Vermont first US state to okay imports of Rx drugs

Vermont has become the first state in the US to approve the importation of prescription drugs from Canada in a bid to trim healthcare costs – despite claims it could introduce vulnerabilities in the supply chain to the entry of counterfeit or substandard medicines.

A bill approving such as programme was approved by the House and Senate and signed into law May 16 by Republican Governor Phil Scott – but has met immediate criticism from both the pharma industry and regulators. It also has a long way to go before it can be enacted, as Vermont still needs to come up with an implementation plan, and that needs to be reviewed and approved by the federal Department of Health and Human Services (DHHS) before it can go into effect.

Importing drugs from Canada and other lower-cost markets was latched onto by President Trump whilst campaigning for office as a means of cutting prescription medicine costs for US citizens, but seems to have fallen out of favour of late. It wasn’t included in Trump’s American Patients First blueprint published earlier this month, which instead favoured other measures such as giving private payers a role in setting the cost of medicines administered in hospitals and doctors' offices.

Health and Human Services Secretary Alex Azar made it clear that prescription drug importation programmes are very much off the agenda as far as the federal government is concerned.

In comments delivered during the presentation of the blueprint document he said: “Many of you are familiar with proposals to give our seniors access to cheaper drugs by importing drugs from other countries, such as Canada. And many of you know, too, that this is a gimmick.”

“It has been assessed multiple times by the Congressional Budget Office, and CBO has said it would have no meaningful effect,” he added. “One of the main reasons is that Canada’s drug market is simply too small to bring down prices here [and] the last four FDA commissioners have said there is no effective way to ensure drugs coming from Canada really are coming from Canada, rather than being routed from, say, a counterfeit factory in China.”

Meanwhile, drug industry trade body the Pharmaceutical and Research Manufacturers of America (PhRMA) has long said it doesn’t support importation schemes, saying “the US is the gold standard when it comes to regulating the safety of our medicine supply. Importing medicines from countries that do not have our same strong standards could taint our medicine supply.”

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