Have you ever wondered why you have to pay $600 in the U.S. for a drug like EpiPen, when the same product is sold in Canada for 70% less and in the U.K. for nearly 90% less? That’s not the way our free-market economy is supposed work. Who’s to blame for this? Of course, the ultimate blame for outrageous drug prices rests with the pharmaceutical companies which set them, but they couldn’t get away with it without a lot of blocking and tackling being provided by parts of our own government. If we are ever going to fix this problem, you need to know where the faults lie.
Much of the blame rests with President Obama. I happen to like our President and believe him to be well-intentioned, but, unfortunately, he threw us under the bus when it comes to drug prices. In exchange for the support of the pharmaceutical industry for the Patient Assistance and Affordable Care Act (Obamacare), President Obama agreed behind closed doors (later opened due to email disclosures) that he would reverse course on his plans to allow Medicare to negotiate drug prices and Americans to legally import their own medications from countries where they are sold at lower cost. How this happened is well described in the Huffington Post article “The Legacy of Billy Tauzin: The White House-PhRMA Deal” with additional details provided by the New York Times.
Going a step further, the White House then agreed to champion a plan devised by the pharmaceutical industry focused on restricting consumer access to medicine from international online pharmacies, under the pretense of a loftier goal of stopping rogue online pharmacies. This lead to the creation by of what’s called the Center for Safe Internet Pharmacies, which has been busy making sure you can no longer find international online pharmacies that sell to Americans (fortunately, you can still find them listed on PharmacyChecker.com), and, when you do find one, you often can’t use your credit card to purchase medication from it (fortunately, you can still use a check). This was explained two weeks ago in the exposé “How Big Pharma's Shadow Regulation Censors the Internet” published by the Electronic Frontier Foundation. Gabriel Levitt, President of PharmacyChecker.com (of which I am the founder), warned against this potential misuse of power in his testimony before the House Judiciary Committee in 2013.
Certainly search engines and credit card companies really never wanted to restrict your access to online pharmacies, as this doesn’t help their bottom line nor does it endear them to the public, not to mention that it seems to be ethically wrong. However, they have “voluntarily” fallen in line with the White House out of what I believe is fear of government action against them by another part of our government’s executive branch, the FDA.
It was reported just last month that FDA’s Office of Criminal Investigations is currently being examined by a Congressional committee over reported complaints by some FDA agents that their managers have them investigating cases involving doctors importing lower cost medication for patients rather than focusing on cases with more potential to protect the public health. The rationale used by the FDA is that the imported products are “mislabeled.” This, however, does not mean they are dangerous or fake, but that their foreign labeling differs from U.S. labeling. This apparent misuse of the FDA’s power was revealed earlier last month in a Reuter’s article which pointed out that “Some agents say their efforts have done little more than protect the pharmaceutical industry's high drug prices in the United States.”
Another person who shares the blame for high drug prices is the Secretary of Health and Human Services. Why? Because whoever holds that cabinet post (which, by the way, is appointed by the President) has the statutory authority to create regulations that make personal importation expressly permitted. Currently, personal drug importation is technically illegal, although individuals have not been prosecuted for importing small quantities of medication for their own use. The Secretary’s authority to permit importation comes from Section 804 of the Food Drug and Cosmetic Act (21 U.S. Code § 384) and was part of the Medicare Prescription Drug Improvement and Modernization Act of 2003. With just a stroke of her pen, the current Secretary (Sylvia Mathews Burwell) could unfetter Americans and permit normal market forces to drive down U.S. prices -- because who’s going to keep paying $600 for a drug they can legally get for $100?
You can also blame high drug prices on those senators and representatives who have failed to adopt legislation which would, once and for all, change the law to allow personal drug importation, such as the Personal Drug Importation Fairness Act and the Safe and Affordable Drugs from Canada Act.
Of course, there are others who could be doing more to stop the price madness, such as large pharmacy chains, insurance companies, and pharmacy benefit managers. But let’s not forget ourselves. We need to push our government officials to do the right thing. Now that you know who’s to blame, it’s time to start voicing your concern (such as signing the RxRights petition) and voting for individuals who will take action.