Florida Governor Ron DeSantis made news last week when his plan to import prescription drugs from Canada was temporarily endorsed by the FDA. Importing drugs from Canada has been under discussion for years, the hope being that these drugs could be acquired at cheaper Canadian prices than those charged in the U.S. By allowing drug importation, Florida claims it could save millions of dollars in drug costs. In fact, estimates are that $150 million would be saved in the first year of implementation alone.
The FDA had been previously reluctant to approve such a plan for safety concerns. It worried that bringing drugs in from Canada opens the door for counterfeit medicines to enter the U.S. system, thereby exposing patients to suboptimal drugs or, worse, impure materials that could prove toxic. To address this concern, the F.D.A. will allow Florida’s program to proceed for two years, all the while tasking this state with keeping close track on any side effects that imported drugs generate. The FDA also wants proof that this plan truly delivers meaningful cost savings to patients.
There are other states that have laws allowing for similar drug importation including Colorado, Maine, New Hampshire, New Mexico, North Dakota, Texas, Vermont and Wisconsin. Now that the Florida plan has been approved, one can expect the FDA to be flooded with other such requests. Furthermore, in this election year, politicians are lining up to take credit for drug importation. The biopharma industry – the industry that saved the world from the Covid-19 pandemic – continues to be the whipping boy for both sides of the Congressional aisle and we can expect to hear politicians boast over the coming months about how they are bringing this important industry to heel in this election year.
However, how does Canada feel about using its drug supply to satisfy America’s demands? Actually, this was put to this test last April. Ozempic, the remarkable Type 2 diabetes drug from Novo Nordisk, had become very popular for its ability to cause significant weight loss. In our weight-conscious society, all sorts of people were trying to gain access to Ozempic leading to temporal shortages of this drug for diabetics who truly needed it. As a result, people turned to Canada. The demand proved overwhelming as was shown in British Columbia. In the first two months of 2023, 15% of the roughly 16,000 Ozempic prescriptions filled in British Columbia were sold to U.S. residents. For perspective, the average proportion of other drugs sold to Americans was a mere 0.4%. As a result, British Columbia announced that it would limit Ozempic sales to Canadian residents only. (Novo Nordisk has since launched another version of Ozempic called Wegovy specifically for weight-loss.)
Admittedly, the Ozempic frenzy was unique. But what would happen if medicines from all drug classes were suddenly shipped to the U.S.? Canada has a population of 40 million – that of Florida is 22 million. Add in the populations of Texas, Wisconsin, Colorado, etc. and it is easy to see that if all these states were to attempt to get their medicines from Canada, there would be enormous drug shortages north of the border. Its pharmacy shelves would be quickly depleted. Furthermore, drug manufacturers aren’t going to suddenly ship more drugs supplies to Canada so that they can be reshipped to the U.S. at lower prices. Manufacturers will limit supplies to Canada to the levels that were sold before U.S. re-importation began. Canada, as happened in British Columbia, will limit its supply of drugs to Canadians. Thus, getting prescription drugs from Canada is a non-starter.
Nevertheless, in the political theater that exists in our nation, politicians will claim credit for enacting such a law – one that will prove to have little utility.
(John L. LaMattina is the former president of Pfizer Global R&D and is the author of three books including: “Pharma & Profits: Balancing Innovation, Medicine, and Drug Prices.”)
