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To Lower Drug Prices, Florida Governor Wants Access to Canadian Medications

Gov. Ron DeSantis announced Wednesday that he wants to give patients access to cheaper prescription drugs from Canada, making Florida the latest state to try to import medications to reduce rising health care costs.

By Emily L. Mahoney and Elizabeth Koh

Gov. Ron DeSantis announced Wednesday that he wants to give patients access to cheaper prescription drugs from Canada, making Florida the latest state to try to import medications to reduce rising health care costs.

"Once we get this in place, U.S. citizens will be able to have access to more affordable drugs," DeSantis told a cheering crowd at The Villages, a retirement community near Orlando.

Flanked by Florida House Speaker José Oliva and Secretary of the state Agency for Health Care Administration Mary Mayhew, DeSantis said he would ask state lawmakers to pass a bill allowing such drug imports from Canada. The federal government would still need to approve it, something it hasn't done since it passed a law to create the process in 2003.

But DeSantis assured the crowd he has a powerful ally.

"I want you to know I spoke personally to President (Donald) Trump both Sunday and Monday about this," he said. "He's not only supportive, he's enthusiastic."

DeSantis said this program would make Florida the first state to take advantage of a provision of the federal Medicare Modernization Act. Until now, the U.S. Department of Health and Human Services has "continually refused" to authorize states to bring in drugs from Canada, but Trump has assured him that will change, DeSantis said.

While it's currently illegal to import prescriptions from Canada, many Americans already do so. Drugs are cheaper for America's northern neighbors in part because Canada imposes restrictions on how much pharmaceutical companies are allowed to charge for medicines. The U.S. does not.

Polls have shown that the majority of Americans are in favor of reducing skyrocketing prescription drug prices, which the powerful pharmaceutical lobby has blocked.

States have tried different approaches. Earlier this year, California's governor announced a plan for the state to bargain directly with drug manufacturers to get better prices for the state's 13 million Medicaid recipients. Last year, the Trump administration launched a plan aimed at lowering prescription costs, yet several major drug companies, including Pfizer and Allergan, still raised their prices last month.

In Wednesday's announcement, DeSantis added that Florida will ensure that there are "appropriate regulatory steps in place" to protect Florida consumers. But many of those details will need to be worked out by state lawmakers.

Even though the legislative session doesn't start until March 5, Oliva has already made it clear that lowering health care costs and stripping health care regulations will be his chief priorities.

"We know what the solutions are. What we have lacked is true understanding and more so, the courage to push forward," he said at Wednesday's event. "I can finally say we're all here and we're going to make a difference."

DeSantis' approach echoes a proposal that has been endorsed recently by politicians on the right and left, including progressives like U.S. Sen. Bernie Sanders.

In addition to some prescription drug importation bills before Congress, some states have considered creating such programs within their own borders. Those programs largely call for the respective states' healthcare agencies to buy drugs from Canada and resell them to hospitals and pharmacies in-state.

Supporters of such proposals say it could save millions in rising prescription drug costs in the United States, and DeSantis suggested similar savings could come to Florida. But others have raised concerns about how to ensure the safety of such prescriptions in the supply chain and how other countries or pharmaceutical companies might react to state- or national-level programs to import drugs to the U.S.

"It's one thing if individual Americans might be crossing the border to purchase Canadian drugs at a discount," said Rachel Sachs, an associate law professor at Washington University of St. Louis, who works in health law and drug regulations. "Once we're in a more large-scale importation system you can see why the pharmaceutical companies would want to stop people from purchasing drugs at lower prices ... It threatens their market here."

Sachs added "some amount of pushback" could also be expected from other countries, should such a program take effect.

DeSantis said he would work to ensure any imported drugs meet regulations set by the U.S. Food and Drug Administration and that Trump's support would be sufficient to ensure federal approval that has not been granted before.

But past federal Health and Human Services secretaries, appointed by presidents of both parties, have raised concerns.

The most recent official in the post, Alex Azar, told reporters last year he considered the idea of importing drugs a "gimmick" that would have no meaningful effect.

"Canada's drug market is simply too small to bring down prices here," Azar said in released comments at the time. "They are a lovely neighbor to the north, but they're a small one. Canada simply doesn't have enough drugs to sell them to us for less money, and drug companies won't sell Canada or Europe more just to have them imported here."

It was a concern echoed by a former Canadian health official in a Washington Post op-ed in 2017, who raised concerns about safety and noted her nation's pharmaceutical industry was "already strained" trying to serve its existing population.

Vermont, Sanders' home state, passed a bill last year -- the first of its kind -- that would have enabled importing prescription drugs from Canada, according to Kaiser Health News. But it still needs federal approval to go into effect.

The House version of this bill was filed by Rep. Tom Leek, R-Ormond Beach. Leek did not immediately return a request for comment, nor did Senate President Bill Galvano. Any bill to create a drug importation program would have to also pass through the Florida Senate.

(c)2019 the Tampa Bay Times (St. Petersburg, Fla.)

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