Canadian health groups urge ban on exportation of pharmaceutical drugs from Canada to the U.S.

Canadian health groups today called on the Government of Canada to ban the exportation of pharmaceutical drugs from Canada to the U.S. The groups, who represent the interests of millions of Canadian patients, were in Washington to highlight their concerns with Internet pharmacies, including:

• Their negative impact on access to prescription drugs and health care providers in Canada;
• The danger they pose to patients by threatening the security of the prescription drug supply chain in both Canada and the United States; and
• The pressure they place on Canada's drug pricing system.

The groups appeared at a U.S. Food and Drug Administration hearing:

• Hepatitis C Network
• Canadian Treatment Action Council
• Canadian Organization for Rare Disorders
• Canadian Arthritis Patient Alliance
• Consumer Advocare Network
• Best Medicines Coalition
• Epilepsy Manitoba
• BC People with AIDS

The public meeting was part of a study on drug importation mandated by the Medicare Prescription Drug, Improvement and Modernization Act of 2003. They also met with U.S. health stakeholder groups who also oppose Internet pharmacies. The position statement issued by the groups follows.

Cross-border internet pharmacies are having an adverse impact on the lives of Canadians and this impact will escalate if left unchecked. Cross-border internet pharmacies must be banned.

Why are cross-border internet pharmacies dangerous?

Shortages Cross-border internet pharmacies are leading to shortages of necessary drugs for Canadian patients. This has already been reported in diabetes and cancer, as a result of drugs being diverted to cross-border internet pharmacies for U.S. consumers.

Price Increases

We are concerned that with huge increases in the U.S. price of one AIDS drug, this will also soon be true in Canada. For the first time in many years, pharmaceutical companies have been taking price increases on Canadian pharmaceuticals. We believe this is a direct result of cross-border internet pharmacies and puts a further burden on public drug budgets. As a result, there will be fewer badly needed drugs available from these payers.

Safety of Drug Supply

Canadians must have confidence that their prescription medications are as safe as they can possibly be. Canada imports drugs from 36 countries, but only has Mutual Recognition Agreements regarding good manufacturing processes with half of them. Thus, unsafe drugs that have not been through Canada's review processes are getting into Canada and have already been found by U.S. customs. At some point they may well get into the Canadian drug supply.

Pressure for Drug Deregulation

The pharmaceutical industry has been lobbying for deregulation of drug pricing in Canada for many years. The issue of cross-border internet pharmacies is being used politically in the U.S. to further advocate for pricing deregulation in Canada.

Access to Healthcare Providers

Another access issue created by cross-border internet pharmacies involves access to health care providers. Up to 30% of pharmacists in Manitoba have left the public domain to work for cross-border internet pharmacies. Pharmacies serving the community, hospitals, and nursing homes are closing or shortening their hours of operations, particularly in rural areas. MDs are spending time co-signing U.S. prescriptions rather than serving Canadian patients.

Professional Ethical Issues

Canadian physicians and pharmacists must conduct themselves in an ethical manner, following regulations currently in place to protect Canadians. The practice of prescribing medication to a patient with whom the physician has had no face-to-face contact or follow up care is dangerous. Risks include managing of adverse reactions and ensuring patient understanding of how to take medications. Physicians and pharmacists are highly skilled professionals. These practices are undermining their professions and marginalizing their expertise.

Recommendation

The federal government must ban cross-border internet pharmacies.

Consumer Groups

Hepatitis C Network
Canadian Treatment Action Council
Canadian Organization for Rare Disorders
Canadian Arthritis Patient Alliance
Consumer Advocare Network
Best Medicines Coalition
Epilepsy Manitoba
BC People with AIDS