BISMARCK — State lawmakers are exploring measures to broaden access to low-cost prescription medication in North Dakota with multiple bills that look to Canada as a standard for cheaper drugs.
The legislation comes as Congress and lawmakers around the country have tried to suppress the prices of prescription medications, which have shot up exponentially in the United States in the last few decades and outpaced the costs in many comparable countries.
Three separate bills introduced by Sen. Howard Anderson, R-Turtle Mountain, on Wednesday, Jan. 27 look north to facilitate access to more affordable medication in North Dakota. One, Senate Bill 2170, would use Canadian prices as a benchmark for setting drug costs in North Dakota, while the other two, Senate Bills 2212 and 2209, are variations on a more ambitious program to ship in lower-cost drugs from Canada for North Dakota customers.
And the bills come after some North Dakotans have already independently resorted to Canada and other countries to access cheaper meds.
Roger Roehl, a Mandan resident and leukemia patient, testified that he turned to Canada to buy the cancer drug Gleevec after he was told that the monthly bill through a North Dakota provider would be $2,400, close to quadruple the Canadian price tag. Mike Worner, a retired Fargo teacher, similarly testified that he could get a three-month supply of a prescription eye medication for $60 through international channels, compared to $1,700 in North Dakota.
"This is simply not right," Worner said. "How long will we be able to pay for our prescription drugs?"
The annual spending on prescription drug treatment by senior North Dakotans increased by 58% between 2012 and 2017, according to data presented by AARP. Pills purchased through Canadian providers, meanwhile, can often come at a fraction of their U.S. costs.
"This model bill just allows the state to import prices, instead of the actual drugs," said Josh Askvig, state director for the AARP. "It goes exactly to what we're speaking to today about reducing costs for consumers."
By mirroring prices north of the border, Anderson testified, North Dakota would establish a negotiating tool to bargain down the drug prices for customers in the state.
Setting a long-term goal to lower drug prices for all North Dakotans, the price reference bill would establish pilot programs with two state benefit programs, drawing on price data from the four largest Canadian provinces and setting the lowest Canadian price or an average of the group as a ceiling for North Dakota customers. If the program works in its trial phase, it could be expanded to encompass all North Dakotans.
But pharmaceutical groups opposing the price reference bill criticized it as a "price control" bill, a characterization Anderson rejected.
"Price controls are not a way to increase access to medicines," said Peter Fjelstad, a representative from PhRMA, a national organization representing pharmaceutical interests, who added that setting reference prices would quash innovation in the pharma sector.
Anderson's two other bills aim to set up an ambitious Canadian drug importation program, to be managed either by the North Dakota Department of Health or state board of pharmacy, shipping in the foreign products themselves, rather than simply adopting their prices.
On top of pushback from the pharmaceutical sector, Anderson acknowledged opposition to his legislation on the Canadian side of the border, where drug prices could get a bump if American states start taking their price tags as a benchmark or shipping in their products.
"I'd like to point out that the Canadians aren't happy about importation," Anderson said. "They like that even less than using their prices as reference prices."
The exact cost of an importation program isn't clear, and Anderson noted that the program's success would likely hinge on similar legislation passing in other states. Colorado lawmakers advanced legislation to launch a similar program earlier this week, while a more developed attempt has been looking for private financial backing.
Legislation establishing a drug price control program could stand on its own, Anderson noted, while lawmakers will winnow the importation bills after determining whether the program would be better managed by the health department or the pharmacy board.
Lawmakers are also considering separate legislation requiring prescription drug manufacturers to report drug prices to the state, with the aim of lowering costs on consumers through a more transparent system.
Readers can reach reporter Adam Willis, a Report for America corps member, at firstname.lastname@example.org.