Heavy Bleeding

Inside-the-Beltway chatter has it that some members of the Republican caucus are getting ready to support Senator Dorgan’s drug importation amendment in the misguided belief that it will serve as a healthcare reform “poison pill.”

Not.

The theory is that if the Dorgan Organ passes, then Big Pharma will throw its weight against the legislation.

Not.

This strategy is ill-considered for a multitude of reasons. Let me mention three:

(1) Volume.  Big Pharma has more immediate big fish to fry, most notably protection of the Non-Interference Clause and a future with many more Medicare-eligible seniors having their on-patent prescription medicines paid for via Part D.  And filling the doughnut hole (another part of “the deal”) is a crucial part of this strategy.  Immediate (and likely permanent) increases in volume trumps the many negatives of drug importation.  Short sighted?  Certainly.  But these are public companies with patent expiry issues, reimbursement worries and questionable pipelines. Big Pharma – while against drug importation – won’t go to the mat at this stage in the process.

(2) Price Controls. Drug importation is a big shove down the slippery slope towards pharmaceutical price controls.  In fact, it is the importation of foreign price controls at worst and reference pricing at, well, at worst.  And don’t kid yourself, that’s the real reason why folks like Rahm Emmanuel (who promulgated similar legislation when he was in Congress) and Bernie Sanders (the Senator from Ben & Jerry’s) support this idea.  Every government study shows that importation schemes don’t save us money.  So, why pursue this silly soundbite strategy if not for more nefarious purposes? Voting “for” drug importation to kill flawed healthcare reform legislation is like having a hysterectomy to control menorrhagia.  

(3) Safety.  Most importantly – MOST IMPORTANTLY – is the fact – THE FACT – that drug importation makes our prescription medicines supply less safe – LESS SAFE.  And that is just not acceptable.  Not under any circumstances.

A vote for drug importation minus Secretarial Certification is a very big mistake – regardless of motivation.