The Hollow Promise of Drug Importation Proposals
Retired FBI Deputy Assistant Director Tom Kubic is the former president and CEO of the Pharmaceutical Security Institute and president of PSM's governing board.
Having spent 30 years in federal law enforcement, I am increasingly alarmed by the growing push in Congress and in some states to enable wholesale prescription drug importation from foreign countries. Consumers are being promised that this is a quick and easy solution to reduce what they pay for prescription drugs, but the truth is that the risk in such a move is unacceptably high and the potential reward is virtually nil.
Today, Federal, State, and local authorities are severely challenged with trying to stop a flood of illegal, counterfeit, and dangerous drugs streaming into our communities. During my tenure in law enforcement, I witnessed the evolution of local criminal gangs into transnational organized crime groups taking full advantage of the anonymity and unlimited reach afforded by the internet. The societal damage has been enormous. A new study published in the Journal of the American Medical Association shows that the fentanyl-contaminated and increasingly deadly illicit drug supply is fueling a major increase in fatal overdoses among our children, with the death rate nearly doubling between 2019 and 2020. This is among our greatest public health crises.
Drug importation proponents will argue that importing drugs from a benign, friendly country like Canada doesn’t pose any of these risks. They are dangerously wrong.
It’s a simple fact that Canada, with a population of 38 million and very little drug production capacity of its own (Canada imports over two-thirds of its medications), does not have the inventory of medicines to meet the needs of the United States and its 320 million people. And these challenges aren’t resolved when you consider importation from other developed countries, like the U.K., France, or Germany. There will be no large influx of cheap, price-controlled drugs from legitimate foreign exporters coming our way.
That doesn’t mean there aren’t illegitimate sellers willing and ready to fill that vacuum. In fact, it’s already happening and having a government stamp of approval on foreign-sourced drugs will only make the problem worse.
Earlier this year, for example, we learned that illegal drug distribution networks operating undetected for two years sold more than 85,000 bottles of fake HIV medicines. Similarly, just over the Mexican border, American citizens were sold counterfeit blood thinners. Looking at these pill bottles, you would think they came from a reputable manufacturer. Instead, many of these counterfeit pills contained improper and potentially harmful substances including painkillers and anti-psychotic meds. This is not unprecedented. The Food and Drug Administration has, in fact, issued prior public warnings about the prevalence of fake cancer drugs.
These are heinous crimes. People with serious, life-threatening illnesses think they are taking medicines that will help them get better. Instead, they are being fleeced by criminals who take their money and give them fake drugs that may be useless or, more concerning, extremely harmful and potentially deadly. This is happening because well-meaning consumers are turning to alternative sources to get their prescriptions filled so they can save money. They might physically go across the borders or log on to so-called internet pharmacies that appear legitimate but are actually fronts for counterfeit and illicit drug operators. The National Associations of Boards of Pharmacy has found that 95 percent of pharmaceutical-selling websites are in violation of federal regulations. They proliferate faster than law enforcement can keep up.
Our federal priority should be to protect patients, consumers, and our children from illegal, adulterated, dangerous substances masquerading as legitimate medicines. Sending the message that drugs brought across our borders are safe and beneficial could not be more misguided given the global proliferation of counterfeit drugs.
Policymakers have other options at their disposal to make prescription drugs more accessible and affordable. The current drug importation proposals are hollow promises of illusory cost savings that threaten to bring danger into our home medicine cabinets.