The Right Prescription
A Good Obama Flip-Flop
Drug reimportation dies, for now.
Candidate Obama was for drug reimportation. President Obama, who has to deal with very different political realities, suddenly is not. That’s a fortunate Obama flip-flop.
The Senate failed to gain enough votes to pass an amendment from Sen. Byron Dorgan (D-N.D.) that would have allowed limited reimportation of prescription drugs. The Obama administration reportedly urged the amendment’s defeat, citing, as past administrations have, the FDA’s safety concerns.
For once, Obama refused to take the overly simplistic position that the government can simply make the world better by passing a law ordering the world to be better.
Dorgan’s amendment would have allowed Americans to buy prescription drugs from certain foreign countries.
“This issue isn’t rocket science. The American people are charged the highest prices in the world. They want Congress to stand up for their interests and do something about it,” Dorgan said.
Arguing for his bill, he listed the prices of some brand-name prescription drugs as they varied from country to country. Inevitably, the United States had the highest prices. Dorgan claimed that U.S. consumers could save $100 billion in a decade if only they could buy the cheaper drugs from foreign countries.
What he didn’t list were the prices of generic equivalents. That’s because, as a 2004 congressionally mandated Department of Commerce study found, generics are cheaper in the United States than elsewhere. American generics are cheaper than both foreign brand-name and foreign generic drugs.
Generics “account for more than half of all prescription drugs consumed in the United States,” the Commerce study found. Which means that more than half the drugs consumed in the United States won’t get any cheaper if we allowed reimportation.
Two Ohio State University researchers noted two years ago, “According to a new study by the FDA, Americans who buy drugs in Canada in hopes of saving money could pay significantly more for certain prescription drugs than if they had purchased generic versions of these drugs in the US.”
The idea that reimportation is a magic pill that would automatically lower American drug prices and keep them low is a fallacy.
The Commerce study determined, not surprisingly, that the primary reason drugs cost less in other Organization for Economic Cooperation and Development (OECD) countries is that those countries impose strict price controls. In other words, the governments set prices well below what the market would produce.
Importing those drugs into the United States would do nothing to lower the cost of developing, manufacturing and distributing prescription drugs. It would simply reduce pharmaceutical company profits.
Liberals think that’s great. But the Commerce Department concluded that reducing pharma profits would substantially reduce research and development, which in turn would reduce the number of new drugs that reach the market.
Sen. Frank Lautenberg (D-N.J.) claimed that the defeat of drug reimportation (Lautenberg had his own amendment, also defeated) would result in more American deaths. Actually, passing it would. Fewer new drugs means fewer new remedies. An AIDS drug might cost many times more in the United States than in Canada. But it would not exist at all without the profit pharmaceutical firms made by charging market prices in the United States, a portion of which was invested in R&D.
In fact, Commerce concluded that foreign price controls harm Americans by lowering drug company profits, and thereby reducing the number of new drugs that make it to market.
About the Author
Andrew Cline is editorial page editor of the New Hampshire Union Leader. His Twitter ID is @Drewhampshire.
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Appleby| 12.17.09 @ 7:32AM
What people like Obamas liberal myrmidion do not understand is that drugs are a finite quantity, and when Americans *reimport* drugs from Canada, we who LIVE in Canada cannot get them at ANY price.
Drugs that are cheaper in Canada (and there are darned few of them) are in fact cheaper because there is a negotiated volume discount by the single supplier we have. (Canadians, it is said, are terrified of choice and insist on only one of everything. Our liberals tell us so.)
My sister is a nurse and she tells me that our drugs are very much more expensive than their equivalent in the States. This is at least partly because there are only 10% as many people up here. It is also partially because we have huge taxes on everything from postage stamps to funerals. And that includes drugs.
Roy| 12.17.09 @ 9:53AM
Yep, that's what would happen, and then Canadians might actually get rid of the statists who imposed the price controls!
That or CANADA would have to vote to prohibit drug exporting, but then enforcement would be THEIR problem.
Right now Canada is free-riding on the US in this area and I don't immediately see an obvious reason to allow that to go on.
Mattled| 12.17.09 @ 8:37AM
I for one never get tired of seeing him on TV. Since last December I have been saying the more he gets on TV, the more we hear how smart he is, the more we hear how beautifuk Michelle is (if you like volleyball players), the better it is for us.
Every time he talks, he contradicts himself or the reality of our lives.
When I got caught eating candy as a little kid, my mother made me eat more until I threw up---so goes Odoogie Howser Obama.
What doesn't show up in the polls are several things:
One; the polls are skewed. you really have to read into the sampling to see the 10-15% oversampling of Demorats.
Second: AA (Average Americans) are not representative sample. Out of 330 million people, only about a third vote.
Lastly; Evangelicals are extremely discreet. They don't poll. They don't show up in most anything. They are largely ignored. They also stayed home in 2008 to the tune of around 10 million.
They are patiently waiting (and praying) for 2010.
And 2012. If he runs or makes it.
He isn't well. Look deep into his eyes----he ails. And he had to cover it up with a "note" from his Docs.
If mister perfect pecs and star basketball player couldn't tout his perfect medical charts-----what is he hiding?
watches | 12.17.09 @ 9:20AM
I think so,. This is at least partly because there are only 10% as many people up here.
Ken (Old Texican)| 12.17.09 @ 9:27AM
Hey, Mattled,
Heh! Was that a freudian slip in your first paragraph.....or is the old arthritus acting up again?
Ray| 12.17.09 @ 9:40AM
"The idea that reimportation is a magic pill that would automatically lower American drug prices and keep them low is a fallacy." Are you forgetting the fact that "reimportation" means that the drugs in question originated right here in America and that we are routinely charged higher prices for those drugs than the citizens of other countries are?
The "generic drug": argument is a red-herring for Canadians also pay less for generic brands versus name brands, even the imported drugs, just as we do. But we're not talking about generic brands here, we're talking about name brands, most of which don't have a generic counterpart. So, the "reimportaion" of name brand drugs WOULD save Americans money. The question is: Why must Americans re-import their own product just to save money? Like any other product, the drugs should always be cheaper in the country of origin, but that's not what is happening. So, what's causing us to pay far more for a drug than it's worth. I would hazard a guess that he problem is with out regulatory system, which is controlled by federal, state, and even local government. That's the problem that needs to be, well, remedied.
Roy| 12.17.09 @ 10:39AM
As far as I can tell, it works like this:
Pharmaceutical company develops a drug at a cost of $1 billion. It therefore needs to make $1 billion back before profit starts. Also for the sake of argument assume the only foreign country is Canada and that the US has 9 times as many people as Canada. So they anticipate 900,000 US customers and 100,000 Canadian customers.
So between the US and Canada the drug in question is anticipated to have 1, 000,000 customers. $1000 from each of them would recoup the development costs and leave room for profit.
However, the statist health care system of Canada then says we won't pay any more than $100. Uh, ok. What to do?
Well, we could not sell in Canada at all, but the thing is production costs of drugs are negligible. Once we've recouped the development costs the drug price drops to something like $10. So we're still getting money from selling in Canada, just not as much as we need, so we're still going to sell.
So what to do? That's easy - jack up the price for US customers to cover the difference! The 100,000 Canadian customers are only paying $10 million, so the 900,000 US customers have to make up the other $990 million = they have to pay $1,100 apiece, 11 times what Canadians are paying. This allows John McCain and Byron Dorgan to howl and yibber on the Senate floor.
Of course, you can only do this if US customers can't buy drugs in Canada. If they can, then the whole thing collapses. The 900,000 US customers also buy $100 drugs, meaning the drug company only recoups $100 million of their costs and goes bankrupt.
The drug company knows this, however, and won't just let it happen. They have a few choices of response. The one hinted at in the article is they simply say that they won't sell more than a total of 100,000 units to Canada. In that case, 1 million Canadians and Americans could buy from a pool that contained 100,000 units at $100 and 900,000 units at $1100. There would be bare-knuckled fistfights in Canadian pharmacies. Some Canadians would lose and complain to their government that they couldn't get any drugs. The government would complain to the pharma companies, who would respond with a loud belly laugh. The Canadians would then have to ban the exportation of drugs from their country. But, being as they would be doing it solely so they could free-ride on Americans, I'm pretty sure the smuggling rings that would immediately spring up(and I'll bet, already have sprung up) would enjoy pretty broad public sympathy in the US. Ideally the end result would be that Canadians would have to repeal their price controls and pay full freight like everyone else.
Clearly, statist Americans like Byron Dorgan think this is a shortcut American getting the same price controls Canada has. If that was the case, then it's simple what would happen. The drug just wouldn't get developed. Yay!
L. Ross| 12.17.09 @ 11:06AM
Very well put, Roy.
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Steve| 12.17.09 @ 11:51AM
I find it interesting that this is one of the first articles I've seen arguing this issue. Way back when Obama revealed his health care objectives, I remember that many of European politicians were incredulous that the U.S. would start down this road. Even to the point that the French were saying that it wasn't a good idea for the U.S. This struck me as odd that leaders of all these countries with socialized medicine would come out against the U.S. having the same, until I thought about it logically. All these countries can maintain and run socialized medicine systems because the real costs of all the development of new drugs and therapies are carried by the U.S.A. This was reinforced when I watched some of the arguments recently about how Medicare works by underpaying doctors and hospitals and those costs end up making it more expensive for people with insurance from insurance companies. If socialized medicine was so great and there wasn't an underhanded "shift the costs trick" going on at an even greater level than the Medicare "shift the cost trick", why wouldn't every leader of a country with socialized medicine be cheering the U.S on to implement this system. The reason they are not is because they all know that their systems will take the brunt of the damage from us doing this. As Roy noted in a previous comment, the pharmaceutical companies have to make money to at least recoup the cost of development. If they can't make it off the U.S customer, either they are gong to raise the price for every customer in every county or they are not going to develop the new drugs. Same goes for new technologies. There are many more MRI machines in the U.S than in other countries and we pay more to use them, but the companies wouldn't invent new technologies if they couldn't make money doing it. Other countries with socialized medicine can hold down their costs for new drugs and technologies by forcing the companies to accept lower prices to be used in their markets, but the companies can turn around and charge higher prices to individual customer in the U.S. If the U.S institutes socialized medicine, then where do the companies go to charge higher prices. But even worse to the European socialized countries is that the U.S would be one of the biggest customers now, so their buying power would be much larger than other socialized countries with much smaller populations. If the U.S. told a company they were only paying a limited price for a drug, the company will have to raise the price in England and France to make money. So if you think about it from this point of view, the U.S. non socialized medical insurance system is the greatest
re-distribution of wealth in the history of the world. We are making it possible for companies to develop new drugs and technologies that save people all over the world from Europe to Africa to Asia. Without the individual U.S. consumer and insurance company paying more than we should, the rest of the world wouldn't have access to new technologies at reduced prices or at all.
Stephen Zierak| 12.17.09 @ 12:05PM
How can conservatives argue against drug reimportation? Pharma can agree to lowball prices throughout the world because they can offload all the development costs onto U.S. consumers. A free market stops this in its tracks. If you try to sell me at a higher price than, say, in France, well then I simply arrange to buy the drugs from sources there at the regulated price. Eventually, there is either pricing neutrality or the cheese eating surrender monkeys don't get the benefits of that drug. If foreign countries attempt to stop reimportation by law, we either cheer on the inevitable smugglers or we take some trade actions of our own as a penalty. Or both! FREE MARKET means that we can't continue to be played for suckers. Somehow I think pharma will figure out that they better stop cutting sweetheart deals with everyone else at U.S. expense. And, for those who don't, let them fade away and be replaced by smarter competitors.
Conservatism doesn't mean industrial policy where we take care of pharma on our own so they continue to develop new drugs. It means creating the conditions where innovation can occur where it makes financial sense, where part of the financial sense is who is willing to buy at a price level that covers costs. In a worldwide market, all will need to bear the costs, not just U.S. consumers because of government undermining of market reality.
The two most nonsensical things I have read this week in the Spectator blogs is support for Romney (talk about undermining the ever growing movement against Dhimmicrats and RINOs!), and this ridiculous opposition to drug reimportation.
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Jeff| 12.17.09 @ 12:24PM
SIMPLE. Make it illegal for Big Pharma to sell for less than they sell in the US. That prevents Americans from subsidizing the world like we do now.
Roy| 12.17.09 @ 1:09PM
Or we could go the non-statist, non-impossible to enforce route and allow reimportation.
Jeff| 12.18.09 @ 12:27PM
Lest anyone be confused I am in complete support of reimportation .The arguments offered by the author are simply a desperate attempt to keep the free market from punishing Big Pharma.
I am a radical free marketeer and I find it amusing when I see the number of incidences of some big corporation or individual trying to use the force of government to CHEAT THE MARKET which is what Big Pharma is doing in this case and Tyson tries to do in the food industry by using illegal immigrants to avoid paying American level wages. The roofing business does the same thing.All of them hide behind the "jobs that Americans won't do " B***S***. Americans won't do those jobs for Mexican wages.
LiveFreeOrDie| 12.17.09 @ 12:27PM
We the people need to be completely overcharged and fleeced by the pharm companies so they have the R&D money to develop new drugs! What a BS argument this is. I need another drug to make my eyelashes longer? I need another psychotic to make me happier day to day? Who cares if my liver is destroyed and the side effects are often worse than the cure just trust them, after all I'm sure they have only our best interests in mind.
Roy| 12.17.09 @ 1:10PM
--Who cares if my liver is destroyed and the side effects are often worse than the cure--
Damn, sounds like somebody might need to do some R+D to eliminate those side effects..
LiveFreeOrDie| 12.17.09 @ 11:52PM
The FDA is corrupt and in the pocket of BP. Do some "Research" of your own, the whole thing is disgusting beyond words. Profits above all even if that means robbing and killing innocent people.
$1 Billion for Ads| 12.17.09 @ 12:51PM
Why do pharmaceutical companies advertise? They spend billions on advertisement, lobbying etc. Every dollar makes their "cures" less affordable to patients who need medication. This in unethical. Good cures don't need advertising, patients don't need advertising. The only thing that needs advertising is pharma if they want to sell the 21st century equivalent of snake oil.
Roy| 12.17.09 @ 1:06PM
Correct, comrade! See you at the next Party Congress.
hunter| 12.17.09 @ 1:19PM
There is nothing new under the sun. All the ingredients for any and all the drugs have come from 'stuff' on the earth. All pharma engineers have either gone to public schools and or benefited from same. Much of the R&D is being done by Universities funded by federal monies (your taxes at work). Any R&D amounts is countered by tax deduction of profits. There are too few pharma companies because of laws protecting the huge hidden behind legalese corporation payoff lobbists, which only yesterday rose and gave away one of their hiding places. This little party needs to be broken up and the guilty put to work on the rock piles, hard time and lots of it. We have seen who they are, now votem out! Break up he huge monoply pharma corporations. They are as dried up old fruit, hard dried out, putrid and are no longer productive.
Nick| 12.17.09 @ 2:11PM
Evidently, you know the meaning of the word "monopoly" about as well as you do English grammar.
There are many pharmaceutical companies and they all have the right to product exclusivity when it comes to their inventions. Ever heard of the patent process, you commie pinko kook?
Karl Marx is dead. And he was a moron.
Roy| 12.17.09 @ 7:22PM
-- All the ingredients for any and all the drugs have come from 'stuff' on the earth. All pharma engineers have either gone to public schools and or benefited from same. Much of the R&D is being done by Universities funded by federal monies (your taxes at work). --
Wow. Now THERE's an argument.
Granted whatever your job is I'm pretty sure you're using materials found on earth, and you may even have gone to a public school or a university that "benefited" from public funds - I guess we can reduce you to total government slavery. Sound good?
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canuckistani| 12.17.09 @ 3:48PM
What's the big deal? You don't actually believe this kaka? Astra, Aventis, Novartis, Bayer, Glaxo are all foreign-HQed and 6 of the top 10 manuf are foreign based. Why have they not moved to the US if the US is the base for the revenues needed to build new drugs? The US is 5% of the global population, spends double per person than other developed countries and is 27th in life expectancy and infant mortality.
Somebody is getting hosed.
Primary care is not rationed in developed countries, and elective-waiting-list-type treatments only account for 3% of overall spending in the US. 97% of treatment costs are yielding same or better results in other countries at a fraction of the price.
Somebody is getting hosed.
We are #1 per capita spender on drugs. We're the fattest bastards on the planet, we smoke, we drink, and we shoot eachother at a faster rate than anybody else.
Somebody is getting hosed.....and it ain't the drug companies!
Steve| 12.17.09 @ 4:14PM
Didn't you just answer your own question after throwing out a completely inane argument?
Question: "The US is 5% of the global population, spends double per person than other developed countries and is 27th in life expectancy and infant mortality."
Answer: " We're the fattest bastards on the planet, we smoke, we drink, and we shoot eachother at a faster rate than anybody else."
Inane Argument: "You don't actually believe this kaka? Astra, Aventis, Novartis, Bayer, Glaxo are all foreign-HQed and 6 of the top 10 manuf are foreign based. Why have they not moved to the US if the US is the base for the revenues needed to build new drugs"
Why would companies want to move to the U.S. when we have some of the worst corporate tax rates, when they can just sell the drugs here at higher prices and take their profits away???
Roy| 12.18.09 @ 10:03AM
And John Edwards lives here, too, of course.
2 Guns AZ| 12.17.09 @ 4:31PM
Want to blame some one? Try the WTO. The reason "Big Pharma" sells oters at a low rate is that, the WTO has ruled that 2 years after the release of a new drug, if it is not sold in France, then France can produce it without paying royalties to the patent holder. So, it pays the developer to sell, even at cost, to prevent someone else from selling the drugs.
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computer telephone | 1.3.10 @ 12:02PM
Well, we could not sell in Canada at all, but the thing is production costs of drugs are negligible. Once we've recouped the development costs the drug price drops to something like $10. So we're still getting money from selling in Canada, just not as much as we need, so we're still going to sell
alyssa| 1.6.10 @ 7:55AM
The "generic drug": argument is a red-herring for Canadians also pay less for generic brands versus name brands, even the imported drugs, just as we do. But we're not talking about generic brands here, we're talking about name brands, most of which don't have a generic counterpart. So, the "reimportaion" of name brand drugs WOULD save Americans money. The question is: Why must Americans re-import their own product just to save money? Like any other product, the drugs should always be cheaper in the country of origin, but that's not what is happening. So, what's causing us to pay far more for a drug than it's worth. I would hazard a guess that he problem is with out regulatory system, which is controlled by federal, state, and even local government. That's the problem that needs to be, well, remedied.
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alyssa| 1.7.10 @ 11:55PM
Yep, that's what would happen, and then Canadians might actually get rid of the statists who imposed the price controls!
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tress| 1.14.10 @ 6:05AM
Dorgan's amendment would have allowed Americans to buy prescription drugs from certain foreign countries.
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coolpete| 1.15.10 @ 8:52AM
SIMPLE. Make it illegal for Big Pharma to sell for less than they sell in the US. That prevents Americans from subsidizing the world like we do now.
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Bob| 2.11.10 @ 11:44PM
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My sister is a nurse and she tells me that our drugs are very much more expensive than their equivalent in the States. This is at least partly because there are only 10% as many people up here. windows cleaner
Mary | 3.18.10 @ 10:44AM
Take the H1N1 virus panic. The pharmaceutical companies did that to sell their garbage to the government!
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Paul | 3.23.10 @ 4:58PM
That is true... Good cures do not need advertising...
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dvd convert to ipod | 3.25.10 @ 4:15PM
America's drug are very expensive as it is the best we can get on the market. However, they are not often efficient. Very nice article from the author.
Derek Cullen | 3.27.10 @ 11:13PM
It is very sad that we Americans have to pay so much for drugs.
This is a commodity I believe should be free from high rate of tax.
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JohnRambo | 4.8.10 @ 5:06AM
My opinion, Obama has done a good job. Let apart all the critics, he is good.
ash | 4.23.10 @ 2:05PM
nice article.
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