Last week, President Trump’s administration released its new drug pricing plan, which calls for more competition and negotiation as well as greater incentives to lower list prices and out-of-pocket costs for patients. However, many commentators have claimed that the plan is too lenient on big pharma, as it does not push for any real drug pricing reform on their part.

In light of this, lawmakers in states across the country have been working on their own price cutting strategies, and, in Vermont, legislators have now passed the first drug importation law. Senate Bill 175, which was signed by state governor, Phill Scott, last Wednesday, will allow cheaper drugs to be imported into Vermont from Canada.

According to the new law, a state agency will now be tasked with designing a wholesale importation program that fully complies with US laws. The only catch is that, once the program is up and running, each importation will require approval from the secretary of the U.S. Department of Health and Human Services, Alex Azar.

The involvement of decision makers at the national level has caused many to worry that this law will have little effect. There have been several indications that the Trump administration, as a whole, is opposed to drug importation, the most glaring indication being that no national-level drug importation measures were included in the newly released drug pricing plan. Reps. Elijah Cummings and Peter Welch had met with Trump last year to discuss a drug importation plan. However, according to Cummings, they were met with “radio silence” from the President in the months that followed, suggesting that the president had no interest in supporting any importation program. Furthermore, Azar himself has gone on record saying that he considers drug importation from Canada to be a “gimmick” that will negatively affect patient safety and health.

As such, with such strong opposition at the national level, it remains to be seen how successful Senate Bill 175 will be at lowering drug prices.