Trump administration takes step forward on Canada prescription drug import proposal

The Trump administration on Wednesday took a step forward in its plan to allow Americans to safely and legally access lower-priced prescription drugs from abroad.

Health officials unveiled a proposed rule that would allow states to import many brand name drugs from Canada, with federal oversight. A second draft plan would let pharmaceutical companies seek approval to import their own drugs, from any country.

It's unclear whether either idea will affect patients' costs ahead of the 2020 election, but the Trump administration has advanced beyond its predecessors in trying to set up a supervised system for importing drugs. Medicines cost less in other advanced countries because the governments take an active role in setting prices.

"A new pathway for importation can move us to a more open and competitive market," Health and Human Services Secretary Alex Azar said.

"We will not take steps that would put patients or our drug supply at risk," he added.

The steps taken Wednesday follow the outline of an announcement by the White House in July.

President Trump frequently criticizes drug companies over high prices, and lawmakers in both parties agree on this. A government report showed that prices for pharmacy drugs fell by 1% last year, for the first time in 45 years. But the decline was driven by lower generic drug prices while the cost of brand name drugs continued to rise, although more slowly.

The cost of medicines remains one of the top health care worries for Americans, and a recent Gallup-West Health poll found that 66% of adults believe the Trump administration has made little or no progress on the issue. The acrimonious politics of impeachment are dimming prospects for major drug pricing legislation in Congress.

The pharmaceutical industry has successfully opposed drug importation for years, arguing that the safety of medicines purchased from other countries can't be guaranteed.

The Trump administration is following a two-part strategy.

A proposed regulation issued Wednesday would set up a system for states to import brand name medicines from Canada, working with pharmacies and wholesalers. Pills would mainly be covered under the plan. Insulin, biologic drugs, narcotics and certain other medications would be excluded, at least initially.

The second part of the plan is draft legal guidance to drug companies outlining steps they can follow to import their own drugs. That could potentially allow for the importation of a broader range of medications, and from any country, Azar said.

The government has no estimates of how much money consumers might be able to save, partly because it's unclear how many states would pursue drug importation from Canada. Florida has strong interest in the idea, along with a handful of other states.

It's "undefinable for the purposes of cost projection at this point," Azar said.

On Capitol Hill, the House and the Senate are pursuing different strategies to cut drug costs. There's considerable overlap between the plans, but there are also sharp differences.

A bipartisan bill in the Senate and House-passed legislation from Speaker Nancy Pelosi would cap what Medicare recipients pay out of pocket for medicines and penalize drug companies that raise their prices above the inflation rate.

But Pelosi would go much further, authorizing Medicare to negotiate drug prices and plowing back the savings to provide seniors with new dental, hearing and vision coverage. With congressional Republicans set against Medicare negotiations, the White House has issued a veto threat on Pelosi's bill, even though as a candidate Mr. Trump supported the idea in 2016.