Why state drug importation pilot programs don’t work

Across the country, some states are recirculating failed proposals that would establish state-run prescription medicine importation schemes

Nick McGeeFebruary 8, 2019

Why state drug importation pilot programs don’t work

Across the country, some states are recirculating failed proposals that would establish state-run prescription medicine importation schemes. Such proposals would allow medicines from foreign countries – medicines that have not undergone stringent review by the U.S. Food and Drug Association (FDA) – into the country.

These dangerous proposals threaten the safety of patients without delivering the savings they promise and would likely come at a high cost to the state. To make matter worse, these proposals would also put a strain on local law enforcement. In fact, the National Sheriffs’ Association has said importation would impact the ability of law enforcement to protect public health.

We know state-run importation schemes simply don’t work. In fact, they have been tried and they have failed.

They have failed because costs to states and cities have far outweighed any potential savings for importation programs. At the same time, there was a lack of interest from consumers in importation due to the delays in delivery and concerns about potentially unsafe drugs.

Here are examples of these importation scheme failures:  

  • Illinois, Wisconsin, Missouri, Kansas, Vermont and Hawaii: In the mid-2000s, these states tried an importation program with a Canadian contractor of online pharmacies. The program cost $1 million to implement, and less than 5,000 people participated. The program was deemed a failure and terminated after four years.
  • Massachusetts: Springfield and Boston created a similar program, which was canceled because participants found greater safety and savings through Medicare Part D.
    • The Springfield importation program was terminated in 2006 after three years of low participation largely due to the introduction of the Medicare prescription drug benefit.
    • Boston’s importation program was terminated in 2008 after four years because it was unable to attract more than a few dozen participants. As of July 2008, only 16 retirees were participating in the program.
  • Minnesota: Similar to the cities in Massachusetts, Minnesota’s importation pilot program was terminated after Medicare Part D showed greater participation and savings.

Further, a recent analysis by Avalere illustrates some of the cost and operational considerations involved in establishing a state importation program. These challenges may be why no U.S. Secretary of Health and Human Services has ever certified an importation program, despite having the authority to do so.

State lawmakers, and federal lawmakers considering similar approaches, should take these importation failures into consideration, and instead focus on real solutions that put patients first and actually address the affordability challenges they’re facing without compromising their safety.

Ensuring rebates and savings are passed on to patients, addressing high out-of-pocket costs and providing information about patient assistance programs are all alternatives that would help patients get the life-saving prescription medicines they need. We remain committed to working with state policymakers, patient advocates and others to help improve the pharmacy counter experience without jeopardizing Americans’ safety

Learn more about the dangers of drug importation and why these proposed schemes won’t work here:  PhRMA.org/Importation.

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