BISMARCK -- The Senate Human Services Committee heard testimony on three bills aimed at getting North Dakota consumers access to lower prescription prices.
“Most of us have never heard a good explanation of why the same drug a few miles across the border [in Canada] sells for 40%, 30% or sometimes even 20% of the price we pay in this country,” said Sen. Howard Anderson Jr., R-Turtle Lake (District 8), who introduced all three.
The first of the three, SB 2170, would create a system to set payment rates for prescription drugs based on international prices, specifically the price of those drugs in Canada. The bill would compare prescription drug prices in America to prices in Alberta, British Columbia, Ontario and Quebec. After comparison, the lowest price would be used as reference rate, or maximum rate, for consumers.
“This is an issue that has continued to grow in the minds of our members,” said Josh Askvig, state director of AARP. “For the last five years, I have not gone to an event where somebody hasn’t asked me about prescription drug costs.”
According to Askvig, the bill “allows states to ‘import’ the drugs’ prices instead of the actual drugs.” According to the National Academy for State Health Policy, the average savings on prescription drug costs would be around 75%.
In North Dakota the average costs of prescription drugs increased by 57.8% from 2012-2017. In 2017, according to the State Health Access Data Assistance Center, 31% of North Dakota residents stopped taking prescription drugs because of cost.
Michael and Marilyn Worner, Fargo residents and retired educators, spoke in favor of SB 2170.
“This year my wife and I will declare $22,000 in medical costs when we file our income tax,” Michael Worner said. “This represents over 30% of our total income. Our prescription drug costs are a major part of this expense and cause us constant concern.”
Worner suffers from dry eyes, a condition that he said cannot be treated using over-the-counter medications. The medication Worner’s eye doctor prescribed him costs $1,700 for a three-month supply. After insurance, Worner’s out-of-pocket cost is around $120.
“About two years ago, when I talked to my doctor and informed him that I was having difficulty paying for the expensive medication, he suggested that I use only half of the prescribed medication daily,” Worner said. “This is one method I use to save money – by rationing my drugs.”
Worner has started buying the medication out-of-country. He said a three-month supply of the drug costs $60 versus $1,700 in-country before insurance.
“A point of interest is that the medication that I purchase from another country is manufactured in Waco, Texas,” Worner said. “In my opinion, this is not right. Why can someone purchase a prescription drug for $60 when I am paying $1,700 for that same drug?”
Peter Fjelstad, senior director of state policy for Pharmaceutical Research and Manufacturers of America, testified in opposition to the bill.
“This kind of legislation will not benefit patients and can jeopardize the competitive market that works to drive down drug prices,” Fjelstad said.
According to Fjelstad, price controls threaten the development of new medications because it reduces the incentive for pharmaceutical companies to invest in research and development.
“It is not the right path forward to help ensure that North Dakotans have access to affordable medicines,” Fjelstad said.
SB 2209 and SB 2212 would establish a wholesale prescription drug importation program with Canada to lower costs. The two bills are essentially the same except the program would be run by N.D. Board of Pharmacy under SB 2209 and the N.D. Department of Health under SB 2212.
Roger Roehl, a Mandan resident, testified in favor of the bills.
“Five years ago, I nearly lost my life to leukemia, but it wasn’t because of the disease, which was under control. It was because my wife and I couldn’t afford my medication,” Roehl said.
Under Roehl’s Medicare insurance plan, his monthly medication cost was $2,400. Roehl said he was not able to afford the medication. After consulting with his oncologist, Roehl was told he would have approximately three and half years to live without the medication. Roehl later discovered he would be able to get his medication from Canada for $690 per month.
“What good is a life-saving drug if you can’t afford to buy it,” Roehl said. “It’s a shame Americans have to turn to foreign countries for affordable prices on life-saving drugs but if that will help consumers like me, I support it.”
Aside from the medication Roehl takes for leukemia he is also now taking insulin, after side effects of COVID-19 elevated his blood sugar.
“I support anything you guys can come up with to help us out. We definitely need some assistance because we’re not getting anywhere on our own,” Roehl said.
Leah Lindahl, with the Healthcare Distribution Alliance, which connects pharmaceutical distributors with pharmacies, hospitals, clinics and long-term care facilities, testified in opposition to the bills.
“Allowing for importation of prescription drug products increases the likelihood of counterfeit or adulterated drugs entering the country,” Lindahl said.
In her testimony, Lindahl referenced the Drug Supply Chain Security Act which establishes a program to track prescription drugs distributed in the United States. The program helps prevent citizens from using counterfeit, stolen, contaminated or other harmful drugs.
“Importation of drugs from Canada, or other countries, would hinder the intent of the DSCSA statute, and therefore increase the risk of illegitimate or counterfeit medications entering the U.S. market,” Lindahl said.