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S 2387Pharmaceuticals

Food and Drugs - Wholesale Prescription Drug Importation Program

This bill creates a state program to import lower-cost prescription drugs from Canada, pending federal approval.

Held for study
Population
Affected
72
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Introduced Jan 30, 2026Committee Senate Health & Human Services

Plain-English Summary

This legislation establishes the "Wholesale Prescription Drug Importation Program" within the Rhode Island Executive Office of Health and Human Services. The program aims to import wholesale prescription drugs from Canada to provide cost savings to Rhode Island consumers. The state must design the program to meet specific safety and cost-saving requirements and must submit a request for approval to the United States Department of Health and Human Services by May 1, 2027. Implementation of the program is conditional upon receiving this federal certification and approval.

For younger readers

This new law creates a plan for Rhode Island to buy medicine from Canada, where it is often cheaper. The state government will work to make sure the medicine is safe and that it saves money for people who need it. Before they can start bringing the medicine in, they have to ask the United States government for special permission. Once they get the okay, they will set up a system so pharmacies and doctors can get this medicine for their patients.

Who & Where It Applies

Impacted groups
ConsumersPharmaciesHealth Insurance CarriersHealth Care ProvidersEmployers
Impacted communities
All

Constitutional & Fiscal Check

The bill explicitly acknowledges federal supremacy regarding drug importation by conditioning the program's implementation on obtaining approval and certification from the U.S. Department of Health and Human Services pursuant to 21 U.S.C. § 384. Because the state is seeking permission through established federal channels rather than attempting to bypass federal law, the risk of unconstitutionality or preemption is low, provided the state does not attempt to operate the program without said federal approval.

Estimated cost
Amount unknown
Estimated revenue
Amount unknown

Bill Analysis

Both viewpoints
For Progressives
  • Directly addresses healthcare inequity by establishing a mechanism to lower prescription drug costs, making essential medication more accessible to low-income and disadvantaged communities.
  • Utilizes state government power to intervene in the market and challenge the pricing monopolies of pharmaceutical corporations, prioritizing public welfare over corporate profits.
  • Expands the social safety net by creating a state-overseen supply chain intended to reduce the financial burden of healthcare on Rhode Island families and employers.
  • Relies entirely on federal approval and certification, which could be delayed or denied by a federal administration hostile to public healthcare expansion, potentially rendering the legislation ineffective.
  • Offers a market-based workaround rather than a systemic fix, failing to fundamentally restructure the pharmaceutical industry or guarantee universal coverage for all residents.
  • Creates potential supply chain vulnerabilities that, if not rigorously managed and audited, could be exploited, potentially risking the safety of patients who rely on government-regulated standards.
For Conservatives
  • Promotes free market principles by introducing international competition into the local drug market, which could drive down prices for consumers and businesses without requiring tax hikes.
  • Exercises state sovereignty by taking independent action to solve local economic problems rather than waiting for a federal solution to high drug prices.
  • Aims to reduce healthcare expenditures for employers and the state government, potentially lowering overhead costs for businesses and saving taxpayer money in the long run.
  • Expands government bureaucracy by creating a new state program involving extensive oversight, contracting, and auditing, which interferes with the private healthcare sector.
  • Undermines intellectual property rights and effectively imports foreign price controls, which could stifle pharmaceutical innovation and harm American corporate interests.
  • Risks the safety of Rhode Island citizens by circumventing the standard domestic supply chain, potentially opening the door to counterfeit or substandard drugs entering the market despite safety protocols.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 79 additions

SECTION 1. Title 21 of the General Laws entitled "FOOD AND DRUGS" is hereby amended by adding thereto the following chapter: 21-38-1. Authorization. The wholesale prescription drug importation program ("the program") is established to allow for the wholesale importation of prescription drugs from Canada by or on behalf of the state. The program shall be designed in accordance with the requirements of this chapter. The program may not be implemented unless the state obtains approval and certification, pursuant to § 21-38- 2(c), from the United States Department of Health and Human Services. 21-38-2. Design of program.

(a) Design requirements. The executive office of health and human services, in consultation with appropriate federal and other state agencies, other states and interested parties, shall design the program to comply with the applicable requirements of 21 U.S.C. § 384, including requirements regarding safety and cost savings. The program design shall:

(1) Designate a state agency to become a licensed drug wholesaler or to contract with a licensed drug wholesaler in order to seek federal certification and approval, pursuant to § 21-38- 2(c), to import safe prescription drugs and provide cost savings to consumers in the state;

(2) Use prescription drug suppliers in Canada regulated under the laws of Canada or of one or more Canadian provinces, or both;

(3) Ensure that only prescription drugs meeting the federal Food and Drug Administration's safety, effectiveness and other standards are imported by or on behalf of the state;

(4) Import only those prescription drugs expected to generate substantial cost savings for consumers in the state;

(5) Ensure that the program complies with the transaction and tracing requirements of 21 U.S.C. §§ 360eee and 360eee-1, to the extent feasible and practical, prior to imported prescription drugs coming into the possession of the licensed drug wholesaler, and that the program complies fully with those federal requirements after imported prescription drugs are in the possession of the licensed drug wholesaler;

(6) Consider whether the program may be developed on a multistate basis through collaboration with other states;

(7) Prohibit the distribution, dispensing or sale of imported prescription drugs outside of the state;

(8) Recommend a charge per prescription or another method of financing to ensure that the program is adequately funded in a manner that does not jeopardize significant cost savings to consumers, including adequate funding for the initial start-up costs of the program;

(9) Apply for and receive funds, grants or contracts from public and private sources; and

(10) Include an audit function.

(b) Rules. The executive office of health and human services shall adopt and promulgate rules and regulations to design the program, in accordance with the requirements of subsection (a) of this section, no later than January 1, 2027.

(c) Request for federal approval and certification. The executive office of health and human services shall submit a request for approval and certification of the program to the United States Department of Health and Human Services no later than May 1, 2027. 21-38-3. Implementation.

(a) Implementation of operation. Upon receipt of federal approval and certification under § 21-38-2(c), the state agency designated to oversee the program pursuant to this chapter shall implement the program as required in subsection (b) of this section. The program shall begin operating no later than six (6) months following receipt of federal approval and certification.

(b) Requirements. Prior to operating the program, the state agency designated to oversee the program pursuant to this chapter shall:

(1) Become a licensed drug wholesaler or enter into a contract with a licensed drug wholesaler in the state;

(2) Contract with one or more distributors licensed in the state;

(3) Contract with one or more licensed and regulated prescription drug suppliers in Canada;

(4) Consult with health insurance carriers, employers, pharmacies, pharmacists, health care providers and consumers;

(5) Develop a registration process for health insurance carriers, pharmacies and health care providers authorized to prescribe and administer prescription drugs that are willing to participate in the program;

(6) Create a publicly accessible website for listing the prices of prescription drugs to be imported under the program;

(7) Create an outreach and marketing plan to generate public awareness of the program;

(8) Provide a telephone hotline to answer questions and address needs of consumers, employers, health insurance carriers, pharmacies, health care providers and others affected by the program;

(9) Develop a two (2) year audit work plan; and

(10) Conduct any other activity determined necessary to successfully implement and operate the program. 21-38-4. Annual reporting. Beginning January 1, 2028, and annually thereafter, the executive office of health and human services, or other state agency designated to oversee the program pursuant to this chapter, shall report to the speaker of the house and president of the senate regarding the implementation and operation of the program during the previous calendar year, including:

(1) The prescription drugs included in the program;

(2) The number of participating pharmacies, health care providers and health insurance carriers;

(3) The number of prescription drugs dispensed through the program;

(4) The estimated cost savings to consumers, health insurance carriers, employers and the state during the previous calendar year and to date;

(5) Information regarding implementation of the audit work plan and audit findings; and

(6) Any other information the executive office of health and human services, or other state agency designated to oversee the program pursuant to this chapter, considers relevant.

SECTION 2. This act shall take effect upon passage.