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Personal Importation Remains Immediate Rx Savings Solution for Americans

The Campaign for Personal Prescription Importation released the following statement and analysis on the drug pricing legislation that passed the House of Representatives in the Build Back Better Act, H.R. 5376.

“The Build Back Better legislation is a step in the right direction for prescription drug cost relief, but this limited legislative package will not solve all of America’s drug pricing problems and will take years to implement. Americans need the access to safe and affordable medicine that only expanded personal prescription importation from Canada offers, and they need it now.”

The House of Representatives’ Build Back Better legislation would indeed lower the federal government’s drug costs. Congressional Budget Office analyses of the bill find savings of around 78.8 billion dollars over ten years. However, Americans own drug prices remain out of control, and access to affordable prescription drugs will continue to plague millions of Americans. The 131 million plus Americans who take prescription medications, including at least 4 million who import medications, need immediate and longterm cost saving solutions.

Build Back Better Rx Analysis

Key Benefits

  • Initiates Medicare price negotiations for some high-cost drugs covered under Medicare Part B and Part D

    • The top 50 drugs account for 80% of all Medicare Part B drug spending and 37% of Part D drug spending.

  • Would limit out-of-pocket costs for Medicare Part D beneficiaries at $2,000 per year starting in 2024.

  • Limits cost-sharing for some insulin at $35 a month for Medicare Part D beneficiaries.

  • Drugmakers would face tax penalties if they increased prices more than the rate of general inflation.

Key Limitations

  • Limited Medicare price negotiations would apply to just 10 drugs per year, with that number eventually rising up to 20 drugs per year. Drugs which have been approved more recently than 7 years ago (or 10 years ago for biologics) would be exempt. Meanwhile many more drugs continue to see major price increases:

    • Kaiser Family Foundation analysis shows that half of all covered Part D drugs had list price increases that exceeded the rate of inflation between 2018 and 2019.

    • Analysis by the HHS Office of Inspector General shows average sales price (ASP) increases exceeding inflation for 50 of 64 studied Part B drugs in 2015.

  • Neither CBO nor the Administration have published estimates of beneficiary premium and out-of-pocket budget effects associated with the BBBA proposal to allow the HHS Secretary to negotiate drug prices.

  • A “Non-Interferance Clause” could prevent HHS negotiated prices from reaching patients covered under private insurance or lacking insurance entirely. “(HHS) may not interfere with the negotiations between drug manufacturers and pharmacies and PDP.”

  • 2023 would be the first year that the limited Medicare price negotiations could start on the first 10 drugs, and it could take years to expand the phased negotations.

  • The out of pocket caps would only apply to Medicare beneficiaries in Part D plans with extremely high out-of-pocket drug costs. According to Kaiser Family Foundation:

    • Most Part D enrollees have not had out-of-pocket costs high enough to exceed the catastrophic coverage threshold in a single year.

    • It is also possible that enrollees could face higher Part D premiums resulting from higher plan liability for drug costs.


While the Build Back Better Act would be a major step in the right direction, it will not provide prescription drug pricing relief to all Americans and the relief it does provide will not be immediate. The Build Back Better Act falls far short of the $450 billion 10-year savings Democrats had aspired to with H.R. 3, and Senate negotiations could claw savings back even further. The Build Back Better Act does put pressure on big pharmaceutical manufacturers to lower prices and be more transparent, but loopholes remain through which patients will continue to be unfairly squeezed for profits. Only expanded personal prescription importation from certified Canadian pharmacies offers Americans the immediate savings they need and a guarantee of safe medication.

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