Florida Republican Gov. Ron DeSantis is trying to convince President Donald Trump to permit the state to be the first in the U.S. to import cheaper drugs from Canada.
“While our prices remain high, our neighbors in Canada are spending significantly less for the same drugs,” DeSantis said in a statement. “These price disparities are indefensible and inexcusable and I am ready to act.”
DeSantis has said Trump and he have spoken several times about the issue, according to news reports. The governor has strong ties with the Trump administration. Trump endorsed DeSantis, a former House member, during Florida’s GOP gubernatorial primary last year and visited the state several times in the runup to DeSantis’ close general election victory.
Now DeSantis hopes those connections will help his state gain approval from Trump’s administration to help lower Florida’s drug costs by taking advantage of Canada’s cheaper prices. A 2003 law gives HHS the power to approve importation, but the agency has never allowed it.
The idea of importing drugs from Canada is picking up a lot of steam in states grappling with high drug prices.
The CMS Office of the Actuary projected that overall outpatient drug spending will increase by 6.1% on average per year over the next decade, according to a report released Wednesday. States have tried several ways to combat high drug prices. California and Maryland both pursued laws to put a cap on drug costs paid by state health programs.
Vermont passed a law last year seeking federal approval to import drugs. There also are 12 state legislatures considering adoption of a similar program this year. But all would need HHS approval.
“It is clearly an issue with great interest to the states,” said Trish Riley, executive director of the National Academy for State Health Policy.
The academy is working with Vermont on its federal application before HHS. The state hopes to submit its application in July.
Riley said states like Vermont want to contract with drugmakers in Canada using the drug supply chain.
Republicans have traditionally opposed personal importation because of safety concerns, primarily that U.S. consumers could buy fake or substandard drug from online Canadian pharmacies. This practice is currently illegal but not very heavily enforced.
The four most recent FDA commissioners wrote in a March 2017 letter to members of Congress that they worried the FDA lacks the resources to oversee a major drug importation program.
HHS Secretary Alex Azar, who would eventually decide on any state’s importation proposal, also has opposed importation because of safety concerns. The 2003 law said that any application must show that importation would result in substantial savings for a state and would be safe.
“The safety issues have already been well addressed given the globalization of the drug industry,” Riley said.
She said that the importation programs would use the existing supply chain and would need to assure “FDA standards are applied and we have tracking and tracing and auditing to make sure the drug supply chain is pure.”
While Azar and congressional Republicans have been skeptical of drug importation, Trump expressed interest in the idea during the 2016 campaign. He also broke with GOP orthodoxy when HHS released a proposal to tie the price for Medicare Part B drugs to cheaper prices paid by countries like Germany and Japan.
Trump has instructed his staff to meet with DeSantis to learn more about the proposal, according to spokesman Judd Deere.
“The administration also looks forward to educating Gov. DeSantis on the many policy options the Trump administration has proposed to reduce costly drug prices for American families,” he added.