Healthy Skepticism Library item: 731

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Rost P .
Contradicting itself on drug imports
The New Jersey Star-Ledger 2005 Jan 5

Full text:

Some recent headlines:

“HHS reports drug imports likely won’t save money.”

“Net saving on drug import not worth action.”

“Legalizing drug imports not worth it.”

“Bush panel sees scant savings in drug imports.”

These were based on a report released two weeks ago by the Department of
Health and Human Services which concluded that “total savings to drug buyers
from legalized commercial importation would be 1 to 2 percent of total drug
spending.”

If this were true, reimportation of drugs would never take off. Why, then,
would the drug industry spend so much time fighting this plan? What is it
that the drug companies know but that the Department of Health and Human
Services doesn’t want you to understand?

The answer is that the data in the report don’t support the department’s
conclusions.

The research in the report actually indicates the possibility of saving 17.5
percent, or $37.8 billion, annually in the United States. And this also
explains the drug industry’s fear of importation.

The department’s conclusion that reimportation will not result in
significant savings is built upon the premise — as stated in the report —
that “imported drugs may be around 12 percent of total use … because drug
companies have incentives to impede exports.” This assumption doesn’t take
into account that reimportation bills would make it illegal to limit supply
— something the drug companies are keenly aware of but the Department of
Health and Human Services completely forgot.

The second faulty premise is that “U.S. drug buyers may get discounts of
only 20 percent or less, with the rest of the difference between U.S. and
foreign prices going to commercial importers.”

This statement should be contrasted with a chart (table 7.2) in the report
showing that U.S. retail drug prices are 100 percent higher than in Europe.
So this premise assumes unprecedented price gouging by importers and a
complete lack of competition among them. Of course, the drug industry knows
that is not how the free market works, but the Department of Health and
Human Services feigns ignorance.

The third premise in the report, which will be applied to the analysis
below, is that “about 30 percent of total drug spending may be unchanged by
legalizing commercial importation because about that much is now spent on
products that are inappropriate for importation.” According to the report,
these would include such drugs as those used during surgery, those that are
injected, controlled substances or low-cost generics.

Let’s now do the analysis of savings possible in the United States, based on
the data in the report. We know that according to the report drug prices in
Europe are at least 50 percent lower than in the United States. Let’s be
very conservative and assume as much as half of this price difference is
captured by greedy importers — a pretty unlikely scenario because with such
costs, reimportation would never have existed within Europe.

Then we take the report’s premise that 30 percent of the U.S. market will
not have competition from reimported drugs because they are generics or
belong to categories that can’t be imported easily.

That leaves 70 percent of the market multiplied by a 25 percent price
reduction, for a saving of 17.5 percent on the total U.S. drug bill of $216
billion, resulting in a net saving of $37.8 billion.

This is a simplified analysis, but more complex mathematical models based on
the Department of Health and Human Services’ research data result in similar
savings. In summary, the report has the right data but the wrong
conclusions.