"President Trump has been clear: for too long American patients have been paying exorbitantly high prices for prescription drugs that are made available to other countries at lower prices", Mr. Azar said.
The second pathway would allow manufacturers of FDA-approved drugs to import versions they sell in foreign countries, using a new national drug code that would potentially allow them to offer lower prices than those required by their current contracts with distributors, provided they could demonstrate to the FDA that the foreign versions were the same as the US versions.
Azar announced a preliminary plan Wednesday to allow Americans to import certain lower-cost drugs from Canada.
"We can be convinced", Health Secretary Alex Azar said.
Azar, a former drug industry executive, said US patients will be able to import medications safely and effectively, with oversight from the Food and Drug Administration.
In one initiative, the Food and Drug Administration and HHS will rely on their rulemaking authority to use existing federal law to set up pilot projects from states or wholesalers.
The second route, through draft guidance, would let companies bring in versions of drugs they sell overseas, using a special national code to offer a lower USA price than what their current, Byzantine distribution contracts require.
"Pharmaceutical distributors support efforts to address the high cost of prescription drugs", a statement by the HDA read.
The move is a blow to the politically powerful pharmaceutical industry which been criticized for spiking drug prices, including commonly-used drugs like insulin, which has seen its price skyrocket in recent years forcing many consumers with diabetes to ration their doses.
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Yet Mr. Trump has been willing to needle the industry in his pursuit of lower drug prices, particularly as his administration struggles to push other ideas for slashing costs.
"I'm glad to see the Food and Drug Administration taking concrete steps to allow states to import safe and affordable medicine".
A new proposal from the Trump administration would take steps toward allowing importation of drugs from other countries. Previous attempts by states to allow importation failed because the secretary opposed them.
The plan is riling the pharmaceutical industry, which argues it relies on higher USA prices to fuel research into the latest cures.
In addition, Sen. Chuck Grassley, R-Iowa, chairman of the panel overseeing Medicare, and Democratic presidential candidate Sen. Amy Klobuchar of Minnesota have a bill to facilitate importation. Sen.
Sanders also raised the subject of cheap Canadian drugs during Tuesday's first instalment of the two-night debate between Democratic hopefuls.
But consumer groups have strongly backed the idea, arguing that it will pressure US drugmakers to reduce their prices.
Reuters has previously reported that Canada opposes any USA plans to buy Canadian prescription drugs if this threatens Canada's drug supply or raises costs for its citizens. "The president said in his executive order he wanted full of transparency of pricing and I ordered our Medicare agency to require hospitals to disclose their charges and disclose what their negotiated discounts are with the insurance plan, so the patient will have the right to have this information before they pick where they will get their services delivered".
"There is no way to guarantee the safety of drugs that come into the country from outside the United States' gold-standard supply chain", Ubl said in a statement Wednesday. Bernie Sanders, I-Vt., noted the disparity in USA and Canadian prices, stating: "I took 15 people with diabetes from Detroit a few miles into Canada, and we bought insulin for one-tenth the price being charged by the crooks who run the pharmaceutical industry in America today". Solving it should not come at the expense of Canadian patients who need their medication, he added.