So much for President Donald Trump's "America first" motto.
The Department of Health and Human Services on Wednesday proposed two potential pathways to allow the importation of drugs from foreign markets, part of a broader effort bring down drug prices.
HHS Secretary Alex Azar said that he has had a prior discussion with Canada about importation - and that it would be up to U.S. states, pharmacies and distributors to address any obstacles.
"Today's announcement outlines the pathways the Administration intends to explore to allow safe importation of certain prescription drugs to lower prices and reduce out of pocket costs for American patients", he said in a press release. It is the first of several steps before patients will have access foreign drugs.
"The FDA has the resources to do this", said acting FDA Commissioner Ned Sharpless.
But HHS clearly put the burden on states and manufacturers to convince it that importing drugs would be safe for consumers and save them money.
The administration's move comes as the industry is facing a crescendo of consumer complaints over prices, as well as legislation from both parties in Congress to rein in costs.
It's unclear when consumers would see lower prices from the Trump administration's plan. Azar spoke of a regulatory process lasting "weeks and months" and he also called on Congress to pass legislation that would lend its muscle to the effort, which could short-circuit attempts by the pharmaceutical industry to overturn the changes in court. For instance, people who rely on biologics like insulin cannot rely on demonstration projects from states or companies, though the administration says those drugs can flow through the second pathway, which allows companies to use special pricing codes.
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Some experts have been skeptical of allowing imports from Canada, partly from concerns about whether Canadian suppliers have the capacity to meet the demands of the much larger United States market. Amy Klobuchar (D-Minn.) have a bill to facilitate importation.
Pharmaceutical Research and Manufacturers of America says there's "no way to guarantee the safety of drugs" coming from outside the United States.
During Tuesday night's Democratic presidential debate, multiple candidates talked about the need to lower prescription drug costs. Sen. Another bill supported by Democrats in the House would allow Medicare to directly negotiate drug prices with pharmaceutical companies on behalf of millions of seniors.
"We all know how unfair it is that other countries are paying lower prices for the same drugs, and we're taking action", Azar said on a Wednesday call with reporters.
But consumer groups have strongly backed the idea, arguing that it will pressure USA drugmakers to reduce their prices.
Reuters has previously reported that Canada opposes any USA plans to buy Canadian prescription drugs if this threatens Canada's drug supply or raises costs for its citizens.
Lee Branstetter, an economics and public policy professor at Carnegie Mellon University who served on former President Barack Obama's Council of Economic Advisors, explained to Salon that prices are higher in the USA because the country does not employ the same policies approaches to lower drug prices used by many other developed countries, including price controls, reference pricing and cost-effectiveness thresholds.
Current FDA regulations prohibit importation of unapproved drugs, which includes foreign-made versions of drugs that are approved in the US and "have not been manufactured in accordance with and pursuant to an FDA approval".
The push for drug importation has come amid mounting scrutiny by pharmacists and drug manufacturers, who have warned that the practice could increase the chances Americans get their hands on counterfeit or adulterated medications with life-threatening consequences.