Approximately 19 million adults in the U.S. have imported prescription drugs at one time or another, according to a Kaiser Family Foundation poll, and with good reason. Many prescription medicines cost half or less than in the U.S. when purchased online from sources outside the country.
Canada, which is a major supplier of safe, affordable online drugs, offers lower medication prices than in the U.S. because of government price controls that were put in place in 1987. The Canadian Patented Medicine Prices Review Board regulates medication prices in Canada and limits the maximum price that can be charged for medications.
Big pharma has opposed consumer access to prescription drugs from online pharmacies outside the U.S. for decades. According to AARP, one of the tactics pharmaceutical companies use to impede importation of drugs is to cut off supplies to legitimate pharmacies that sell lower-cost drugs to Americans.
On the other hand, while the Internet has made it easier for Americans to buy prescription drugs abroad, frequently it is from disreputable sources, according to Jaime Ruiz, a spokesman for U.S. Customs and Border Protection. And some of those drugs are addictive and deadly.
In just the past year, 100,000 Americans have died from drug overdose. Two-thirds of these overdoses are attributed to synthetic opioids. One of them, fentanyl, is 50 times more potent than heroin. It therefore made sense when Senators Marco Rubio (R-FL) and Amy Klobuchar (D-MN), and Congressmen David McKinley (R-WV) and Bobby Rush (D-IL) introduced legislation in late 2021 in the Senate and House aimed at curbing online access to opioids and fentanyl.
“The opioid epidemic is hurting communities across our nation,” Klobuchar said in introducing the legislation. “None have been immune to its devastating effects.” Rubio said, “We need to crack down on bad actors, including those from China, that target our youth and families with the online sales of counterfeit and illicit drugs like fentanyl.”
But the legislation, S.3399, Domain Reform for Unlawful Drug Sellers (DRUGS) Act, and the House version, H.R. 6352, has a major flaw. The proposed law would eliminate consumer access to unlawfully dispensed opioids from tier 3 non-US online pharmacies which are not certified by a credentialing agency. But it doesn’t distinguish between those websites and tier 2 online pharmacies that are highly credentialed and sell non-addictive medications to treat conditions such as diabetes, high blood pressure, arthritis and COPD.
The House and Senate bills require any website offering prescription drugs to U.S. residents, whether tier 2 or tier 3, to demonstrate that it holds a pharmacy license where it operates and where its patients live. This will effectively prevent consumers from obtaining affordable drugs from tier 2 non-US online pharmacies that are credentialed and do not sell opioids or controlled drugs.
Eliminating access to highly credentialed online pharmacies outside the U.S. that are a safe, trusted source of daily medications will place substantial financial burden on consumers and may cause some to go off their medication. Meanwhile, the legislation has the backing and support of big pharma, which uses its influence over special interest groups in seeking to eliminate access to online medicines from outside the U.S.
The special interests backing the DRUGS Act include the Alliance for Safe Online Pharmacies, Partnership for Safe Medicines, Pharmaceutical Security Institute, and International Federation of Pharmaceutical Wholesalers, which are heavily funded by big pharma.
Other special interest groups backing the legislation include National Association of Chain Drugstores and National Association of the Boards of Pharmacy (NABP), which seek to protect the market dominance of its pharmacy members. It is especially galling to note that NABP took $1 million from Purdue Pharma, which makes the highly addictive opioid painkiller OxyContin.
Addressing the online availability of opioids and fentanyl is critical to protecting public health. However, the DRUGS Act also targets legitimate licensed pharmacy websites that sell lower-priced non-narcotic and non-controlled maintenance medications approved by reputable health authorities in other countries. U.S. residents who struggle to afford their medications will no longer be able to purchase lower cost medicines from such websites if S.3399 and H.R. 6352 are passed as currently written.
Small Epiphanies From a Life in Progress 