Hillary Clinton’s Plan to Allow Overseas Pharmacy Competition in Pharmaceutical Market

September 6, 2016

HealthNetwork

The debate to legalize personal drug purchases from other countries has been thwarted repeatedly by the FDA and pharmaceutical industry for years. Currently, imports are considered illegal due to the high risk of finding counterfeit medicines, but it results in unfair competition and a lack of transparency regarding product pricing.

Americans spend more on prescription drugs than any other nation for maintenance medications for chronic illnesses as well as life-saving medications for disease. Congress agrees the country needs immediate results on efforts to lower pricing, safely, across borders and without the interjection of corporate interests.

Drug prices in the U.S. have become a public health crisis. In 2014, 35 million people went without their prescriptions because of the cost. A survey conducted by the Harvard School of Public Health and the Kaiser Family Foundation shows that half of them – 17.5 million – became even sicker as a result.

Other industries would not be allowed to exceed their profit margins like the largest pharmaceutical companies are today. The prescription drug industry earns a combined $80-$90 billion per year above the margins of other business and trade. They accomplish this by charging Americans thousands of dollars for new drugs at higher costs than in other developed nations and by using tax dollars intended for research and development to bombard the public with incredible amounts of unwanted, and often misleading, advertising. The burden is unaffordable and people are being forced to choose between medical bills and other major household payments.

The Upcoming Election

The high cost of prescription drugs has been brought to light once more with the upcoming election and candidates for president are in agreement that importing prescription drugs from other countries is the answer to lowering the cost of medications in America.

Donald Trump and Hillary Clinton have both publicly stated support for allowing Americans access to imported drugs from overseas to counter the high cost of drugs in the United States. Consumers agree with the candidates with 72 percent in support of personal drug importation from Canada. Even Congress has a majority in agreement. Consumers should have the choice to purchase drugs in an industry that is subject to the same competition and transparency as others.

Rising drug costs could be one of the biggest reasons American families cannot afford a middle-class life. The cost of living has outgrown wages and incomes gradually for years and that affects every American family and individual.

Every month, 90 percent of seniors take a prescription drug, spending over $500 out-of-pocket beyond their Medicare benefits. Around half of all Americans take a prescription drug and individuals with chronic health conditions or serious illnesses can spend thousands of dollars each year in out-of-pocket spending on prescription drugs.

International Prescriptions Online

Many people have heard about international online pharmacies, but they may not actually know how to find them. Guidelines for making safe and reliable purchases from online pharmacies are currently available to make sure you find trusted pharmacies that verify and protect your personal data and always require a prescription.

Despite the illegal nature of importing medication, about four million Americans are currently making online purchases. According to RxRights.org, researchers sampled a variety of prescription drugs bought from online pharmacies and found them to be independently verified through price comparisons and reliability ratings done by the Canadian International Pharmacy Association or PharmacyChecker.com.

“[Online Pharmacies] deliver authentic medicine and provide it at prices that are an average of 49.2 percent cheaper than the U.S.-based online pharmacies in the study.”

The FDA law is antiquated and has not prosecuted anyone for this perceived crime, however, the National Association of Boards of Pharmacy, the FDA, and even the popular press criticizes drug importation. Instead, they should be sharing knowledge needed to make more informed decisions about buying medications internationally. These outdated laws are eroding consumer health, the health of families, and their wallets.

The Impact on Drug Companies

Hillary Clinton believes that we need to hold drug companies accountable, promote competition, and allow Medicare to negotiate with drug companies to lower drug costs for Americans. She fought against lobbyists for affordable health coverage since the 90s and when it comes to pharmaceutical companies, she believes they need to cease fat marketing campaigns and raking in obscene profits. She will deny tax breaks for direct-to-consumer advertising and demand they use taxpayer funds to invest in research and development (R&D) as intended.

Other industrialized countries ban or severely restricts direct-to-consumer advertising because the consumer ends up with increased prescription drug costs. The government incurs additional costs to regulate against confusing, misleading, incomplete, and exaggerated claims as well. She will require:

Elimination of corporate write-offs for direct-to-consumer advertising.
The use of proceeds to help invest in company research and will dedicate funds to simplify the R&D tax credit.
A mandatory FDA pre-clearance procedure, paid for by fees collected from pharmaceutical manufacturers, to generate clear and understandable advertising.

Americans should receive valuable prescriptions to improve and save lives for the financial support they have contributed through taxes. Huge profits and marketing agendas suggest they do not need this tax support unless it is to meet target requirements, enhance their investment, or pay rebates to sustain their research for the benefit of consumers. There is a current provision in the Affordable Care Act directed at this issue that seriously needs enforcing.

Biologics and other specialty drugs for new treatments and improved health for chronic conditions and serious diseases are often initially the only ones on the market and can cost up to $10,000 a year. Increased competition through generic drugs and lowering the exclusivity period from 12 to seven years could save up to $5 billion for the federal government over a 10-year period. The FDA should expedite review of these drugs to avoid situations leading to excessive pricing and no longer accept agreements from manufacturers that “pay for delay”.

The Impact on Americans

Clinton wants to allow Americans to import drugs from abroad with the appropriate protections for safety and quality. Drug companies often unfairly charge nearly twice the price to Americans as they would abroad. It is an extreme situation especially when a new drug does not show a significant improvement over a previous treatment. Evaluating and comparing drugs is necessary to properly justify costs and drug companies need to be held accountable.

She wants to create competition to get more generics on the market and include a way for the Federal government to intercede in situations when a lack of competition leads to disproportionately high-priced drugs. She will fund the FDA’s Office of Generic Drugs to clear the backlog of generic drug approvals that delay competitors from reaching the market.

Hillary intends to cap out-of-pocket charges from insurers to keep money in the consumers’ bank accounts. She will require health insurance plans to have a monthly limit of $250 on prescription drug costs for those with chronic or serious health conditions provided the medication is FDA approved for the treated condition.

She will require more rebates to be extended from drug companies to low-income Medicare recipients, similar to the Medicaid program, to further reduce the cost of prescription drugs for seniors and individuals with disabilities. Under current law, the Medicaid program has more rebates and equalizing them would save more than $100 billion in Medicare costs.

Hillary Clinton also believes Medicare should be using their collective bargaining power for the best possible pricing, especially for unusually high-cost drugs with limited competition. Prescription pricing, currently being negotiated by an objective set of benefits managers, is not as effective as using the leverage of 40 million enrollees to drive down the cost of prescription drug and new biologic prices. This needs to change.

Leading by Example

The state of Maine – according to a recent Forbes article – enacted a law that allows its residents to purchase prescription drugs from online pharmacies in Canada, the UK, New Zealand and Australia. The business community and politicians, both liberal and conservative, agreed to try it because it was clear they would save money.

This example has drug manufacturers nervous that other states, not as conveniently located next to the Canadian border – like California – will also encourage consumers to purchase drugs elsewhere. The pharmaceutical industry is on the defense as a bill, the Personal Drug Importation Fairness Act of 2013, is being considered to allow U.S. consumers to buy medicine from other countries believed to have comparable safety standards, such as Australia, Canada, Israel, Japan, New Zealand, Switzerland, South Africa, and countries in the European Union. Much of Hillary Clinton’s plan could easily become a reality after the election.