Longtime pharma critic and Democratic candidate Sanders pledges importation action 'on day one'

Pharma has fought off importation time after time, but it might just lose the fight this time. With a push this week by President Donald Trump and a separate commitment by Democratic presidential candidate Bernie Sanders, the idea might just be gaining traction.

After the Trump administration’s importation proposal this week, Democratic presidential candidate Bernie Sanders said Thursday he’d implement drug imports—in a broader way than Trump has so far proposed—"on day one" to fight high pharma prices, The Hill reports. 

In an MSNBC interview, Sanders said he’d direct his Department of Health and Human Services (HHS) secretary and FDA head to "make sure that the medicine coming in from Canada or any other country is in fact perfectly safe." 

But his plans for pharma don't stop there. The candidate also wants to use the federal government’s "march-in rights" and break pharma patents if companies don’t sell drugs in the U.S. on "reasonable terms," Sanders said in a statement to The Hill. 

Of course, neither proposal is completely novel, and pharma has fended off similar measures—including some from Sanders. The independent senator has been one of pharma’s loudest critics in Washington, D.C., and has laid out a range of proposals to take on the industry. So far, not so successfully, at least when it comes to getting bills through Congress.

On the public opinion side, Sanders has used the campaign trail and his congressional oversight powers to not only blast pharma as a whole but also to focus on individual companies for their pricing moves. 

Far on the other side of the aisle, Trump has repeatedly pledged to lower pharmaceutical prices—and has made some progress—but his efforts have taken recent setbacks, and prices continue to climb. 

The administration recently pulled its own proposal to revamp drug rebates after the Congressional Budget Office found the plan would boost federal spending by about $177 billion over 10 years. Trump’s popular FDA chief Scott Gottlieb also resigned and took a post on Pfizer’s board, and a judge blocked the administration's attempt to force drugmakers to include prices in TV ads.  

Importation faces plenty of challenges as a price-fighting measure. For one, it’ll require public consultation and face resistance from the pharma industry, The Globe and Mail notes. Drugmakers could lobby against the proposal, fight it in courts or not cooperate when it comes to shipping drugs to and from Canada.

Already, the industry’s top trade group in the U.S. has lambasted Trump's proposal as "far too dangerous for American patients." 

"There is no way to guarantee the safety of drugs that come into the country from outside the United States’ gold-standard supply chain," PhRMA CEO Stephen Ubl said in a statement. "Drugs coming through Canada could have originated from anywhere in the world and may not have undergone stringent review by the FDA." 

Other market watchers have raised concerns about drug supplies for Canadian patients if the U.S. were to start buying up the nation's pharmaceuticals in bulk.

The escalation on importation this week only emphasizes that pharma will be busy defending itself through next year’s presidential and congressional elections. So far in the Democratic race, former Vice President Joe Biden and Sen. Kamala Harris have touted their own drug pricing plans, and each favors capping drug prices. 

Harris released a "People Over Profit" plan that’d direct HHS to cap pharma prices based on average costs in other developed countries. Any revenue generated by prices above the cap would face a 100% tax, with proceeds going back to consumers. Harris also said she’d take a look at "march-in rights." Biden has said he favors imports and a plan to cap drug prices at the rate of inflation.