Sanders in Canada: U.S. drug prices 'an embarrassment'

Jonathan Oosting
The Detroit News
Bernie Sanders talks to Sahil Mehta of Novi on July 28, 2019, at The Olde Walkerville Pharmacy in Windsor, Ontario.

Detroit — Stephanie Odette of Berkley is getting a decent deal on insulin through private insurance provided by her husband’s employer, but there’s a catch:

It's not the type of insulin her doctors actually want her to use, she said Sunday as she boarded a bus for Canada to purchase a $229 trial supply of a version she estimates would have cost her $2,400 if she paid out of pocket in the United States.

“No one here likes to say, ‘I’m sick,’ but I feel like sh-- every day,” Odette said, telling The Detroit News she has been in the hospital 74 times since 2008.  “It’s like a bad hangover that just never goes away.”

Odette is one of roughly a dozen type 1 diabetics who purchased life-sustaining insulin on Sunday after traveling across the Ambassador Bridge in a caravan with Democratic presidential hopeful Bernie Sanders, who blamed high U.S. prescription drug prices on “collusion" and "corruption” by profit-driven pharmaceutical companies.

“They buy and sell politicians, Republicans and Democrats,” Sanders said outside the Olde Walker Pharmacy in Windsor. “In the last 20 years, they have spent billions of dollars on lobbying Congress to make sure they can continue to charge the American people any price they want.”

The avowed democratic socialist is ramping up his calls for prescription drug cost controls and a government-run, single-payer health insurance system ahead of this week’s second Democratic presidential debate in Detroit.

Sanders narrowly won Michigan’s primary in 2016 over eventual Democratic nominee Hillary Clinton but is facing new competition for progressive voters this cycle from others within the 25-candidate field.

Diabetics on the trip described struggles to afford their insulin and potentially deadly decisions to save money by rationing the drug despite the risk of ketoacidosis.

Sanders called the need for Canadian drug caravans an “embarrassment” for the U.S.

“How does it happen 10 minutes away from the American border in Michigan, people here are paying one-tenth of the price for the vitally important drug they need to stay alive?" he said.

Canada’s national health care system does not cover prescription drugs, but the country’s Patented Medicines Price Review board oversees prices and caps medication at a rate partially based on costs in other countries.

U.S. prices are often dependent upon insurance company negotiations and market forces. 

It's generally illegal to import medications from other countries for personal use, according to the U.S. Food and Drug Administration. But diabetics who returned from the trip with bronze tote bags full of prescription drugs had no problem crossing back over the border.

Odette’s doctors want her to take a “non-formulary” insulin called Fiasp, which her insurer does not cover. She bought a trial supply in Canada, where it does not require a prescription and recently became more widely available, for one-tenth of the price she would have paid at home.

Her husband’s late grandparents immigrated to the United States in the 1950s, but as her family struggles to navigate the American health care system, Odette said they’re now considering a move back across the river.

"I think it would absolutely destroy them to know how hard they had to work to come here,” she said. “They came to Detroit because of the Red Wings,” she added, noting their love for Gordie Howe.

The insulin her insurer will cover is not effective and requires her to take three other medications to make it work better, she said. She has four pharmacists and uses mail-order services to get her medication.

“Anyone making six figures a year shouldn’t struggle to pay for insulin,” Odette said. “There’s no sense in it.”

Stephanie Odette of Berkley, Michigan, poses with insulin she purchased in Windsor.

Sanders was greeted with a warm welcome in Windsor, where several dozen locals gathered outside the pharmacy and cheered when the Vermont senator arrived.

Kathy Sego of Indiana broke down as she told onlookers how she’d spent $1,000 on 25 vials of insulin for her 22-year-old son Hunter. It was more than she had planned to pay, but she said the six-month supply still cost $10,000 less than she would have paid stateside.

“That’s still less than we would have paid for one month in the United States,” she said, sobbing. “How can we be the greatest country, and I am paying that much?

Prescription drug prices are not a new issue for Sanders, who organized a separate Canadian trip in 1999 with women who purchased the breast cancer drug tamoxifen for significantly less than they were paying in the United States.

 Americans can buy cheaper and older versions of human insulin over the counter in most states, but not the analog insulin now recommended for most type 1 diabetics that require a prescription.

The FDA is hoping a new congressional mandate to regulate medication like insulin as “biologics” rather than a drug could encourage production of “biosimilar competition” and lower-cost versions.

Sanders is a leading advocate for a nationalized health care proposal known as Medicare for All that would eliminate private insurance in favor of a single-payer government system. He said the plan would cap yearly prescription drug bills at $200 and drive down costs by using Medicare to negotiate with drug companies. 

The proposal appears relatively popular with Democratic primary voters, but Michigan general election voters oppose the strict Medicare for All plan by a margin of 52%-37%, according to a July 17-20 poll conducted by Glengariff Group Inc. and commissioned by the Detroit Regional Chamber. 

Republican President Donald Trump has bashed Medicare for All, arguing it is a “radical socialist” idea that would cause taxes to “skyrocket” and could jeopardize the traditional health insurance program for seniors.

Sanders has introduced Senate legislation that seeks to reduce prescription drug prices by giving the federal government power to authorize generic versions of name-brand medication if pharmaceutical companies charge more than the median price in five other major industrialized countries, including Canada and the United Kingdom.

He's also sponsored legislation that would allow wholesalers and licensed pharmacists to import cheaper prescription drugs from Canada and eventually other advanced countries. 

A handful of states are developing plans to import certain high-priced medications as allowed under a 2013 Medicare law, an option endorsed by Trump.

Desralynn Cole, 36, said she pays roughly $500 a month for insulin and related supplies in the United States, including Omnipod pumps and a Dexcom system that continuously monitors her blood sugar levels instead of requiring regular pin prick blood draws.

The Minnesota woman, who works for the Minneapolis Office of Race and Equity, said she has a high-deductible insurance plan that requires her to pay thousands of dollars a year for medicine that is partially covered. She typically rations her insulin to make it last longer.

“For insulin, they don’t have generic forms,” she said. “I would gladly take that, but it doesn’t exist. So you’re just stuck paying these high prices.”