NATIONAL HARBOR, Md. — Responding to intensified concerns that patient out-of-pocket costs for prescription drugs have hampered access to needed medications, physicians at the Interim Meeting of the American Medical Association (AMA) today adopted new policy supporting in-person purchase and importation of prescription drugs from licensed Canadian pharmacies, if the safety of such importation can be assured.

AMA support for in-person prescription drug importation from licensed ‘brick and mortar’ Canadian pharmacies would be conditional on the import of a limited quantity for personal use only. Medications imported in-person also must be approved by Health Canada, the government agency that reviews the safety, effectiveness and quality of prescription drugs authorized for sale in Canada.

The new AMA policy does not apply to the importation of prescription drugs via online or mail-order pharmacies. The AMA already has policy opposing personal importation via the Internet until patient safety can be assured. 

“Faced with high out-of-pocket costs for prescription drugs, some Americans travel to Canada to purchase and import their medications, as it’s oftentimes more affordable,” said AMA President Barbara L. McAneny, M.D. “While it generally remains illegal for individuals to import prescription drugs into the U.S. for personal use, the FDA has used its enforcement discretion to allow the personal importation of prescription drugs under very limited circumstances. Allowing for the in-person importation of prescription drugs from Canada, if product integrity can be assured, represents a step forward, as well as a measured and conservative option to lower patient costs for prescription drugs.”

In 2016, the U.S. had the highest pharmaceutical spending per capita in the world at $1,443, versus $613 in Canada. Retail spending on prescription drugs per capita was also highest in the U.S. at $1,026, with Canada’s retail per capita spending amounting to roughly half that of the U.S.

Eight percent of respondents to a 2016 Kaiser Health Track Poll indicated that they or someone in their household had imported prescription drugs from Canada or other countries.

“The AMA policy comes as the U.S. Department of Health and Human Services (HHS) and lawmakers are examining options to lower patient costs for prescription drugs, including through importing prescription drugs from Canada” said Dr. McAneny. “The new policy will help direct AMA support for relevant regulatory and legislative activity.”

HHS has the authority to permit importation of prescription drugs from Canada if the HHS Secretary certifies to Congress the medications pose no additional risk to the public’s health and safety, and result in a significant reduction in the cost of the drugs to Americans. While no HHS Secretary has provided the enabling certification for prescription drug importation, a work group requested by HHS Secretary Alex Azar will assess how to safely import prescription drugs from other countries under certain narrow circumstances.

In addition, federal legislation has been introduced to permit prescription drug importation, while nine states have also introduced drug importation legislation this year. State and federal legislative approaches to prescription drug importation vary in many respects.

The AMA support for allowing in-person importation of prescription drugs from licensed Canadian pharmacies adds to the steps the AMA is taking to address high and unaffordable prescription drug prices. In November 2016, the AMA launched a grassroots initiative, TruthinRx.org, with the goal of collecting patient stories about how rising drug prices are affecting their lives. The AMA favors steps to increase transparency about prescription-drug pricing, and has also recommended sustainable solutions to address the flaws and inefficiencies in the U.S. pharmaceutical marketplace.

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