SALT LAKE CITY — Utah lawmakers squashed legislation Friday designed to help establish a wholesale prescription drug importation program from Canada.
Only two members of the Senate Health and Human Services Committee voted in favor of advancing House Bill 267 to the Senate floor for further deliberation, while five voted against it. In late February, Utah House representatives approved it in a 63-6 vote.
The bill’s sponsor, Rep. Norman Thurston, R-Provo, said the measure — touted as potentially saving taxpayers $100 million each year — is now effectively dead, but the idea of trimming high prescription drug costs by importing medications from Canada is still very much alive. Utah is among more than a dozen states pursuing similar programs.
“There are several options that I’m exploring,” Thurston said, noting that Utah’s Health Department could possibly seek federal approval without his legislation in place.
Sen. Majority Leader Evan Vickers, a Cedar City Republican and pharmacist by profession, spoke against HB 267 Friday, raising concerns about the safety and practicality of such a program.
“What if there’s not a widespread group of pharmacies who would be willing to bring the product in?” Vickers asked. “Are you assuming that every pharmacy is going to stock this medication?”
Thurston replied that at a minimum, “you’d need one source in Canada, one distribution channel in Utah, and then any pharmacy in Utah that wanted to receive those drugs could … if people are willing to fly to Tijuana to pick up these drugs, they’d certainly be willing to drive to Salt Lake City or St. George to pick them up.”
In 2018, Thurston successfully sponsored a “right to shop” bill that paved the way for members of Utah’s Public Employees Health Program to cut prescription drug costs by flying to San Diego, crossing the border into Tijuana, Mexico, and purchasing a 90-day supply of their medication.
PEHP Director Chet Loftis told Senate committee members Friday that the program has about 400 people who qualify for high-end drugs that cost about $50,000 per year.
“If they are willing — there’s no pressure, none of that kind of thing — we do say if you’d like to go, we can send you there,” Loftis said. “We pay for the flight, we pay for the drug, we arrange for the services. And as a result the state saves about half that amount over the course of a year.”
PEHP also pays patients $500 per trip or $2,000 total if they travel four times per year, Loftis added.
Dana Malick, senior policy director for the Pharmaceutical Research and Manufacturers of America (PhRMA), represented the trade organization’s stance in opposing HB 267.
“Any drugs that are intended for another country — even Canada and their gold standard regulatory system — would not be compliant with the U.S. track and trace system,” Malick said. “And under federal law, wholesalers believe that they would then not be able to dispense these drugs legally.”
Canadian drug manufacturers also lack the capacity to supply more than their own population, Malick added.
But Libby Willmore, speaking on behalf of the Utah Nurse Practitioners Association, voiced support for HB 267, saying that patients can’t fill their prescriptions due to increased costs.
“Any creative ideas to lessen the cost and strain on patients and their families is applauded by the Utah Nurse Practitioners Association,” Willmore said.
Before HB 267 cleared the House last month, two lawmakers who are doctors spoke in its favor — Rep. Ray Ward, R-Bountiful, and Rep. Stewart Barlow, R-Fruit Heights.
Ward spoke to the rising costs of insulin in the U.S.: “In my own practice I have several patients who are taking less than they should or going without, or who are embarrassed to come back in and have another visit because they know they’re not taking what we agreed on. That is not safe. It can never be safe when the prices are that high.”
A Kaiser Family Foundation poll released in February indicated that 24 percent of adults found it difficult to afford their prescriptions, with one in 10 describing it as very difficult. And 80 percent perceived pharmaceutical company profits as a major cause of high drug prices.
In 2018, PhRMA and pharmaceutical companies donated almost $42,000 to the campaigns of these Utah legislative leaders:
House Speaker Brad Wilson received a total of $10,400. He voted against HB 267.
House Majority Leader Francis Gibson received a total of $3,250. He voted against HB 267.
Senate President Stuart Adams received a total of $8,250. He voted against HB 267.
Senate Majority Leader Evan Vickers received a total of $9,250. He voted against HB 267.
Senate Majority Whip Daniel Hemmert received a total of $6,250. He did not get a chance to vote on HB 267.
Senate Executive Appropriations Chair Jerry Stevenson received a total of $4,500. He did not get a chance to vote on HB 267.
Adams, who voted against HB 267 in committee last Friday, said Thurston had a great idea that “probably wasn’t ready yet.”
“There’s so many problems with it that we have to be careful as to how we do that,” Adams said. “Sometimes you need to measure twice and cut once.”
But Adams balked at the notion that campaign donations buy access or influence.
“They probably donated to me, but I can’t tell you how much and when ... I don’t think that plays a significant role,” Adams said. “Our voting records are out there. People can respond to us and support us or not support us according to our voting records.”
Sen. Jani Iwamoto, a Salt Lake City attorney and Democrat, and Sen. Allen Christensen, a North Ogden Republican and retired pediatric dentist, voted in favor of HB 267.
Christensen noted that Utah Medicaid spends over $175 million per year on prescription drugs.