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Archive for November, 2009

The Truth about Cross Border Drug Importation

Tuesday, November 17, 2009 @ 04:11 PM

There was a time when Canadians thought that a free flow of goods and services between Canada and the United States was the sign of prosperity and good neighbourliness.  There was a time when free trade was a battle worth fighting because some might have thought that Canada would be the net loser in a battle between the richest and most powerful nation on earth who would never yield sovereignty on trade to any country.  And now, as Canadians, we face a challenge equal to the election fight in 1988 on Free Trade and that is the little understood  issue of cross border re-importation of drugs  from Canada to the United States.

To add perspective, in the past 10 years or so, there has been the proliferation of mail-order and internet sales of prescription medications  from Canada to the United States.  On the surface, this  might appear to be a good way for enterprising Canadians to make good on the sale of what is widely known as ‘cheaper’ Canadian prescription medications to Americans.  This occurs ostensibly because Canada’s  Patented Medications Prices Review Board (PMPRB) regulates prices in this country at a level that is about fifty percent cheaper for the same patented medications in the United States. In short, the practice of selling these drugs to the United States has made some people in Canada very wealthy.  And what’s wrong with that?  Well plenty if  you consider what the ramifications are.

The United States has a problem with its prescription drug policy.  It can’t seem to fix it at home, so lawmakers in Congress and in many States across their Union are looking outside the United States to fix that problem.  In the summer 2006, a piece of Legislation was introduced in the US that allowed a 90 day supply of prescription medications to be purchased by American patients and brought back to the United States without any problem. That was just the start.  Recently a bi-partisan piece of Legislation was introduced in the US that will allow the bulk re-importation of prescription medications to the United States compliments of enterprising Canadian supply companies who can source the medications that Americans want at the expense of Canadian patients.

Let’s delve into this deeper.  The highly regulated world prescription drug business is based on population.  Canada is 2% of the world’s business, so, it is allotted a 2% quota per se on the amount of prescription medications. Consider for a moment that the United States legislation on the free flow of cheaper Canadian meds can make their way to the US through bulk re-importation and we, as Canadians, are faced with the potential for supply shortages on chronic or other meds.

If  you don’t think its real, think again..  Recently supply shortages for oral contraceptives in Canada are being realized.  Consider that US Internet Pharmacy Global Americana has increased its profitability to 34% based largely on imports from Canadian sources and that the fastest growing target group is no seniors as you might have suspected, but young people wanting cheaper priced pharmaceuticals – you get the picture.

Canadian pharmacy organizations are  quite rightly concerned about this issue and have weighed in on this matter loudly. Our reasons are based on our obligations to our patients in Canada and, frankly, on the right thing – to ensure an adequate supply of Canadian prescription medications  for Canadians.

This issue is complicated because it crosses so many policy areas – health, international trade, foreign affairs and industry.

But looking at the issue on the whole there are basically 3 areas of major concern to Canadians. They are:

  1. The Canadian prescription drug supply cannot withstand an all out onslaught of US patients wanting cheaper Canadian priced meds.  Imagine if we, in Canada, at 33 million people went to Iowa, a State of 3 million people and said ‘ hand over your meds’? This is what we’re dealing with in the face of this  new  US legislation. In fact, an authoritative report out of the University of Texas at Austin recently published  suggested  that if this Legislation in the US was allowed to proceed, American patients could wipe out Canada’s  drug supply in 38 days.  Think about that for a moment –  in one month our quota would be gone. That’s  not a trade issue that’s outright lack of respect for our system,
  2. The proliferation of greed – counterfeit medications have increased as a direct result of this practice.  In fact, in a recent crackdown in the United States, lawmakers seized a shipment of meds at the border at Detroit and uncovered 19 million dollars  worth of counterfeit meds. That meant that several million Americans would not be receiving counterfeit meds and as a consequence lost millions  of  dollars in this scheme.  The very real threat continues with much of the ‘booty’  going to nefarious organized crime elements in off shore locations.
  3. In much of our advocacy efforts, we have concurred with Giuliani Partners who in 2005  readily opined that if the practice of wholesale bulk importation was allowed to proliferate a new threat could emerge and that would be through terrorism via this re-importation scheme. Today it’s counterfeit drugs from crime gangs in off-shore locations –  tomorrow it may be anthrax or  cyanide from a terrorist element.  Think about that for a moment.

We have brought our concerns to several State legislatures and Congress.  We continue to fight this issue back home plying pressure on the federal government to move legislation of its own that will ban the practice of internet pharmacies selling to US  patients  and to ban outright any attempt to bulk importation. We have met recently with the federal Minister of Health, Tony Clement who has informed us that this issue is a high priority for him.  In the meantime, we are taking our fight right to Washington with visits there in the coming weeks.  Our  goal is to protect the interests of Canadians patients and ensure that our supply and our system remains intact and Canadian.

- Marc Kealey
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In response to the growing concerns over the cross-border prescription drug trade, an event was hosted at the National Press Club where Dr. Marv Shepherd, an expert on the importation of drugs from the University of Texas, spoke to a Canadian audience about the negative impact of drug exports to the US.

We have been voicing concerns for the past two years about the detrimental impact of the spread of cross-border trade in prescription drugs, and more specifically drug re-importation into the United States via Internet pharmacies.

“Our message to the government of Canada is to move quickly to ban all export of prescription drugs, said Marc Kealey. “This will in effect eliminate the potential risk to the Canadian supply of prescription drugs, and as importantly, eliminate the potential risk on patient safety due to the unregulated internet pharmacy trade.”

Prescription drugs are a highly political issue in the U.S. because of their high prices and cases of Americans going across the border to Canada for treatment or to buy drugs have been growing.

One of the biggest problems associated with importation is people never know exactly where the drugs are coming from.  There is no guarantee that imported drugs are safe.  Just because there is a Canadian flag on the website, doesn’t mean that the source of the drug is from Canada.  Therein lies the problem for Americans – who may not be certain that the drugs they receive via Internet Pharmacy may be real.

A country with 33 million citizens should not be supplying the prescription needs of a country with 280 million,” said Kealey. “Raiding Canada’s medicine cabinet will not solve health care problems in the U.S.”

This has been the ongoing message that Marc Kealey has delivered to media and to stakeholders across the country and in several states in the United States, including Texas, Maine, Florida, Rhode Island, Michigan, Illinois, Nevada and Vermont.

- Marc Kealey
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