Updated: Apr 27
The American public has long supported prescription importation from Canada as a solution to high drug costs in the U.S. A 2019 Kaiser Family Foundation polling found 78% of the public favors allowing Americans to buy prescription drugs imported from licensed Canadian pharmacies. This proposal has broad support across party lines – 75% of Democrats, 82% of Independents, and 75% of Republicans. Millions of Americans already depend on personal prescription importation for affordable access to safe medications. According to the Kaiser Family Foundation, 8 percent of American adults – 19 million people – say they or someone in their household had imported a drug at some point to get a lower price. So what do health experts say about prescription importation?
Despite the passage of legislation in the 2022 Inflation Reduction Act to lower drug prices, there remains a high demand among Americans for more affordable prescriptions, with as many as 37% recently reporting skipping medications due to costs.
On March 23, 2023, the Senate held a hearing to investigate the persistent high costs of medications and vaccines in the United States, during which health policy expert Craig Garthwaite Phd., encouraged “Congress and regulators to consider a broader system of importation across developed countries with similar safety and regulatory systems.”
Garthwaite, a professor of Strategy Herman Smith Research Professor in Hospital and Health Services Management Director of Program on Healthcare at Kellogg (HCAK) Kellogg School of Management Northwestern University, has provided expert testimony to Congress on a number of occasions, but he is not the first health expert to encourage Congress to expand prescription importation to improve American access to medications.
Dr. Aaron Kesselheim, a professor of medicine at Harvard Medical School, has testified before Congress, “Patients in the U.S. should have access to safe, effective, and affordable medications, regardless of where they are manufactured or distributed.”
Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, has said, “Many of the medications sold in the United States are actually manufactured in the same facilities that produce drugs for foreign countries. These drugs are subjected to the same safety and quality controls, and importing them would not compromise patient safety.”
A report from the FDA Center Drug Evaluation and Research, "Quality Testing of Difficult-to-Make Prescription Pharmaceutical Products Marketed in the U.S.," authored in part by Dr. Janet Woodock, the former Acting FDA Administrator, investigated 252 drugs made in the US, Canada and other countries. The report found that all samples met U.S. FDA standards for dosage uniformity and dissolution, and further that the U.S. performance was below average.
A Harvard report, by Dr. Niteesh K. Choudhry, MD, PhD, Professor of Medicine at Harvard Medical School, Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health, finds that, in wealthier countries with active regulatory systems like Canada, drug safety can be adequately ensured, and brand-name products are usually less expensive than in the United States.
In 2018 then-FDA commissioner Dr. Scott Gottlieb stated that “Importation of drugs from lower-cost countries could be an important lever to lower the cost of medicines for Americans.” CPPI drug cost comparisons show that Americans save 50 to 90% on leading brand-name prescription drugs from licensed Canadian pharmacies compared to the best US pharmacy prices.
Roger Bate, a health economist with the American Enterprise Institute who has written several books on counterfeit medications, says “Buying medicines over the web can be risky, but purchasing prescriptions from credentialed online pharmacies can be done safely. Price controls in Canada and Europe allow their medicines to be far cheaper than in the US. US patients without adequate insurance should be allowed to import cheaper medicines.”
Bate has warned that “Industry pressure and the opioid crisis are making it harder for importation to occur: Credentialing organizations cannot advertise, payment organizations are restricting users, and shippers are impounding products.”
In 2022 CPPI was forced to mount a campaign to stop the DRUGS Act, legislation that was backed by BigPharma front groups under the false claim that it would protect Americans from opioids crossing the border. Americans from across the country who depend on prescription importation for critical daily medications wrote over 50,000 letters to Congress demanding personal prescription importation be protected.
Many experts funded or backed by pharmaceutical companies have cast strawman arguments against prescription importation, but independent health experts and millions of Americans agree that prescription importation from safe licensed pharmacies in countries like Canada can save Americans money and ensure access to critical medications at affordable prices.