The Executive Order on Increasing Drug Importation to Lower Prices for American Patients proposes to reduce costs of prescription drugs by allowing for the importation and re-importation of FDA-approved drugs from Canada. The policy aims to lower prices of costly prescriptions, most notably insulin products, by reducing trade barriers and increasing the exchange of drugs with countries that pay less for the same drug. This order also authorizes grants to individuals of waivers of the prohibition of the importation of certain prescription drugs, as long as the importation poses no additional risk to public safety and will lower costs to American patients.
The expert panel was split on whether or not this executive order would reduce drug spending, though the majority stated that it would minimally reduce spending. Most of the experts agreed that there would be no change in either drug list or net prices, however two experts felt both would moderately decrease. The experts agreed that this policy would only increase drug access for uninsured patients, with no change in access to any of the other patient groups.
The majority of the panel agreed that this executive order does not advance drug spending policy. Experts unanimously agreed that both the size of the affected patient population and the magnitude of the drug spending impact are weaknesses of this policy. Other weaknesses of the executive order were reported to be its ability to be implemented and the evidence base in support of the order. The panel was split on if the precedent-setting value of the order was a weakness or strength, with five noting it as unknown, three as a strength, and one as a weakness.
Experts highlight many considerations for policymakers. The most important consideration is the standard of “no additional risk.” There is currently no clarification on how any possible additional risk will be measured or monitored. Other key considerations include the uncertainty of international response (particularly EU and OECD countries), the degree of discretion that will be exercised by the HHS Secretary, and the administrative burden in light of the minimal possible savings. Additional considerations include that this executive order does not change the existing authority on drug importation and it is unclear if this is to be implemented for individual patients or at the population level.