While Canada is sympathetic to U.S. efforts to make prescription drugs more affordable, it's not the solution to the U.S. problem, Kirsten Hillman, Canada's acting ambassador to the U.S., said following a discussion last week with Trump administration officials about the proposed Safe Importation Action Plan. Importing prescription drugs from Canada has been a go-to solution for U.S. lawmakers and President Donald Trump as a way to make the drugs more affordable in the U.S. Hillman cited a study published in the September Canadian Health Policy Journal that predicted if 40% of U.S. prescriptions were imported from Canada, the Canadian drug supply would be exhausted in 118 days. "It is important to recognize that Canada's market for pharmaceuticals is too small to have any real impact on U.S. drug prices," Hillman said. "Canada represents only 2% of global pharmaceutical consumption vs. America's 44%. In fact, the state of Florida alone spends more than all of Canada on prescription medicine. Last year, 699 million prescriptions were filled in Canada compared to 4.2 billion in the United States." As it is, Hillman pointed out, Canada imports about 70% of its final dosage form drugs and more than 90% of the ingredients for the remaining 30% of drugs that are manufactured domestically. Thus, it can't increase its domestic supply to meet both its needs and those of the U.S. Meanwhile, a proposed FDA rule on drug importation was sent to the White House Office of Management and Budget Friday for regulatory review.
The Institute for Clinical and Economic Review (ICER) released an evidence report assessing the comparative clinical effectiveness and value of Novo Nordisk A/S' oral Rybelsus (semaglutide), a GLP-1 receptor agonist for the treatment of type 2 diabetes. Judging from the list price of the drug, "its net price is likely to be much higher than that of competitor oral treatments, including the SGLT-2 inhibitors like empagliflozin [Jardiance, Boehringer Ingelheim GmbH] that appear to have similar benefits with fewer common side effects," ICER's Chief Medical Officer David Rind said. The assessment compared Rybelsus, which is an oral version of Novo Nordisk's injectable Ozempic, to background therapy with metformin alone and to three competitors for add-on therapy: Novo Nordisk's Victoza (liraglutide), Merck & Co. Inc.'s Januvia (sitagliptin) and Jardiance. The report will be reviewed at the Nov. 14 public meeting of ICER's New England Comparative Effectiveness Public Advisory Council.