Canada May Slam Door on Prescription Drug Sales to Americans

The door might soon close on Internet and mail-order sales of low-cost prescription drugs from Canada.

A group of Canadian pharmacists and other advocates of legal drug importation warned Thursday that the Canadian government plans to crack down on Canadian mail-order pharmacies that sell medicines to an estimated 2 million Americans.

“The threat is very real, in fact, it’s imminent,” said Dave MacKay, executive director of the Canadian International Pharmacy Association, which convened a conference of a pharmacists from across Canada Thursday.

MacKay’s group blames pressure by the Bush administration on Canadian Prime Minister Paul Martin, saying the Canadian government made an abrupt about-face on its policy soon after the two leaders met Nov. 30 in Ottawa.

A White House spokesman said he hadn’t heard that charge, but said Bush’s top concern on drug importation is maintaining a “safe and effective” drug supply. “That’s an issue that continues to be looked at,” said the spokesman, Jim Morrell.

The Minnesota Senior Federation, which has a Web site directing people to Canadian pharmacies, said it will consider steering their members to Europe and other sources of U.S. government-approved drugs.

“We don’t want to overreact, but we want to get our resources in order,” said Lee Graczyk, the group’s legislative director. “We’ve known for a while that this was a possibility.”

The proposed Canadian restrictions would not affect people who travel to Canada and see Canadian physicians.

Meanwhile, Minnesota Gov. Tim Pawlenty, a Republican who has championed a state Web site directing people to approved Canadian pharmacies, is drafting a protest letter to the Canadian government.

In a statement Wednesday, Pawlenty said, “The Canadian government should not slam the door on American consumers seeking more affordable prescription medicines from safe Canadian pharmacies.”

Canadian law requires that prescriptions be signed by Canadian doctors. In the past month, Canadian Health Minister Ujjal Dosanjh has said publicly that he considers it unethical for Canadian doctors to co-sign prescriptions for American patients they have not examined.

Under new rules that could be taken up by the Canadian Cabinet as soon as Jan. 11, Martin’s administration could criminalize the practice, effectively ending the $850 million-a-year cross-border trade.

“We’re very confused,” said Andy Troszok, president of Extended Care Pharmacy, a mail-order pharmacy in Calgary, Alberta. “The federal government has allowed this business to start and flourish for the last five years. There’s been no issue of safety.

“We can only think of one thing,” added Troszok, who also serves as president of the Canadian International Pharmacy Association. “This is politically motivated. There has been a deal between our federal government and the U.S. federal government.”

Troszok said he suspects that the Canadian government has quietly won U.S. trade concessions on Canadian beef and lumber in exchange for shutting down the mail-order drug industry, which employs thousands of Canadians, particularly in Manitoba.

The White House dismissed such a linkage Thursday. “Canada’s actions are determined by the Canadian government, not the government of the United States,” Morrell said.

The U.S. Food and Drug Administration (FDA) has issued frequent warnings about cross-border Internet and mail drug purchases, which are technically illegal, though U.S. authorities rarely act against individual retail shoppers. Last week, a Bush administration task force issued a report critical of drug importation, saying it poses “substantial safety risks.”

The Canadian government, meanwhile, has raised alarms about putting its own drug supplies at risk. In a speech at Harvard Medical School last month, Dosanjh said “Canada cannot be the drugstore of the United States.”

Drugs are typically 40 percent cheaper in Canada than in the U.S. because of Canadian government price controls.

As Congress debates legalizing the importation of FDA-approved drugs from Canada and other industrialized nations, the U.S. pharmaceutical industry has warned that it is not willing to supply extra quantities of medicines to Canadian pharmacists just so that they can resell them to Americans at cut rates.

Canadian mail-order pharmacists say they can deal with those threats, but they can’t survive if their own government blocks cross-border sales without doctor exams.

“If those regulations were to be implemented and enforced, it would completely eliminate our industry in Canada, and leave U.S. patients in a therapeutic crisis,” said MacKay.