The news: Colorado received FDA approval to import certain prescription drugs from Canada, a move aimed at lowering drug costs for state residents. Its approved import list covers 20 brand-name and specialty drugs, including treatments for cancer, cystic fibrosis, HIV, and type 2 diabetes.

Colorado is the second state to receive FDA authorization. Florida won approval in 2024 but has yet to launch its program, while Maine, New Hampshire, and New Mexico have also submitted applications to the FDA.

Why it matters: Colorado projects its Canadian import program would save about $46 million over three years, money that would otherwise go to drugmakers or come out of patients’ pockets and state healthcare budgets. Brand-name drugs in Canada and 32 other developed countries that also negotiate prices were more than four times lower than in the US, according to a 2024 RAND analysis.

Drugmakers continue to oppose importation from Canada even after losing a 2023 lawsuit to block states from doing so. Meanwhile, Canadian officials have previously warned they will not support US state programs for importation that could disrupt their domestic supply or cause drug shortages.

Implications for pharma companies: Colorado's program alone won't move drug revenues, but each new state approval adds weight to the argument that US prices should be benchmarked against what other developed countries pay, which is exactly what the Trump administration's plan to codify most-favored-nation pricing aims to do..

The bigger risk for drugmakers is reputational. Continued opposition to importation efforts may reinforce perceptions among policymakers and consumers that drugmakers are defending the price gap rather than closing it.

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