The Role of Online Pharmacies and Personal Importation in the Battle for Lower Drug Prices

Last night, in his speech before Congress, President Biden called for allowing Medicare to negotiate drug prices to bring down the cost of drugs in the United States. Before thinking this is some liberal vs. conservative, Democrat vs. Republican thing, you should know that a huge majority of voters on both sides of the aisle want this to happen. We at PharmacyChecker want this to happen. I started a nonprofit organization, Prescription Justice, in which allowing Medicare to negotiate drug prices is a staple of the group’s policy platform. That support does not diminish my advocacy for safe personal drug importation as an important tool to protect Americans from high drug costs.

PharmacyChecker is in some respects different from most companies in that we believe in public policies to lower drug prices that could very well weaken demand for the information we provide on our website. In short: PharmacyChecker’s niche is providing consumers with the information they need to safely obtain a prescription drug they can actually afford from Canada or another country. That demand is there because the prices of many brand-name drugs are around 90% lower in other countries. If the government—Republicans, Democrats, etc.— gets its act together to finally lower drug prices, then fewer Americans will need to look to Canada and abroad for drug affordability. Our company (and I) would like to see such change!

In the meantime, we absolutely need to make it easier for patients to safely import lower-cost prescription drugs. To highlight prescription drug importation as the public health imperative that it is, PharmacyChecker released its own analysis of 10 drugs from a newly released GAO report on drug prices, one requested by Sen. Bernie Sanders (VT-I). The potential average savings of those prescription drugs through personal drug importation was 89%.

Senator Sanders and colleagues are placing pressure on the Biden administration to include policies to expand and improve healthcare – and reduce drug prices – as part of his sweeping American Families Plan legislation. Their focus is on Medicare negotiation of drug prices – not importation. It seems that Biden will not be including drug price reforms in his American Families Plan bill – but is committed to signing legislation this year to allow Medicare to negotiate drug prices.

The GAO report shows that drug prices are two to four times higher in the United States than in three other high-income countries. It explains the public policies employed in those countries to keep drug costs reasonable. In announcing the GAO report, Senator Sanders stated: “We can no longer tolerate the American people paying, by far, the highest prices in the world for prescription drugs.”

PharmacyChecker’s analysis shows that they don’t have to.

Safe international online pharmacies exist and play an important role as providers for those Americans that have fallen through the cracks of our broken healthcare system. Wholesale drug importation, through which people and businesses import and resell prescription drugs, as a means to lower drug prices is categorically illegal without the consent of the drug manufacturers. This is not the case for personal drug importation, and it’s high time for this to be brought to the forefront of the debate. From our press release yesterday:

Under federal law, Section 804 (J) of the Food, Drug, and Cosmetic Act, Congress declares that the FDA ‘should… exercise discretion to permit individuals to’ import prescription drugs for their own use that do ‘not appear to present an unreasonable risk to the individual.’ Through peer review and a decade of testing international prescription drug orders, personal importation is found to be safe when consumers receive good guidance about credentialed online pharmacies. About 2.3 million Americans import medication each year, according to a report published in the Journal of the American Medical Association.”

Opponents of drug importation, namely Big Pharma and Pharma-funded friends, will continue to say federal law doesn’t allow it – but it does. Just read it.

Drug price negotiations are the right long-term policy to bring down prices in the U.S., but it will take time to get legislation passed and regulations implemented. Federal law has clear flexibilities built in to make safe personal drug importation a more effective lifeline for Americans, who are increasingly going without medications due to cost. Furthermore, even if the strongest drug price legislation on the table today – The Elijah E. Cummings Lower Drug Costs Act Now – is enacted, we will still see uninsured or underinsured Americans face daunting or flat-out unaffordable prescription drug prices. Personal drug importation can remain a lifeline for those that need it.

Many companies, most notoriously the pharmaceutical industry, only lobby the government to advocate policies that will help their companies maintain or increase profits. As a tiny company, we have little lobbying power, but we try to do what we can to bat for policies that could make our company more viable and helpful – and even make more money. But we’re comfortable in staying small in a more reasonably priced American pharmaceutical market in the future where health justice prevails.