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opinion

Florida Gov. Ron DeSantis speaks during a news conference in Miami, Fla. on Sept. 7.Rebecca Blackwell/The Associated Press

Gus Carlson is a New York-based columnist for The Globe and Mail.

Time and again, Florida Gov. Ron DeSantis has made it clear that he will run the Sunshine State his way and fight anyone – including the federal government and big corporations – who challenges his authority to do so.

Mr. DeSantis, a Republican who is expected to run for U.S. president in 2024, loudly rejected federal mandates on masks and vaccinations during the COVID-19 pandemic, suggesting that in what he calls the Free State of Florida, personal liberty trumps government control.

He has punished the Walt Disney Co., stripping it of tax breaks and self-governance of its Orlando theme park property, for publicly vowing to repeal Florida’s new parental rights law – dubbed the “Don’t Say Gay” law by opponents – that prohibits the teaching of sexual orientation and gender identity to schoolchildren from kindergarten to third grade.

Mr. DeSantis has taken the gloves off again in his continuing tussle with the Biden administration. But this time, Canada is front and centre in the fight. Mr. DeSantis is suing the U.S. Food and Drug Administration, claiming it is dragging its feet on approving Florida’s application to take advantage of a program that would allow states to import cheap prescription drugs from Canada.

“People use drugs in Canada – this isn’t Djibouti. This is a safe country,” Mr. DeSantis said in announcing the lawsuit last week in Tampa.

Political posturing? Partisan positioning? Perhaps. But Mr. DeSantis, whose state was the first to apply for the Canadian Prescription Drug Importation Program, says the savings to Florida residents for imported drugs used to treat HIV, diabetes, Hepatitis C and mental illness could top US$150-million a year. Other states, including Colorado, New Mexico and Vermont, are also lining up to participate in the program.

“It’s our view that we’ve waited long enough,” Mr. DeSantis said, adding the application had been sitting on someone’s desk for more than 600 days. “The clock’s been ticking. We have a right to know what the FDA has been doing the last two years to ensure whether they are putting politics over patients or putting the interests of Big Pharma over the interests of average Floridians.”

For its part, the FDA said in an update in the spring it continues to work with states to “implement a statutory pathway” for imports, but could not give a timeline on approval of Florida’s application.

Mr. DeSantis signed a law in 2019 authorizing the drug importing program in Florida and seeking FDA approval to import medications from Canada, where prescription drugs can be up to 80 per cent cheaper than in the United States.

In anticipation of approval, he has also invested US$40-million of taxpayers’ money in building the infrastructure to manage the program, including a giant warehouse in Central Florida.

The current dispute is rooted in a 1980s U.S. federal law that says pharmaceutical manufacturers are the only ones authorized to import drugs from another country without special clearance.

In 2020, then-president Donald Trump signed an executive order allowing states to import some prescription drugs from Canada, but Canadian officials blocked bulk exports for fear of shortages in this country.

A year ago, Mr. Biden issued his own executive order authorizing the FDA to help states implement the drug importing program. But the process has taken much longer than Mr. DeSantis and his administration would like.

Florida Attorney-General Ashley Moody suggested the Biden administration “is not quick to act to get things done for Florida. An agency of the administration cannot just sit on applications. They have to act with reasonable timeliness.”

What’s lost in the U.S. conversation around the dispute is Canada’s ability – and willingness – to supply the program with the medications it needs to succeed. Canada’s 2020 blocking of bulk exports suggests concerns about shortages could be a critical regulating factor on the success of the program.

And as crushing inflation shines a bright light on high drug prices in the U.S. – and more states express interest in participating in the importing program – the bigger question of supply looms large. Right now, Florida and just a handful of other states are seeking to take advantage of the program. What happens if 15, or 25, or even all 50 states step up to the trough?

The notion that there is a huge supply of surplus medications in Canada just waiting to be exported to the U.S. seems far-fetched. That reality, not the Biden administration’s lack of efficiency, may be the bigger obstacle to Mr. DeSantis getting his way this time.