Canada's Rx Chill
Friday, June 24, 2005; 9:29 AM
The word "socialism" carries a negative connotation among most Americans -- except, of course, when the economic ideology results in lower prices for consumers.
Take the example of Canada's pharmacies, where people can buy prescription drugs at far cheaper prices than anywhere in the United States. Predictably enough, pharmacies up north now list thousands of Americans among their best customers.
That is why Canadian Health Minister Ujjal Dosanjh will propose restricting Internet pharmacy sales, the Associated Press reported. "Dosanjh did not specify what steps would be taken, but his spokesman said the measures being considered include preventing Canadian doctors from co-signing prescriptions without examining patients. Other measures might be prohibiting prescriptions for foreigners who are not in Canada, barring a price reduction if the drugs are exported and banning bulk exports, spokesman Ken Polk said. Dosanjh has been studying options to restrict the practice for at least six months. 'I am concerned and we're acting on it. There will be news soon,' Dosanjh said."
Here's how American consumers currently work the system to their advantage, the AP reported: "A prescription from a U.S. doctor is faxed to a Canadian doctor, who reviews the document along with the patient's health history. The Canadian doctor signs and sends the prescription to a so-called Internet pharmacy, which ships the drug to the patient. Canadian officials say such sales endanger the Canadian drug supply, though they admit no shortages currently exist. The government also maintains it is unethical for doctors to sign prescriptions without examining patients."
Dosanjh fretted over the arrangement in an article published on June 14 in the Winnipeg Sun. His chief worry is that American pill-poppers could cause a drug shortage in Canada. Here's the problem, as the Sun explained: "Canada imports 94% of its prescription drugs and regulates the prices at levels much lower than in the U.S. Internet pharmacies then sell those cheap drugs to Americans, some states legalizing this trade."
Reuters said that Internet pharmacy sales generate about $690 million a year for Canada, and much of it benefits the economy of Manitoba, the province whose capital is Winnipeg. Pat Martin (NDP), a member of Parliament who represents Winnipeg, put the trade at $1 billion a year. He told the Sun that Dosanjh's proposed action is designed to "give in" to the pharma companies based in Quebec. MP Real Menard of the Bloc Québécois hit Dosanjh from the other end, criticizing him for not taking action against Internet pharmacies in the 18 months since he was appointed health minister, the Sun wrote.
There's action happening on this front in Washington as well, Reuters reported: "Several bills to allow importation of foreign drugs are now before the U.S. Congress, and cities and states have also taken action. U.S. pharmaceutical companies have threatened to halt shipments to Canada if the drugs are simply shipped back to the United States and sold at levels that undercut U.S. prices."
It's a tricky issue to resolve. The Bush administration and the gang up north agree that something ought to be done; the White House thinks so because it doesn't want to see drug companies' revenues shrink and Canada because it wants to keep its drugs in-country.
The two nations split in a notable way: Canada would certainly dispute the notion that its drugs might not be safe for American use, something the Bush administration says is a possibility when U.S. pharmaceuticals exported up north are then reimported. Of course, when we faced a flu vaccine shortage in the states, former Health and Human Services Secretary Tommy Thompson couldn't say enough good things about the reliable Canadian drugs we brought in to bridge the gap.
On the other hand, a recent report conducted for the U.S. Food and Drug Administration by research firm Cyveillance showed that many so-called Canadian pharmacies are based elsewhere, and a good number of them could be described as "shady." (See my colleague Brian Krebs's news report on the study.)
In the end, it's one more dispute that might never have emerged if it were not for the Internet. Free-market supporters in the United States often praise the Internet as a goose that laid the golden egg. The result, however, is that access to the World Wide Web drove consumers to find the best deal available, no matter how far away or in what country. If anything, the Canadian pharmacy debate should make U.S. policymakers think a little harder about how to ensure that American citizens can buy affordable medication here at home.