El plan del gobernador de Florida para importar medicamentos más baratos de Canadá sigue en la nada

Thursday, November 21, 2024 - 10:50

Casi un año después que la administración Biden diera luz verde a Florida para convertirse en el primer estado en importar medicamentos recetados más baratos de Canadá —un objetivo de muchos políticos de todas las tendencias, incluido el presidente electo Donald Trump— el programa aún no ha comenzado.

El gobernador de Florida, Ron DeSantis, celebró en enero que la Administración de Alimentos y Medicamentos (FDA) aprobara su plan, calificándolo de victoria sobre la industria farmacéutica, que se opone a la importación alegando que provocaría un aumento de medicamentos falsificados.

Un funcionario de salud de Florida, familiarizado con el programa de importación, dijo a KFF Health News que aún no había fecha prevista para que el estado comenzara a importar medicamentos. El funcionario pidió no ser identificado porque no estaba autorizado a hablar públicamente sobre este tema.

Florida solicitó crear un programa de importación en noviembre de 2020, pocos meses después que la administración Trump concediera esta opción a los estados. El republicano DeSantis se había quejado públicamente sobre el ritmo del proceso de aprobación federal bajo la administración Biden y en 2022 presentó una demanda contra la FDA por lo que llamó un “retraso imprudente”

Trump promocionó la medida de su administración para pasar medicamentos por la frontera en una entrevista previa a la elección publicada en octubre por AARP, la organización nacional que aboga por los derechos de los adultos mayores y que apoya que se permita a los estadounidenses comprar medicamentos en Canadá. En la entrevista, prometió “continuar mis esfuerzos para proteger a los estadounidenses de los precios inasequibles de los medicamentos” en un segundo mandato.

No está claro si su segunda administración hará o podrá hacer más para ayudar a Florida y a otros estados a establecer programas, porque en última instancia corresponde a los estados actuar. Colorado es el único otro estado que tiene un plan de importación pendiente con la FDA.

Funcionarios de la administración DeSantis se han negado durante meses a responder a las preguntas de KFF Health News sobre el programa. Alecia Collins, jefa de personal de la Agencia de Florida para la Administración del Cuidado de Salud, dijo en octubre que los funcionarios no estaban disponibles porque estaban de viaje. A mediados de noviembre, dijo que todavía no tenía respuestas.

El secretario de prensa de DeSantis, Jeremy Redfern, señaló que había sido “objeto de críticas” desde la primera semana de noviembre y no podía responder a las preguntas.

Cherie Duvall-Jones, vocera de la FDA, expresó que no podía responder a la pregunta sobre si Florida había presentado los documentos que la agencia exige antes de que el estado pueda empezar a importar medicamentos. Y remitió todas las preguntas al estado.

Las farmacéuticas suelen vender los medicamentos mucho más baratos en Canadá que en Estados Unidos por los controles de precios del gobierno canadiense. Pero por motivos de seguridad y eficacia, la ley federal prohíbe a los consumidores comprar medicamentos fuera de las fronteras de Estados Unidos, salvo en contadas ocasiones.

Políticos que van desde conservadores como DeSantis a liberales como el senador Bernie Sanders, de Vermont, llevan mucho tiempo presionando para que se importen medicamentos recetados de menor costo desde Canadá.

En el año 2000, el Congreso aprobó una ley que permite a los estados importar medicamentos recetados al norte de la frontera, con la advertencia de que sólo podría seguir adelante si el secretario del Departamento de Salud y Servicios Humanos (HHS) afirmaba que era seguro. Eso no ocurrió hasta 2020, cuando el secretario del HHS de Trump, Alex Azar, hizo tal declaración.

Desde 2022, Azar ha sido presidente de la junta directiva de LifeScience Logistics, una empresa con sede en Dallas a la que Florida está pagando millones de dólares para establecer su programa de importación de medicamentos, incluido su almacenamiento.

El 13 de noviembre, Azar se negó a responder a las preguntas de KFF Health News sobre la importación de medicamentos, diciendo que no estaba autorizado a hablar sobre el asunto.

El programa de Florida no ayudaría directamente a los consumidores en la farmacia. Su objetivo es reducir los costos del programa estatal de Medicaid y de los departamentos de salud y prisiones.

Matthew Baxter, director de Methapharm Specialty Pharmaceuticals, con sede en Ontario, que ha contratado a LifeScience para exportar medicamentos, no quiso decir si Methapharm ha enviado algún medicamento a través de la frontera.

La industria farmacéutica y el gobierno canadiense se oponen a la exportación de medicamentos a Estados Unidos. Las farmacéuticas afirman que aumentaría el riesgo de que aparezcan medicamentos falsificados en las estanterías de las farmacias estadounidenses, mientras que el Gobierno de Ottawa ha advertido de que no permitirá la exportación de medicamentos si, como consecuencia, los canadienses pudieran sufrir escasez.

El ahorro previsto en Florida también sería relativamente menor. DeSantis estimó que el programa ahorraría a las agencias estatales hasta $180 millones en su primer año. El presupuesto anual de Medicaid de Florida supera los $30,000 millones.

Florida identificó 14 medicamentos, entre ellos algunos para el cáncer y el sida, que intentaría importar de Canadá para sus agencias estatales.

Camm Epstein, analista de políticas de salud en Saratoga Springs, Nueva York, señaló que la importación de medicamentos es un concepto aparentemente simple que atrae la atención de los ciudadanos, razón por la cual DeSantis y otros han recurrido a la idea como respuesta al aumento de los precios de los medicamentos. “Es algo que agita a las masas”, dijo Epstein. “¿Quién no quiere pagar menos por las medicinas?”.

Pero pasar medicamentos por la frontera es complicado debido a los numerosos requisitos de la FDA, entre ellos encontrar empresas con las que trabajar —un exportador canadiense y un importador estadounidense— y seguir un proceso que garantice que los medicamentos sean auténticos, apuntó Epstein.

“Esto lo convirtió, en el mejor de los casos, en un despilfarro”, añadió.

Florida ha gastado decenas de millones de dólares para poner en marcha su programa de importación de medicamentos. El estado ya ha pagado a LifeScience Logistics $50 millones para establecer un depósito en donde guardar los fármacos. DeSantis señaló los costos en su demanda de 2022 contra la FDA.

“Los demandantes han pagado a su importador y distribuidor más de $24 millones hasta ahora —aumentando a razón de $1,2 millones cada mes— a pesar de que ni una sola píldora ha sido importada, reetiquetada o distribuida, debido a la desidia de la FDA”, expresó el estado en su demanda.

El retraso de Florida puede deberse a problemas operativos, según Epstein. “Previsiblemente, aunque abrieran el grifo no habría flujo, porque Canadá no iba a permitir el suministro”, dijo.

Colorado y Florida se encuentran entre los nueve estados que han aprobado leyes que permiten la importación de medicamentos canadienses. La solicitud de Colorado a la FDA, en 2022, sigue pendiente. En diciembre de 2023, las autoridades de Colorado publicaron un informe en el que señalaban que el estado era incapaz de encontrar un fabricante de fármacos dispuesto a venderle medicamentos procedentes de Canadá.
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