Canada: Down on the Pharm

By Robert MacMillan Staff Writer
Friday, July 1, 2005; 9:54 AM

Canadian Health Minister Ujjal Dosanjh did just what he promised last week, laying out a plan Wednesday to restrict bulk pharmaceutical sales to Americans -- a step aimed in part at preventing U.S. consumers from buying drugs from online pharmacies based north of the border.

Here are the details, according to The Washington Post: "The measure would stop the plans of a variety of U.S. municipalities and states to reduce drug costs by tapping the Canadian market. Those plans are awaiting the approval of legislation in Congress. The minister also said he was drafting regulations aimed at controlling individual purchases of Canadian prescription drugs over the Internet, as made by about 2 million Americans last year. He said Canada would toughen its rules to require 'an established doctor/patient relationship for any cross-border drug sales.' Currently, patients who receive a prescription from a U.S. doctor can have it filled over the Internet, with the prescription endorsed by a Canadian doctor and the drugs mailed from Canada directly to the patient."

Dosanjh told reporters that "Canada cannot be a drug store for the United States of America; 280 million people cannot expect us to supply drugs to them on a continuous, uncontrolled basis," the Buffalo News reported.

Why shouldn't we? As the Boston Globe reminded us, Americans pay the highest prescription drug prices in the world.

The eternal quest for a bargain is why the Internet tends to treat stop signs more like yield signs. The Buffalo News and the New York Times noted that Dosanjh's plan could give a boost to online pharmacies in other countries, including places that the Bush administration says do not meet shipping and safety standards mandated in the United States.

Here's an example from the News: "Charlie Bell, an Internet broker of foreign drug sales who operates out of the Rochester suburb of Webster, said he has already turned from Canada to the United Kingdom, Australia and New Zealand to obtain name brands at cut-rate prices."

Or, the rules could prompt online pharmacies currently doing business from Canada to move their inventories to other countries.

A Canadian Press story quoted Pat Martin, a New Democratic Party legislator from Manitoba, as saying that Dosanjh's plan could signal the industry's "death knell" in Canada. "He sounds bound and determined, based on anecdotal evidence and based on hypothetical shortages, to find a way to undermine this important western [Canadian] industry," Martin told the CP wire service. Manitoba, as I have pointed out before, is home to much of the online Canadian pharmacy business. Also from Martin: "This industry needs a champion, not an executioner." Dosanjh was quoted in many news outlets as saying it was not his intention to kill the Internet pharmacy business.

Here are some details on how much money we're talking about, courtesy of the Chicago Tribune: "Nearly 2 million Americans order prescription drugs from Canada each year, realizing savings of 20 percent to 80 percent off drug prices in this country. All together, Canada's Internet pharmacies rack up annual sales of about $1 billion, with another $500 million coming from so-called foot traffic across the border."

The Buffalo News said that American "walk-ins" to Canadian drugstores must have a Canadian doctor's signature, but quoted Dosanjh as saying the some Canadian doctors "are abusing the system through bulk Internet sales. 'Several doctors are known to have signed several hundred prescriptions a day to facilitate these sales across the border,' he said."

Here's more from the News: "The new orders will have only limited effect on sales by drug stores in nearby Fort Erie. Gerard Longval, pharmacist at Zeller's on Garrison Road near the Peace Bridge, said that only about 3 percent of his sales are to American visitors and they all must have prescriptions. 'It could be higher,' Longval said, 'but the government has been trying to discourage' sales to Americans. A druggist at Fort Erie's Wal-Mart store, who spoke on condition he not be identified, said occasional busloads of seniors from the United States shop for drugs at his store. 'Yes, that does happen,' he said. 'I discourage it.'"

The message didn't play well with people who like to save money by shopping in Canada, the Press-Enterprise in California's Inland Empire quoted a few locals: "'I'd just have to pay more' if Canadian imports stop,' said Oretta Baker of Grand Terrace. 'What else can I do?' Baker lives on Social Security and buys about $300 worth of drugs a month, including some from Canada, she said. She estimates that the drugs she orders from north of the border are about 40 percent cheaper than the American equivalents. ... 'Seniors have learned what they need to do, what they have to do undercover, when it's not a legitimized process,' said Lu Molberg, director of the Riverside County Office on Aging. A closed border likely won't deter seniors from finding cheaper drugs elsewhere, including Mexico, Molberg said. And the debatable safety of cheaper foreign drugs would be a risk worth taking for some seniors if they were forced to miss doses because of the cost. 'Human nature is ruled by doing what you need to do in the short run to survive. That's just how we're built,' she said."

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