Podcast Summary: CNBC Special Report

Episode: How Soaring U.S. Drug Prices Fueled What Feds Call An Illegal Import Of Medications
Air Date: November 27, 2025
Host: CNBC’s investigative team, including Melissa Lee

Overview

This episode investigates the explosive growth of Alternative Funding Programs (AFPs) supplying Americans with cut-rate prescription medications sourced from overseas, despite federal laws prohibiting the importation of such medicines. Driven by soaring U.S. drug prices, these gray-market channels have become lifelines for desperate patients and cash-strapped employers, but experts and officials warn that these practices are illegal and potentially life-threatening.

Key Discussion Points & Insights

1. The Skyrocketing Cost of U.S. Prescription Drugs

• U.S. drug prices average nearly three times more than those in other developed countries, pushing patients and employers into financial strain.

  “With some specialty medications costing tens or even hundreds of thousands of dollars per year… prescription drug prices in the U.S. averaging nearly three times more than in other countries…” (01:13-01:29)

• Personal stories highlight desperation:

  • Bruce Zimmerman, MS patient:

    "It's a desperate thing to think that you might not have your medication at all." (01:29-01:34, 17:32-17:42)

2. The Rise and Risks of Alternative Funding Programs (AFPs)

• AFPs act as a workaround: They buy specialty drugs from abroad at a fraction of U.S. prices, then distribute them to patients—often without patients’ full understanding or explicit consent.

  • Greg Santuli, CEO of Rx Valet:

    “We do a public service, we help people get access to medications…” (01:42-01:44, 30:55)

• But the legality is murky:

  “…what they're doing is illegal and it's putting American lives at risk.” (Nicole Johnson, Homeland Security Special Agent, 01:48-01:52)

• Risks of counterfeit/dangerous drugs:

  “Every time you’re taking a foreign medicine that’s been delivered from overseas, you’re playing a game of Russian roulette.” (Lori Mayal, Gilead Sciences, 02:43-02:50)

3. How AFPs Function—and Circumvent Oversight

• Employers, including cities and school districts, under financial pressure, carve out expensive drugs from standard coverage and push employees into AFPs.

  • Sometimes patients are forced to use these programs or pay full price without coverage.

    “It's no choice at all. Patients are put in an impossible position..." (06:14-06:19)

• Drug origins are often unclear: Medications labeled as from Canada may actually transit through countries like Turkey, India, or Australia, increasing risk.

  “You don’t actually know if that medicine truly came from Canada.” (05:23)

• Evasive distribution tactics: Prescriptions are shipped directly to consumers, bypassing U.S. customs and regulatory checks.

  “This is a way for them to evade customs and being detected by law enforcement.” (Nicole Johnson, 07:38-08:13)

4. The Legal Debate and Regulatory Response

• AFPs' legal defense: They claim to operate under personal importation policy (small-scale importation for personal use).

  “They are operating legally under the FDA's personal importation policy, a narrow exception that lets individuals get medications from abroad for personal use.” (08:44)

• FDA and former officials refute these defenses:

  • Leigh Verbois, ex-FDA Director:

    “What AFPs are doing are importing misbranded and unapproved foreign drugs, which is illegal... There’s no gray area when the product is approved in the United States... there is not a gray area.” (10:57-12:02)

• Homeland Security’s position: Patients are considered victims, not perpetrators; responsibility falls on AFPs.

  “We are viewing our patients in the United States as victims of these crimes... the company itself is the criminal...” (Nicole Johnson, 18:35-18:52)

5. Patient Story: Luxury Medical Junkets

• Bruce and Becky Zimmerman described being sent on all-expense-paid trips to pick up medications in the Cayman Islands and Bahamas via Price MDS.

  "I went to the Cayman Islands four times. Bruce went five. And then we went to Bahamas and we did that three times." (14:19-14:29) “If I’d have been told that, I’d say, send me the tickets, I’ll go again.” (17:17-17:29)

• Drug supply chain shown to be unauthorized: Biogen (maker of Avonex) confirms these channels are not legitimate.

  “Biogen... told us this route is not part of Biogen’s authorized supply chain…” (15:06)

6. AFPs’ Contracts Shift Liability to Patients

• Contracts require patients to assume all responsibility, attempt to release AFPs and employers from liability.

  “It seems like the patient is saying, 'I'm assuming all liability here.'” (18:14) “That's the scheme... So even if they write this in a contract, that doesn't mean that they're not violating U.S. federal and state laws.” (Nicole Johnson, 18:18)

7. Industry Pushback and Ongoing Legal Play

• Companies like Canorex claim their practices are legal and safe, and that U.S. regulators are wrong or misinterpreting policy.

  “Built into my client’s program are the safety precautions that ensure that the medicine is real, that it’s coming through a legitimate supply chain...” (Canorex General Counsel, 20:55) “On behalf of the patient, I will say boldly those regulators are wrong.” (Canorex General Counsel, 22:05)

• FDA and Leigh Verbois dispute:

  "That is not what is meant by that handbook… Absolutely not.” (Leigh Verbois, 22:48-22:53)

• Litigation in progress: Gilead filed lawsuits to block these flows, obtaining injunctions against various parties.

8. The Human Impact: Desperation vs. Safety

• Patients left with impossible choices: For many, using AFPs is the only feasible route to their medications.

  "For others, it’s a matter of using an AFP or not getting their prescription at all." (24:22)

• Advocacy organizations push back:

  "The biggest concern is the patient is the pawn here.... Why are we making individuals with a life-threatening disease, chronic illness, be the guinea pigs for something that we thus far have said is not the way we’re going to go in US Healthcare..." (Mary Dwight, Cystic Fibrosis Foundation, 33:45-34:48)

Notable Quotes & Memorable Moments

• "Every time you're taking a foreign medicine that's been delivered from overseas, you're playing a game of Russian roulette."
  – Lori Mayal (Gilead Sciences), 02:43

• "What AFPs are doing are importing misbranded and unapproved foreign drugs, which is illegal."
  – Leigh Verbois (Former FDA Director), 10:57

• "We are viewing our patients in the United States as victims of these crimes. This company is providing them with illicit pharmaceuticals. And so we would consider that the company itself is the criminal in this scenario, not the patient."
  – Nicole Johnson (Homeland Security Special Agent), 18:35

• “When it comes to prescription medicines, prioritizing cost over quality is dangerous.”
  – Lori Mayal, 27:46

• "I have no comment."
  – Greg Santuli (CEO of RX Valet), challenged on legal compliance, 30:48

• "It's such a desperate thing to think that you might not have your medication at all."
  – Bruce Zimmerman, multiple instances (01:29, 17:32)

Timestamps for Important Segments

• US Drug Pricing Crisis – 01:02-01:29
• AFPs Explained & Patient Risk – 01:34-02:50
• Legal/Regulatory Overview (FDA, Homeland Security) – 06:41-11:45
• Patient Story: Medical Tourism for Drugs – 12:38-17:32
• AFPs Contracts & Liability – 17:42-18:52
• AFPs' Defense vs. FDA’s Stance – 18:57-23:01
• Litigation and Enforcement – 23:01-24:22, 28:09-32:09
• Patient/Advocacy Perspective – 33:38-34:48

Conclusion

This CNBC special paints a vivid, unsettling picture of how surging U.S. drug prices, paired with a fractured healthcare and regulatory system, have fostered a dangerous gray market of potentially illegal drug imports. Patients and employers, desperate for relief, are drawn into shadowy arrangements that may compromise their safety and legal standing.

Experts urge greater transparency and enforcement. The bottom line: until the U.S. drug pricing crisis is addressed, patients face an impossible choice—risk foreign, potentially unsafe medicines, or go without lifesaving treatments.