In a sizable executive order released earlier this month, President Joe Biden asserted his determination to rein in prescription drug prices, higher in the United States than anywhere else on earth. The directives included measures intended to boost competition between insurers, ease generic drug entry into the market, and more. But one dictate received special attention from commentators: the continuation of a Trump-era shift toward facilitating large-scale drug importation from Canada, with Biden instructing the Food and Drug Administration to work with states to implement appropriate plans.
Drug importation has long been a popular and unusually bipartisan idea for providing relief from pharmaceutical price-gouging. Lawmakers as politically diverse as Bernie Sanders, Barack Obama, and Donald Trump have all championed the scheme, and 78 percent of Americans support it. For those rightfully outraged by the fact that peer countries pay an average of 56 percent of what the U.S. pays for any given drug, the prospect of routing our supply through our northern neighbor seems like a no-brainer. As David Sirota wrote at The Daily Poster before the signing of the executive order, by pushing drug importation forward, “the Biden administration is in the position to deliver a big win to begin saving consumers billions of dollars.” Florida Governor Ron DeSantis, frequently floated as a 2024 presidential candidate, welcomed the executive order (without exactly giving Biden any credit) and is awaiting approval of his state’s importation proposal.
But drug importation has never actually been as promising as it sounds. Even the most optimistic estimates offered by its loudest proponents amount to a barely perceptible dip in overall spending, and its ability to deliver even that depends on the willing participation of stakeholders who have already expressed extreme distaste for the measure. Even more, the plan’s drawbacks mirror those of other drug pricing reforms: They ultimately may not do much to help the people who need it.