Trump Administration Takes First Step to Allow Drug Imports From Canada

Lara Moser organizes various medications that help treat her cystic fibrosis at her home in Leander, Texas, June 14, 2018. New York’s Medicaid program says Orkambi, a new drug to treat cystic fibrosis, is not worth the price. Moser said she had to stop taking the drug because she could not afford the first month’s payment of more than $3,000 required by her insurer. (Tamir Kalifa/The New York Times)

Katie Thomas

c.2019 The New York Times Company


The Trump administration said Wednesday that it would move forward with plans to allow states to safely import prescription drugs from Canada, for the first time.

The decision is an unusual one for a Republican administration. Progressives have long supported such a policy, but the pharmaceutical industry vehemently opposed drug imports by claiming they were unsafe. Food and Drug Administration commissioners had also opposed importing drugs intended for overseas use, citing safety issues.

In a telephone call with reporters Tuesday, Alex Azar, the secretary of health and human services, described the announcement as momentous. “For the first time in history, HHS and the FDA are open to importation as a means to lower drug prices,” he said.

He also said, “We will not take steps that would put patients or our drug supply at risk.”

First announced in July, the proposal is still a long way from affecting consumers’ wallets. States will have to submit their own plans to the federal government for approval, to see if they are both safe and would significantly reduce costs.

Importantly, many of the most expensive drugs are excluded from this proposal, including insulin and biologic drugs like Humira and other injectable drugs. A 2003 law limited the types of drugs that could be imported.

A separate plan that would allow manufacturers to import into the United States their own drugs that were intended for sale in other countries would apply to a wider range of products. But under that proposal, manufacturers would have to agree to participate. Federal officials have said that some drugmakers have expressed interest in doing so, without providing specifics.

Azar said that the announcement this week was just the beginning and that if the programs were successful, they could be expanded.

“I would envision that as we demonstrate the safety as well as the cost savings from this pathway, that there can be basically a pilot and a proof of concept that Congress could then look to,” he said.

As public outrage over high drug prices has mounted, state leaders from both parties have considered importing drugs from Canada as a way of addressing the issue. Florida Gov. Ron DeSantis favors such a plan, and President Donald Trump has repeatedly said he will help make it happen. Other states, including Colorado, Vermont and Maine, also favor importation.

Candidates and lawmakers in both parties are competing to show voters they are serious about lowering drug prices. Last week, the House passed legislation that would allow the federal government to negotiate drug prices with pharmaceutical manufacturers, an ambitious move that delivered on a key campaign promise but is unlikely to be taken up in the Republican-controlled Senate.

Administration officials have struggled to show they are making real progress on the issue. In July, the administration abandoned a proposal that would have given Medicare beneficiaries drug discounts at the pharmacy counter, but which also would have raised their premiums. That same month, a federal judge threw out a rule that would have required pharmaceutical companies to list the price of their drugs in television advertisements.

The policy supporting importation represents an about-face for Azar, who previously described such importation programs as “gimmicks.”