Bills aimed at lowering health care costs by importing less expensive drugs were heard Thursday in the Michigan House Health Policy Committee, but opponents say this isn’t a viable option.
No action was taken on the bills.
The two-bill package, sponsored by state Reps. Tommy Brann (R-Wyoming) and Steven Johnson (R-Wayland), would allow Michiganders to have more affordable pharmaceuticals imported in from other countries, specifically from Canada.
Many Michiganders cross the border into Canada to get their medicine for lower costs. In July, Democratic presidential candidate U.S. Sen. Bernie Sanders (I-Vt.) took a bus with Type 1 diabetes patients from Detroit to Canada to get cheaper insulin.
Brann says this isn’t an uncommon roadtrip Michiganders take to find an alternative to expensive drugs here in America. He told the committee a story about a constituent who has three kids, each with Type 1 Diabetes. By driving across the border into Windsor, the family was able to save $6,500 a year for insulin.
“We’re all fed up with the high cost of prescription drugs,” Brann said. “The patient will be able to go directly to the pharmacist to get the drug. There will no longer be any need for my constituent, Rachel, to go over to Canada because she can get that drug rate at home.”
House Bill 4978, introduced by Brann, allows the state to contract with Canadian suppliers, including manufacturers, wholesale distributors or pharmacies. House Bill 4979, sponsored by Johnson, opens importation up to international markets with other countries besides Canada that meet U.S. Food and Drug Administration standards.
According to Brann, 17 other states have introduced bills similar to these and three states have passed laws, including Colorado, Vermont and Florida.
Shabbir Safdar, executive director of Partnership for Safe Medicine, a nonprofit based in Washington, D.C., says that importing pharmaceuticals from countries like Canada is more complicated than the bills let on.
One of the greatest issues that Safdar sees in the proposed legislation is that the state does not govern the right to import drugs. In 2003, the Medicare Modernization bill was passed in the U.S. Congress that gives the federal government the right to authorize or prohibit importation of pharmaceuticals from Canada.
“Unless the Congress and the President suddenly get along well enough to change federal law, which seems very unlikely, there is no way that [HB] 4979, if passed, could ever be enacted to import drugs from any country other than Canada,” Safdar said.
The Medicare Modernization bill also excludes biologic drugs, which includes insulin.
Another issue raised in opposition of the bill package was that the drug supply in Canada is not substantial enough to support an increase of demand from Americans. Don Bell, retired chief superintendent with the Ontario Provincial Police, says that the higher demand could open a backdoor for illegal activity in drug importation.
“The problem is not that Canadian drugs are unsafe, or that we have a high prevalence of counterfeit drugs. Canada simply does not have enough legitimate prescription drugs to supply the United States. Canada is one-ninth the size of America and our drug supply is designed to supply our domestic population,” Bell said. “The imbalance of our genuine supply and demand created by importation will create a lucrative market ideal for criminals to step in by transshipping adulterated, substandard and counterfeit drugs to Michigan sourced from anywhere but Canada.”
Safdar says that opening up importation from other countries would create limitations for regulators in Michigan.
“When a board of pharmacy inspector from Michigan walks into a pharmacy anywhere in the state, they have legal rights. They can demand entry, they can inspect records and they can sanction the pharmacy for refusing the different records. We have no controlling legal authority and cannot do that. We are setting our regulators up for failure,” Safdar said.
He called on committee members to look to other states who have addressed costly drug prices through other avenues besides importation.
According to Safdar, West Virginia and Louisiana were able to lower prices for pharmaceuticals, save the state money and serve more patients by eliminating middlemen, like pharmacy benefit managers, and negotiating with vendors.
“These are really good, but not as easy to explain, methods of reducing the price of medicine,” Safdar said. “And I think that if we really want to have an effect, then we don’t want to enact a plan like this.”