[jariel]

The laws regarding importation from other countries are odd, but they are not what you think they are.

In effect, it's about 're-importation' of drugs, not so much regular import.

The Government of Ontario negotiates drug prices for it's citizens, as to other entities elsewhere.

By selling to XYZ regime at ABC price, drug companies create a situation wherein 'the resulting price will be the lowest price we sell to any regime' - because of course everyone will want to import from there.

In many cases, the price sold to XYA regime isn't quite a very good measure of net market prices.

Ergo, it's a weird law, but it's rational on a level.

To start - there could be a slew of laws requiring transparency on pricing for everything in the medical domain. That would be a good start.

More challenging - Americans could actually get together and start negotiating hard on prices. This may require some legislation.

So the 're-importation' issue is an artifact of an odd system, not in and of itself the issue.

[arcticbull]

Ontario's a great example of how this problem is usually solved in developed countries.

OHIP negotiates the prices of all drugs on behalf of Ontarians by being the sole purchaser, and then drugs are sold at that rate (cost plus, I believe) in pharmacies. Further, the cost of all services is listed on the OHIP website. [1] Not that anyone needs to worry about that as they are fully covered for everyone - not the drugs (yet, fingers crossed), the procedures.

[1] http://www.health.gov.on.ca/en/pro/programs/ohip/sob/physser...

[inter_netuser]

Tons of new drugs are never even marketed in Canada due to this, or marketed much later.

Almost all expensive drugs end up being on a special permission list, where you must to beg the government for access.

Not any different than dealing with an insurance company, really. At least you can sue an insurer.

[arcticbull]

You can sue the province too.

However of course consider delays in getting a drug to market aren’t always provincial; Health Canada has their own timelines and schedules for approvals, sometimes it’s faster than in America and sometimes it’s slower.

The difference is frequently you’re forced to sue insurers as they have a profit motive to screw you. The province only cares about getting you healthy within their means.

[jariel]

It has benefits but also obviously drawbacks.

Ambien is not available in Canada for example.

One of the things about hard negotiations is that sometimes the other side will call the bluff and walk away.

And of course in rationed systems you don't get things that 'the masters' decide you don't need, like Ambien.

In the case of Ambien, I don't care, I question the real medical value of it, but you can see how that could get out of hand with other things.

It would better to solve the 're-import' problem with better regulation - and of course, initiatives such as the the MC Company here.

I think the Cleveland Clinic and some others like it are technically non-profits, there are models that work.

[arcticbull]

The thing about MC company is they have no obligation to keep their pricing or business model moving forward. They can sell to an insurer or pharma company or just raise their margins. This is good but shouldn’t be integral.