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O, Canada! Like his across-the-aisle rivals, Trump looks to imports to cut drug costs

Canada and Quebec flags

In a move to lower drug prices, President Donald Trump is calling for new rules on importing drugs from Canada. (Wikimedia Commons)

President Donald Trump and his 2020 challengers are in a heated skirmish to prove to voters who is the toughest candidate on Big Pharma. Now, Trump has found even more common ground with Democrats on lowering the cost of drugs.

The Trump administration is drafting a plan to allow the Department of Health and Human Services (HHS) to “safely and effectively” import branded drugs from Canada. Freeing up Canadian imports would help lower drug prices by providing U.S. consumers with the “benefit of the deals that pharma themselves are striking with other countries,” HHS Secretary Alex Azar told CNBC’s “Squawk Box” on Tuesday.

In most cases—often with the exception of chronic shortages—federal law prevents foreign drug importation. Azar, Trump’s appointee, has balked at the idea in the past, as have previous FDA chiefs and many GOP politicians. But at least once each congressional session over the past decade or more, the idea ends up in a bill or two, only to be voted down.

Now, though, the Canada import scheme represents a rare point of common cause between Trump and the Democratic candidates challenging him for the presidency in 2020.

Some of the biggest names in the Democratic field have already come out openly in support of freeing foreign imports, including Sen. Kamala Harris,  Joe Biden,  and Sens. Elizabeth Warren and Sen. Bernie Sanders.

While it’s unclear whether Trump envisions allowing imports by executive order or through legislation, the move continues the “one-upmanship” the president and his challengers have engaged in when promising punitive measures on drug pricing.

Earlier this month, Trump said his team was working on a “favored-nation clause” for price negotiations, which would theoretically lower the price of prescription drugs for government payers to the lowest cost among other developed nations. The term “favored nation” is typically used as a designation for trade partners, and it’s unclear whether allowing imports was part of that plan.

And despite Trump’s new focus on allowing imports, the idea is nothing new on Capitol Hill.

In February, Vermont Rep. Peter Welch called for opening Canadian imports of insulin as a measure that “bypasses Big Pharma’s pricing monopoly” on the drug.

The call followed a wave of letters in January sent from the House Energy and Commerce Committee and Oversight and Investigations Subcommittee to Sanofi, Novo Nordisk and Eli Lilly raising questions about rising insulin prices. Welch is a member of the Energy and Commerce Committee.

In fact, Welch was not even the first politician in Vermont to call for importation from Canada. In 2018, Vermont legislators passed a bill allowing wholesalers to import Canadian drugs, with the catch that it needed approval from Azar.

At the time, Azar called the measure a “gimmick” that posed safety risks to patients but now appears to have changed his tune after Trump’s newest plan came to the fore.

The White House has also publicly come out behind a bipartisan Senate bill aiming to tackle rising drug prices that does not include a foreign import clause. That bill, from Sens. Charles Grassley and Ron Wyden, focuses on Medicare Part B and D changes and inflationary rebates and is projected to save taxpayers $100 billion in annual Medicare and Medicaid costs.