Vermont may allow import of prescription drugs

MONTPELIER, Vt. — The Vermont Senate is considering a proposal to save money on prescription drugs by importing them from Canada, where many are sold for a fraction of the cost in the United States.

The cost of prescription drugs is a factor driving the increase in state health care costs and the state budget, said Democratic and Progressive Sen. Tim Ashe. He supports the proposal that was discussed Thursday during a meeting of the Senate Health and Welfare Committee.

Two main sections of the proposal include drug importation and authorizing the state to buy prescription drugs in bulk, including working with other states to create buying pools.

"We need to do something to bring down prices," Ashe said. "It is eating everyone's lunch."

Under the proposal, any imported drugs must meet all U.S. safety requirements. It draws on efforts from other states, Ashe said. In Utah, a drug importation proposal that failed last year is being expanded and will be introduced on the first day of that state's Legislature next week.

The Pharmaceutical Research and Manufacturers of America, a trade group for drugmakers, claimed in a statement that Vermont's proposal would allow sales from online Canadian pharmacies, which it said would threaten the health of Vermonters. But the proposed Vermont legislation does not mention online pharmacies.

"Patient safety must be our top priority, and our public policies should reinforce — not undermine — that commitment," the group said.

The concept of saving money on prescription drugs by importing them has been around for years. In 1999, Vermont's then-U.S. Rep. Bernie Sanders famously took busloads of people to Canada, where they met with doctors who then wrote them prescriptions for drugs that cost a fraction of what the same drugs would have cost them in the United States. Last year, Sanders, now an independent U.S. senator, introduced another proposal in Congress to allow for the importation of drugs from Canada.

In 2003, federal law was changed to allow the secretary of the Department of Health and Human Services to authorize the importation of prescription drugs, but such permission has never been granted.

Many drugs are sold in Canada, some of which were manufactured in the United States, for a fraction of the cost of the same in the United States. A chart by the National Academy for State Health Policy distributed at the meeting included a number of examples, including the cost of a single popular arthritics drug, which costs $6.44 in the U.S. and 13 cents in Canada; a cholesterol drug that sells for $8.74 in the U.S. and 19 cents in Canada; or a respiratory inhaler that sells for $392.40 in the U.S. or $38.44 in Canada.

Prescription drugs account for 10 percent of the $3.2 trillion in overall health care spending, outpacing all other health care services, according to government statistics. Consumers with diabetes, cancer and leukemia are some of the most likely to feel pain at the pharmacy due to recent drug price hikes. The cost of two common types of insulin, for instance, increased 300 percent in the past decade.

Other governments bargain on behalf of their citizens, which helps to keep costs down. The biggest U.S. buyer of medication, Medicare, is barred by law from negotiating pricing. That means Americans are largely without the type of bargaining power available to other countries.

In the U.S., no single entity can bargain on consumers' behalf, given the country's patchwork of insurers, employers, and federal and state programs. Domestic prices are more expensive for 93 percent of 40 popular branded drugs than what is charged in Norway, a  2015 Wall Street Journal investigation found. The analysis found similar results for medications in England and in Ontario, Canada.

The lawmakers involved in the Vermont proposal recognize enacting it into law will be difficult, but they're committed to trying.

"There will be a lot of pushback on this," said Vermont's Democratic U.S. Rep. Peter Welch, who spoke to the committee by phone.