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Colorado submits list of 112 prescription medications it wants to import from Canada

Prescription medications
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DENVER — The state of Colorado officially submitted its plan to the federal government to begin importing prescription medications from Canada.

The Section 804 Importation Program (SIP) application listed 112 medications the state hopes to start bringing across the border to save people money.

“The big picture is we have Coloradans that can't afford to take their medication as prescribed because it's too expensive,” said Kim Bimestefer, executive director of the state’s Department of Health Care Policy and Financing.

The department estimates the program will save Coloradans between $53 million and $88 million on their prescriptions each year.

On average, prescription medications account for roughly 19% of total health care spending in the state, according to the department.

“If we can import through the tracks that we're setting up now, drugs that bring an average savings of 65%, it's going to make a meaningful difference to Coloradans,” Bimestefer said.

Among the 112 prescription medications the state wants to import is:

  • EpiPen, which the state expects to see a 66% savings on
  • Xarelto, a blood thinner medication, which could result in a 77% savings through importation, according to the state
  • Advair Diskus, a respiratory inhaler, which the state expects to see a 66% savings on
  • Invokana, a type 2 diabetes medication, which the state expects to see an 81% savings on
  • Nuvaring, a birth control medication, which the state expects to see a 90% savings on

The biggest cost-saving medication on the list per prescription is Cabenuva, an HIV medication that patients are currently being charged $6,240. The department estimates an imported version of the medication would cost $3,074 for patients.

To determine which medications to include, Bimestefer’s team combed through the claims data of the 2,000 most expensive medications in Colorado and narrowed it down from there.

“We looked at the highest cost drugs and also drugs that are high volume. So a drug like Synthroid, for example, which is for hyperthyroidism. That drug isn't particularly expensive, but it is highly utilized,” said Lauren Reveley, the drug importation program manager for the department. “We really tried to focus on drugs that treat chronic conditions like HIV, asthma, COPD.”

Even though 112 drugs are currently on the list, the application warns that the list is aspirational at this time and not every medication could be imported initially. Reveley said that’s because of the way drug manufacturers have contracted with wholesalers in Canada.

“We are going to have to negotiate directly with drug manufacturers to secure supply agreements and pricing agreements on every drug on the list. So we intend to start those negotiations in earnest in the new year,” Reveley said.

Eventually, though, she’s hoping to go well beyond the list of 112 medications.

Before any medications would be imported, they would have to go through FDA-approved manufacturers, be tested for authenticity and quality and then relabeled.

The FDA now has six months to review the state’s application and determine whether it can move forward.

Bimestefer said the state already submitted a draft application to the FDA in the hopes of smoothing out the process and speeding things along. They are hopeful for a speedy review.

Colorado has become the second state in the nation to submit a SIP application behind Florida, but Florida has been waiting for a response from the FDA for more than 600 days.

In August, Governor Ron DeSantis and the state filed a lawsuit against the FDA over the delay. A ruling on that lawsuit could affect how quickly or slowly Colorado’s application moves.

“We hope for a speedy review, and that we hope they're collaborating throughout so that we can answer and bring the savings to Coloradans as quickly as possible,” Bimestefer said.

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