need.