Americans may soon be able to import prescription drugs from Canada, courtesy of an executive order signed by President Donald Trump on Friday.

Restructuring America’s Pharmaceutical Industry

Americans may soon be able to import prescription drugs from Canada, courtesy of an executive order signed by President Donald Trump on Friday. It was one of four executive orders designed to counter rising pharmaceutical prices.

“The four orders I’m signing today will completely restructure the prescription drug market in terms of pricing and everything else to make these medications affordable and accessible for all Americans,” Trump proclaimed.

The first directive Trump introduced mandates community health centers that take federal funding to pass their discounts on to patients requiring insulin and EpiPens. The policy is limited to low-income individuals, however, ABC 7 New York reported.

“These providers should not be receiving discounts for themselves while charging their poorest patients massive, full prices. Under this order, the price of insulin for effective patients will come down to pennies a day,” Trump said. “Pennies a day from numbers you weren’t able to think about. It’s a massive cost savings.”

Opening the Door to Canada

Trump’s second executive order focused on allowing the importation of FDA-approved drugs from other nations. Under the new guidelines, states, wholesalers, and pharmacies will be permitted to import prescription drugs from Canada. Previously, the US Postal Service generally allowed small quantities of orders to be imported by private customers, but large corporations could not import bulk quantities. That changes with the new executive order.

“[It] will allow states wholesalers and pharmacies to do something about their politicians who have promised for decades and decades but never done. They never delivered. We will finally allow the safe and legal importation of prescription drugs from Canada and other countries where the price for the identical drug is incredibly lower.”

Trump said the price difference between buying a drug in the the US versus Canada could be “70%, 800%, 90%, 30%. But massively lower than the identical drug made in the same plant, same factory, same exact drug. Same box. Same pill.”

The president also asserted that America funds “all of the research and all of the development, and foreign countries pay absolutely nothing and our consumers get charged. This has been going on for decades..”

He also claimed US customers are charged 30-50 more than their Canadian counterparts.

“Many people go to Canada, I see it all the time. They go to Canada, they buy drugs and then they come back. Prescription drugs because they save so much money the trip is well worth it,” Trump said.

However, although the Trump administration and consumers may favor Canadian drugs for their lower prices, the Canadian government is concerned it will not have enough if it starts exporting to the US.

‘The Middlemen, and Women’

Trump also used the opportunity to criticize his predecessor, former President Barack Obama, and Democratic opponent Joe Biden.

“The Obama–Biden administration pledged to end this unfairness and allow drug importation but they never got it done. They were never able to get it done. They didn’t get a lot of things done.”

Trump said that with the four executive orders, he is taking a stand against “lobbyists and special interests and fighting back against a rigged system. I’m unrigging the system that is many decades old.”

The president’s third executive order will require rebates that have traditionally been paid to benefit managers and insurers to be passed on to consumers. Trump referred to benefit managers and insurers as “middlemen, and women.”

“[The order] will prevent middle-men, and women I guess, but you’ve heard about the middlemen, right. The middle man that makes so much money nobody knows who they are. Nobody knows who they are and they make more money perhaps than even the drug companies themselves,” Trump said, describing the problem.

“They don’t do much. Maybe they don’t do anything. Some people say they don’t do anything. Nobody knows who they are. But the middle men are making a fortune and pharmacy benefit managers, people are just milking medicare patients with these high drug prices while they pocket gigantic discounts,” he added.

The president then claimed that the rich middlemen, and women, who are unknown, won’t be rich for much longer. Trump said he fielded numerous phone calls when “they heard I was going to be doing this. Despite taking phone calls from the people Trump said would lose money, the middlemen, and women, Trump emphasized “we don’t know who they are.”

Favored Nations Rule

Finally, the last executive order Trump signed will mandate that Medicare uses the lowest price among economically-similar nations in determining how much it will pay for prescriptions. The order is commonly referred to as the ‘Favored Nations Rule’.

The move would essentially give Washington the power to look, for example, at how much consumers in Canada pay for a drug. Medicare then would use that price as the amount it would pay to pharmaceutical companies. The idea resembles similar pharmaceutical pricing structures in other nations such as Canada.

The tactic could generate pushback from drug manufacturers that fear it could lead to Medicare dictating drug prices, ABC 7 New York reported.

Trump said he would give pharmaceutical companies one month to discuss alternatives with the White House before the White House begins implementing the new laws. Stat News reported. Some companies have already requested audiences with Trump to craft alternative solutions, according to Reuters.

Reducing drug prices was a promise Trump made during the 2016 election campaign. At his press conference Friday, he took credit for prices that he said have already fallen.

“Thanks to my administration, We have successfully lowered drug prices for the first time in 51 years,” Trump said. “Unfortunately we’ve been waiting for Congress to takc action for decades. I’m unwilling to wait any longer.”