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house Bill H.R. 478

Should Patients Be Allowed to Buy Prescription Drugs From Canada?

Argument in favor

Prescription drug prices in the U.S. are incredibly high compared to Canada. Patients whose drugs are cheaper in Canada should be allowed to buy their drugs from there in order to keep their healthcare costs as low as possible.

Amy's Opinion
···
02/19/2019
Unfortunately, many Americans cannot afford the prescribed medicines they need here in the states. If Congress will not act to reform the pharmaceutical & healthcare industries, the absolute least you can do is to allow us to purchase our medications elsewhere. And maybe this will force pharma here to become more competitive.
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Dave's Opinion
···
02/19/2019
You talk about the free market, which is all talk, more of a monopoly. You should be able to buy from around the world; Canada, Mexico, Europe and others. You talk about Competition and driving the price down, but you protect corporations and drive prices up, with no limits, which is what we got fleecing of America.
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Cherie's Opinion
···
02/19/2019
Until costs of prescription medicine are regulated, we need to allow people to get their medications without bankrupting themselves.
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Argument opposed

Pharmaceutical companies need the revenue from their sales in the U.S. to fund innovative research that saves lives. Additionally, allowing personal importation from Canada might lead to unsafe or counterfeit medication entering the U.S., putting patients’ lives at risk.

J's Opinion
···
02/19/2019
Allowing people to buy prescriptions across boarders is not the fix. It’s a band-aid. We need to fix the US market for prescription drugs. They are cheaper in Canada and Mexico because of relaxed regulations and taxes. Let’s fix the problem and reform the FDA and the domestic pharmaceutical markets. Only legally imported drugs should be allowed into US markets. If not people will begin smuggling prescription drugs and public safety will suffer.
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SneakyPete's Opinion
···
02/19/2019
“CROSS-BORDER” DRUG SALES Pharmaceutical companies need the revenue from their sales in the U.S. to fund innovative research that saves lives. Additionally, allowing personal importation from Canada might lead to unsafe or counterfeit medication entering the U.S., putting patients’ lives at risk. Additionally we’d be seeing: * The potential importation of drugs which are illegal in the USA 🇺🇸. * The potential “sud-standard” manufacturing 👩‍🏭 in comparison to those in the USA 🇺🇸. * Only “Legally” imported drugs should be allowed in the USA 🇺🇸. SneakyPete......... 👎🏻👎🏻👎🏻👎🏻. 2*19*10..........
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Mary's Opinion
···
02/19/2019
Absolutely! Medicine here in the US is way too expensive and half the time it doesn’t even work well with the generic brand.
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
    IntroducedJanuary 10th, 2019

What is House Bill H.R. 478?

This bill would allow the personal importation of safe and affordable drugs from approved pharmacies in Canada. After two years, personal importation from other countries with strong pharmaceutical regulations would also be allowed.

Under this bill, the FDA would be required to register qualified international pharmacies and identify websites selling FDA-approved medications directly to consumers from licensed pharmacies. It’d also create registration requirements with multiple layers of oversight to permit U.S. pharmacies to import wholesale quantities that could be sold at much lower prices. Finally, this bill would increase penalties for online pharmacies that knowingly sell counterfeit drugs.

Impact

Patients; healthcare system; healthcare costs; pharmaceutical companies; pharmacies; and Canada.

Cost of House Bill H.R. 478

The CBO scored similar Senate legislation, the Affordable and Safe Prescription Drug Act, introduced by Sen. Bernie Sanders, in the previous Congress. It estimated that drug importation would save $1 to $1.5 billion a year.

More Information

In-DepthRep. Chellie Pingree (D-ME) reintroduced this bill from the past two Congresses to allow consumers to import medications from Canada, where they’re less expensive:

“I’ve heard from so many individuals and families who don’t know what to do about shocking increases in their medication costs—whether it’s the prescription they need to manage their high cholesterol or asthma, or the EpiPen that could save their life during an allergic reaction. Just across the border in Canada, most medications are available at a fraction of the cost, because their government negotiates on price. Right now, we are denying our citizens access to those safe, lower price alternatives just to keep pharmaceutical companies happy. This bill would put an end to that and offer some much-needed relief to consumers.”

Rep. Jaime Herrera Beutler (R-WA), lead Republican cosponsor of this bill, adds:

“The high cost of prescription drugs is leading some folks in Southwest Washington and across the country to skip doses, cut pills in half, or forego filling prescription drugs altogether. That’s alarming, and Congress needs to work on solutions to ease the financial burden of expensive drugs to make sure that residents aren’t forced to take these kinds of actions. Today, I’m proud to join with Congresswoman Pingree in introducing bipartisan legislation to allow the safe, responsible importation of certain prescription drugs from our neighbor to the north. If a person can save hundreds or thousands of dollars and get identical prescriptions from licensed Canadian pharmacies, Congress should move forward with a solution allow that to happen.”

After his election, then-President-elect Trump said that drug companies were “getting away with murder” in regards to drug prices. As President, Trump has backed multiple regulatory actions aimed at reducing drug costs, including approving more generic drugs and using lower international prices to save money for Medicare. He has also used his Twitter account to criticize individual drugmakers.

Dr. Joel Lexchin, a former emergency department physician and drug policy expert at York University in Toronto, Canada, says it’s “fine for an individual” to buy drugs from Canada, but the U.S. government needs to tackle drug pricing for a sustainable solution:

“Even if the US bought every pill in Canada, you have almost 10 times the population. This is not going to solve the problem of drug prices in the United States. The solution is for the US to start regulating its own prices. And you can do that.”

The Pew Charitable Trusts also points out that pharmaceutical companies could easily change their pricing to account for international personal importation:

“Importing drugs into the U.S. could also affect foreign markets, and pharmaceutical manufacturers might alter their pricing strategies. To mitigate decreased U.S. revenue, manufacturers could seek to increase their prices abroad. In addition, the U.S. market’s large size could strain the supply of pharmaceuticals, resulting in drug shortages in other countries if importation were to be implemented on a large scale.”

The pharmaceutical lobby fiercely opposes efforts to allow drug importation for personal use, arguing that U.S. Food and Drug Administration (FDA) oversight protects consumers from unsafe medications. Making their case against importation, pharmacy groups have also argued that it opens the door to counterfeit and tainted medications. The Pharmaceutical Research and Manufacturers Association of America also argues that the price spikes of a few years ago have eased, and government intervention on prices will stifle innovation and deprive patients of access to innovative medications.

This bill has seven bipartisan cosponsors, including six Democrats and one Republican, in the current Congress. It’s been introduced in the previous two Congresses (114th and 115th). Last Congress, it had nine bipartisan cosponsors, including five Democrats and four Republicans, and died without receiving a committee vote.

Congress has passed legislation legalizing the importation of prescription drugs several times over the past 20 years. However, both Democratic and Republican administrations have opted not to implement the legislation.


Of NoteFederal regulations currently strictly limit the importation of prescription drugs from foreign countries for personal use. However, the FDA doesn’t prosecute consumers for buying medicines for foreign pharmacies for personal use. Instead, if they’re detected, such packages are intercepted at the border and their contents are returned or destroyed.

Additionally, consumers who meet the following conditions can import 90-day supplies of some prescription drugs and medical devices if they meet the following conditions:

  • The drug is to be used to treat a serious condition and no effective treatment is available in the U.S.;They won't be selling it or promoting it to others in the U.S.;
  • The medication doesn't represent an unreasonable risk;
  • They affirm in writing that the drug is for their personal use; and
  • The quantity is no more than a three-month supply and they provide the name and address of the doctor licensed in the United States responsible for their treatment with the medication, or they provide evidence that the medication is for continued treatment begun in a foreign country.

In June 2013, Maine — Rep. Pingree’s home state — set a national precedent by passing a law allowing residents to purchase prescription medication from overseas by mail. This made it the first state in the nation to formally defy the federal ban. However, in February 2015, a federal judge overturned the state law, ruling that Maine infringed on the federal government’s established regulatory authority.

In December 2016, Kaiser Health News reported that unaffordable drug prices in the U.S. were already pushing millions to buy medicine outside the country. Rachel Bluth reported:

“As drug prices have spiraled upward in the past decade, tens of millions of generally law-abiding Americans have committed an illegal act in response: They have bought prescriptions outside the US and imported them.”

In January 2019, the House and Senate held separate hearings to address high drug prices. STAT observed that the hearings could indicate Congressional action on drug prices will happen in the near future:

“Democrats here have, of late, been making far more noise about high prescription drug prices. But at two dueling hearings on Tuesday, the most powerful Republicans on each committee made their own mark… [I]ncreasing political enthusiasm for tackling drug costs could lead to bipartisan legislation, even in a divided Congress and even as the historically powerful pharmaceutical lobby pushes back.”

Rep. Elijah Cummings (D-MD), chairman of the House Oversight and Reform Committee, which held the House hearing, said that there’s bipartisan agreement that something has to be done to rein drug prices in:

“There’s a strong bipartisan consensus that we must do something — something meaningful — to rein in the out-of-control price increases. Even President Trump has said that drug companies are ‘getting away with murder. This is a matter literally of life and death, and we have a duty to act now.”

High prescription drug costs have consistently polled as a top voter concern. The January 2019 Congressional hearings particularly focused on insulin, the cost of which has risen significantly in recent years. Reuters reported that the annual cost of treating a type 1 diabetes patient in the U.S. nearly doubled from 2012 to 2016, increasing from $2,864 to $5,705.

Buying drugs from Canada can cost as much as 80 percent less than buying them in the U.S., thanks to government-negotiated prices in Canada. For example, Solvadi, a hepatitis C drug, costs $90,000 U.S. retail for a 12-week course; in the U.K., it costs $16,770 a month, and $14,493 in Canada. Gleevec, a leukemia drug, is an even more dramatic example: it costs $10,122 in the U.S., $2,645 in the U.K., and $2,420 in Canada.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / michaelquirk)

AKA

Safe and Affordable Drugs from Canada Act of 2019

Official Title

To amend the Federal Food, Drug, and Cosmetic Act to allow for the personal importation of safe and affordable drugs from approved pharmacies in Canada.

    Unfortunately, many Americans cannot afford the prescribed medicines they need here in the states. If Congress will not act to reform the pharmaceutical & healthcare industries, the absolute least you can do is to allow us to purchase our medications elsewhere. And maybe this will force pharma here to become more competitive.
    Like (174)
    Follow
    Share
    Allowing people to buy prescriptions across boarders is not the fix. It’s a band-aid. We need to fix the US market for prescription drugs. They are cheaper in Canada and Mexico because of relaxed regulations and taxes. Let’s fix the problem and reform the FDA and the domestic pharmaceutical markets. Only legally imported drugs should be allowed into US markets. If not people will begin smuggling prescription drugs and public safety will suffer.
    Like (37)
    Follow
    Share
    You talk about the free market, which is all talk, more of a monopoly. You should be able to buy from around the world; Canada, Mexico, Europe and others. You talk about Competition and driving the price down, but you protect corporations and drive prices up, with no limits, which is what we got fleecing of America.
    Like (103)
    Follow
    Share
    Until costs of prescription medicine are regulated, we need to allow people to get their medications without bankrupting themselves.
    Like (84)
    Follow
    Share
    Why not? I am sick and tired of Big Pharma being allowed to financially rape us and the government turning a blind eye because their palms are being greased. It’s time for “We the People”!
    Like (54)
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    Why not! At least the less fortunate can live longer. The price of prescriptions in the United States is outrageous.🤦🏾‍♀️
    Like (52)
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    Go a step further and flood the market with cheap Canadian drugs and break up the big Pharm monopoly. The free market is not capable of producing reasonably priced drugs.
    Like (43)
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    Of course citizens should be able to buy drugs from Canada. The real legislative task however is to stop taking “gratuities “ from the US pharmaceutical industry and actually lower the cost of US drugs like other countries. This certainly affects taxpayers in the form of Medicare Part D and Medicaid.
    Like (37)
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    If the legislators won’t fix the outrageous RX pricing in this country then the very least they can do is give them the ability to get better pricing.
    Like (29)
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    Competition lowers pricing.
    Like (23)
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    This should be a no brainer, especially for free enterprise Republicans. Allowing patients to mail order drugs from Canada will provide downward price pressures on American drug stores, who in turn will demand lower wholesale prices from drug mfg to compete. The argument that American drug prices are high in order to provide drug companies capital for drug R&D is specious. American tax payers already finance drug R&D through direct financing by the government and tax deductions for all R&D expenses: scientists’ and management’s salaries, materials, buildings and equipment. Americans are forced to pay twice for drug company’s R&D.
    Like (22)
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    Yes increase the competition. Lower drug prices.
    Like (19)
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    How can you lefties believe in free market competition when it comes to drugs? But you are against free market competition when it comes to health insurance?
    Like (12)
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    Excuse me! They sure want to take away ALL our freedoms, don’t they? When you allow drug companies to rip our country off like there’s no tomorrow, this is what you can expect. Quit taking Big Pharma money and make our drug pricing the same as other countries. Problems solved! Just shows you how much better to their people other countries are. Better at not being bribed. Better at the art of the deal, too, eh, huuuge orange pig? Seriously, moving to another country so I don’t have to worry about what lies, crisis or emergency the orange pig is going to manufacture, daily (thereby enabling me to FINALLY get a good nights sleep after the last three years), is really is beginning to look like my only option. Our elected officials don’t seem to gave a damn. That’s a for sure!
    Like (11)
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    Yes. This is free trade. This is an issue where Progressives and Conservatives agree. It’s the Establishment Republicans and Establishment Democrats that are blocking this. Reduce consumer regulations and allow us to purchase alternatives!
    Like (10)
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    Not only Canada but Europe as well. We are getting scalped on scripts every single day. Many people will die because they cannot afford either insurance or the drugs they need to live. I know, I am one of them.
    Like (9)
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    That would be ok but wouldn't it be better if we worked on transforming our own healthcare system by removing this massive for profit push in healthcare insurance and pharmaceuticals. This just sounds so simple. Just because we want affordable healthcare doesn't mean we are socialist, communist thinking. That is nothing more than fear mongering.
    Like (8)
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    I see no reason to vote against this. I don’t buy the argument that big pharma needs the money to do research. They already hold back sales of orphan drugs from desperate people. They’d have all the money they’d need if they cut back on what they spent lobbying Congress, influencing doctors and their office staff and lowering CEO wages, benefits and golden parachutes. I crossed the bridge to Juarez to get much cheaper prescription drugs. I see no reason to be gouged in this country when they can be gotten for a reasonable price in Canada.
    Like (7)
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    “CROSS-BORDER” DRUG SALES Pharmaceutical companies need the revenue from their sales in the U.S. to fund innovative research that saves lives. Additionally, allowing personal importation from Canada might lead to unsafe or counterfeit medication entering the U.S., putting patients’ lives at risk. Additionally we’d be seeing: * The potential importation of drugs which are illegal in the USA 🇺🇸. * The potential “sud-standard” manufacturing 👩‍🏭 in comparison to those in the USA 🇺🇸. * Only “Legally” imported drugs should be allowed in the USA 🇺🇸. SneakyPete......... 👎🏻👎🏻👎🏻👎🏻. 2*19*10..........
    Like (6)
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    Yes. Prescription drugs are extremely expensive in the US and causes economic hardship for many Americans. This is a no brainer. Help Americans by opening up the market to Canada and give them options. Then maybe these drug companies will feel the pain of how they are overcharging Americans for their own selfish greed.
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