The whole debate on re-importing pharmaceuticals is a monumental distraction that's grown out of the resourcefulness of some individuals who live near the Canadian/US border. But the cleverness of some individuals does not always scale up to make good public policy.
Let's think about how this got started. Some folks went across the border to buy their pharmaceuticals because they are noticeably cheaper in Canada. Then some local government officials sought to multiply the effect for their constituents by doing group purchasing through Canada. (Perhaps that's not a bad idea to put pressure on the Federal government - if that's what it is.) And now we're caught up in a national debate on the topic with some saying the safety of the drugs can't be assured, others complaining about the costs, and the allotments that go to Canada being threatened.
Dr. Mark B. McClellan, who currently heads the FDA, has been nominated to head CMS. Yesterday, at the Senate hearing on his nomination, the topic inevitably turned to re-importing pharmaceuticals from Canada. McClellan spoke of beefing up the FDA staff to ensure that the drugs being imported or re-imported to the US meet the standards. Though that may hint at a policy change, there was the usual grandstanding. Because the FDA has blocked re-importation, two Senators, McCain and Dorgan, threatened to block the nomination.
Let's see if I've got this right ...
The product is manufactured and inspected here. We could buy it here. We send it somewhere else. Then we bring it back and (hopefully) inspect it again. Nowhere in the real world is this less expensive than simply buying directly and negotiating aggressively at the front end.
What we're really doing is a bit of theatre to avoid the ideological debates on price regulation and the big ticket politics of aggressive price negotations. Rather than take on either approach directly, the proponents are trying to piggyback the Canadian price control system.
It's great drama. "Good guys and bad guys." But it's lousy policymaking. Even if the proponents of re-importation win, they get a Rube Goldberg mess in which we add a complex and costly process to - reduce costs.