US states want to buy cheap drugs from Canada—and the FDA says yes after three year delay

On 5 January the US Food and Drug Administration approved Florida’s plan to import drugs from Canada, after a delay of more than three years.1 Florida was the first state to ask the FDA, in November 2020, to import drugs from its northern neighbour, taking advantage of lower costs over the border. In autumn 2023 Texas became the fifth US state in three years to apply to the FDA for permission to import drugs from Canada.2 Colorado, New Hampshire, and New Mexico are the other states to have requested approval.

The delay led Florida to sue the FDA, but the courts put the lawsuit on hold in June 2023, pending further developments.3

The FDA had said in August 2023 that Florida’s plan had “deficiencies” and called on the state to correct these.4 The US health news website STAT reported that the plan “did not show whether it meets the two overarching requirements of saving money and securing the drug supply chain.” The FDA gave the state until 28 August 2023 to flesh out those two subjects,5 hence the court staying the lawsuit.

The idea of importing from Canada is “nonsense,” one expert says. Marc-André Gagnon, a professor at Carleton University in Ottawa who specialises in pharmaceutical policy, says it ignores the underlying problem: “What …