The Risky Business of Drug Importation

BIOtech Now
Andrew Segerman

You hear it all the time: prescription drugs in the United States are too expensive, so let’s go buy them abroad. Tracy Cooley of the Campaign for Personal Prescription Importation was the latest to join this chorus with an opinion piece this week in Morning Consult. What Cooley fails to acknowledge is that such a move would likely expose patients to counterfeit, adulterated, or unapproved drugs, and any savings would mostly wind up as profits for middlemen, not lower prices for patients.

As a bipartisan group of four former FDA Commissioners recently wrote to Congress: “…importation represents a complex and risky approach — one that the evidence shows will not achieve the aim [of lowering costs], and that is likely to harm patients and consumers and compromise the carefully constructed system that guards the safety of our nation’s medical products.”

Cooley and others often assume that if drugs are imported from countries like Canada, such supplies would pose little to no safety risks. This stems from a misguided assumption that these medicines would always be coming from a system overseen by Canadian regulators, which would not necessarily be the case. While the Canadian government works to ensure the safety and authenticity of medicines entering their market that are intended for use by patients in Canada, they do not apply those standards for medicines intended for export only. In fact, the Canadian government has even stated, “Health Canada does not assure that products being sold to U.S. citizens are safe, effective, and of high quality, and does not intend to do so in the future.”

What’s more, a recent FDA evaluation revealed that while nearly half of imported drugs claimed to be Canadian or from Canadian pharmacies, 85% of such drugs were actually from different countries — even Cooley herself points out that “rogue online pharmacies selling counterfeit medication are a threat to public health.”

As it relates to the “painfully high cost of drugs in the United States,” it’s important to remember that prescription medicines, including retail pharmacy sales and provider‑administered drugs, are only about 14% of overall health care spending – and growing at an extremely slow pace. Hospitals, on the other hand, comprise by far the largest share, at about 30% of U.S. health care spending, or close to $1 trillion annually. Physicians and clinical services are another 20%. Furthermore, any improved access or cost savings resulting from importation are likely to be minimal — with most savings winding up as profits for middlemen.

When it comes to addressing prescription drug costs, patients and consumers deserve a more responsible approach. That’s why a broad-based coalition of drugmakers, insurers, patient advocates, and others have proposed a set of consensus reforms that include increasing competition and driving greater value within the system. These are the kind of positive solutions that will encourage more access to affordable medicines and protect the safety of America’s patients.

For more on the challenges associated with drug importation, head over to

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