The Sunsine State's Drug Importation Scheme Creates More Problems Than It Pretends to Solve
The logic behind Florida's new drug-importation program, which the U.S. Food and Drug Administration formally approved earlier this month, might seem straightforward. Since prescription drugs cost less in Canada, purchasing medicines in bulk from across our northern border should deliver significant savings.
As Florida will soon discover, however, the devil is in the details.
For starters, any savings the program might generate won't flow to patients but to Floridas state government.
More importantly, the logistical challenges of ensuring the safety and authenticity of drugs entering the country from Canada are considerably more daunting than most realize. Failing to address those challenges could cost lives.
As in much of the country, a strong majority of Floridians believes that lowering prescription drug prices should be a top policy priority.
Gov. Ron DeSantis, R-Fla., has touted his importation program as an answer to that call.
In announcing the FDA's decision, the state government claimed that the importation program "will save Florida up to $180 million in the first year."
Individual consumers won't see any of those dollars directly.
That's because the imported drugs, per an official state announcement, "will be for individuals who are under the care of the Agency for Persons with Disabilities (APD), Department of Children and Families (DCF), Department of Corrections (FDC), and Department of Health (DOH).
"The program will then expand to include providing imported prescription drugs for Medicaid members across the state."
Assuming these savings materialize, they could come at a considerable cost to patient safety -- and not just in the Sunshine State.
The world is currently awash in counterfeit drugs. According to the World Health Organization (WHO), about 1 million people die each year from counterfeit medicines.
The FDA has fared better than regulators in other countries at keeping counterfeits off the market. It's done so by maintaining strict control over every pill and vile sold domestically.
But by allowing drugs to enter the United States from Canada, the agency is opening the U.S. market to contamination from fake medicines.
The FDA is ordering Florida to test imported drugs for authenticity and compliance with the agency's rules, and to relabel them "consistent with the FDA-approved labeling."
The state will also need a system for transporting, tracking, and storing imported medicines securely — and distributing them to state agencies.
The infrastructure and expertise required for this undertaking is so vast and complex that Florida has agreed to pay the Dallas-based firm LifeScience Logistics up to $39 million to manage the operation, according to reporting from Kaiser Health News.
That's equivalent to roughly one-fifth of what the state says importation will save in its first year.
And should the state or LifeScience Logistics — or the FDA, for that matter — fail in any of its duties, the result could be a public health catastrophe with the potential to result in deaths.
The practical challenges of drug importation don't end there.
The program can only function if Canada is willing to sell Florida medicines in the first place. Yet as Canada's Health Minister, Mark Holland, recently put it, "We're going to do everything in our power to make sure that another country cannot be given the ability to pillage our health system for its own benefit."
His apprehension is understandable.
Exporting medicines in bulk to the United States could lead to shortages in the Canadian market. For years, Canadian leaders have made no secret that they won't allow mass importation to the United States. "Canada cannot be the drugstore for the United States of America," Ujjal Dosanjh, Canada's former Health Minister, said in 2005.
Florida's drug importation scheme might sound appealing in theory. In practice, it creates new, formidable problems for patients and governments both — while offering very little in return.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.