Simone Marstiller, secretary for the Florida Agency of Health Care Administration, provided an update to the Senate Committee on Health Policy on the state’s prescription drug importation program, which could eventually bring cheaper prescriptions into the state from Canada.
In 2003, Congress passed the Medicare Modernization Act, which authorized the commercial importation of prescription drugs from Canada, but it wasn’t until 2019 that it was acted on. Florida that year passed HB 19 which created the state’s prescription drug importation program. Since then, staff have been working to set the program up, and Florida became the first state to apply for conditional approval from the FDA. Now the state is in the process of figuring out which drugs to import, which will also need approval from the FDA.
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Prescription drug prices have skyrocketed in the U.S., increasing nearly 181% from 2003 to 2020. Little more than one-quarter of active ingredients for prescription drugs are made in the U.S., with roughly another quarter coming from the E.U., followed by India and China rounding out the largest producers.
Marstiller said in most if not all cases, the drugs they are looking at importing are at least 50% less expensive than prescriptions they could find in the U.S.
The agency looked at the current cost per pill for prescriptions that are widely used by Florida Medicaid and participating state agencies. They also examined utilization data and ensured that there was a Canada-approved equivalent. The initial slate of drugs they’re looking to import will be used to treat asthma and COPD, hepatitis C, diabetes, HIV/AIDS and mental health issues. Marstiller said:
“These are medications for chronic illness among the populations that we are going to be serving.”
As required by law, Florida is contracting with a private company, LifeScience Logistics, to arrange the importation of the drugs from a Canadian seller. The prescriptions are required to either be surplus or produced in excess of what Canadian manufacturers normally make so as not to impact their internal supply.
There are also bans on importing controlled substances, biological products like insulin, injectable drugs, infused drugs and drugs that are inhaled during surgery, or ones that need to go through a drug safety program. In order to import insulin, both the Florida legislature and the FDA would need to approve.
Marstiller said her agency has begun working with pharmacies who participate in the Medicaid program to make sure the supply chain is in place for them to dispense imported prescriptions. Once the program matures and expands, health plans who work with the state will be required to utilize these lower cost drugs in alignment with the state’s Medicaid plan.
Eventually, Marstiller said the goal is to expand the program to state group insurance, and if that proves successful, allow private plans to serve all Floridians with cheaper, imported prescriptions.
While Florida was the first state to get conditional approval from the FDA to begin their importation program, Colorado also applied after passing a similar law in 2019. Earlier this year, Colorado passed a bill to pursue importing cheaper prescriptions from countries outside of Canada, pending federal approval.