The Food and Drug Administration on Friday cleared the way for Florida's first-in-the-nation plan to import prescription drugs from Canada, a long-sought approach to accessing cheaper medications that follows decades of frustration with U.S. drug prices.
Republican Gov. Ron DeSantis signed the plan into law in 2019, but it required federal review and approval by the FDA, which controls prescription drug imports.
Democratic President Joe Biden has backed such programs as a way to lower prices, signing an executive order in 2021 that directed the FDA to work with states on imports.
The White House called Friday’s action “a step in the right direction,” and encouraged more states to apply for importation.
“For too long, Americans have been forced to pay the highest prescription drug prices of any developed nation,” White House spokesperson Kelly Scully said in a statement.
But even as U.S. politicians applauded the plan, Canadian health providers said it was impractical given the supply challenges the country already faces.
“Historically, we’ve had some pretty devastating drug shortages in Canada,” Joelle Walker, spokesperson for the Canadian Pharmacists Association, told the Canadian Broadcasting Corporation “So the idea that they could import them from us is not really feasible."
The policy represents a major shift in the U.S. after years of successful lobbying by the pharmaceutical industry, which said imports would expose U.S. patients to risks of counterfeit or adulterated drugs. The FDA also previously warned of the difficulties of assuring the safety of drugs originating from outside the U.S.
But the politics surrounding the issue have shifted in recent years, with both parties — including former President Donald Trump — doubling down on the import approach.
Jeff Johnson, director for AARP Florida, said he was excited about the federal decision, though he said it’s only one step of many the group would like to see to help lower prescription drug costs. He noted savings won’t be noticed by most people, but the state will save money overall.
“Unless our healthcare coverage comes through Medicaid or through some another state-run program, we probably won’t save that money on prescription drugs,” Johnson said. “If there are enough different things out there that help reduce drug prices, together they’ll make a difference.”
The FDA said Florida’s program will be authorized for two years, though imports won't begin immediately. Under federal requirements, state officials must first test the drugs to make sure they’re authentic and relabel them so that they comply with U.S. standards.
Florida’s health department must also provide a quarterly report to the FDA on the types of drugs imported, cost savings and any potential safety and quality issues.
The FDA action was first reported by The New York Times.
DeSantis, who is battling Trump for the Republican presidential nomination, previously sued the Biden administration for allegedly delaying approval of the import program. Several other states are also awaiting federal approval.
“After years of federal bureaucrats dragging their feet, Florida will now be able to import low-cost, life-saving prescription drugs,” said DeSantis in a statement.
The FDA is likely to face legal challenges over the decision, which the pharmaceutical industry's trade organization called “a serious danger to public health.”
“We are deeply concerned with the FDA’s reckless decision to approve Florida’s state importation plan," the Pharmaceutical Research and Manufacturers of America said in a statement Friday.
Many people already buy at least some of their medicines from pharmacies in Canada or Mexico, although technically it’s illegal to import them.
Work on allowing state imports began under Trump, a relentless critic of industry pricing.
Under the current regulations, states can import certain medicines through pharmacies and wholesalers. DeSantis has previously estimated taxpayers could save up to $150 million annually under the program.
The state’s proposal includes a number of drug classes, including medications for asthma; chronic obstructive pulmonary disease, or COPD; diabetes; HIV and AIDS; and mental illness.
The medications would be only for certain people, including foster children, inmates, certain elderly patients and — eventually — Medicaid recipients.
Like most developed nations, Canada sets limits on the prices drugmakers can charge if they wish to enter the market. Health officials there have suggested their country’s prescription drug market is too small to have any real impact on U.S. prices.
Until recently, the U.S. government had almost no leverage over the prices set by drugmakers. Only in 2022 did Congress pass a law allowing the federal government to negotiate prices for a small number of medications used by seniors in the Medicare program. The first such negotiations are set to take place later this year.
