Drug Costs

Drug Importation: “Not Your Silver Bullet”

July 24, 2019 2:54 pm

Tariffs stemming from the “trade war” and ongoing negotiations about NAFTA replacement and modernization have strained U.S. relations with Canada. But another issue also has increased tensions with our neighbors to the north: drug reimportation.


The governors of Colorado, Florida and Vermont all have signed legislation to allow residents of their states to buy pharmaceutical products from Canada. Other state lawmakers are considering similar measures. Presidential candidates like Sen. Cory Booker (D-N.J.) and Sen. Bernie Sanders (I-Vt.) have made importation a key component of their health-care and drug-pricing platforms.


With an election of their own on the horizon, Canadian officials have begun to push back. According to Reuters, talking points developed by the country’s foreign ministry outline Canada’s “clear” opposition to the idea. The foreign ministry believes importation measures could exacerbate the already short supply of drugs in Canada, and could drive up prices there.


That worry is well-founded. As this 2017 study points out, prescription drug shortages already “are frequent in the Canadian health-care system.” And, as Reuters reminds readers, a 2010 study found if even 10 percent of U.S. prescriptions were filled from Canada, the drug supply in that country “would run out in 224 days.” This past February, health economist Steve Morgan warned “Canada’s shelves would run dry” if the U.S. federal government implements an importation plan.


In other words, Congress could pass importation legislation in 2019, and by next November’s elections, Americans would not find any drugs to buy in Canada anyway.


The Canadian foreign ministry’s points reportedly ask the country’s officials to warn their U.S. counterparts that “importing drugs from Canada is probably not” their “silver bullet.”


As we have explained in this blog post, for safety reasons, it most certainly is not.


Because many drugs sold in Canada are not actually manufactured there, importation could harm U.S. consumers. According to this article in the Rhode Island Medical Journal, a National Association of Boards of Pharmacy review of 108 websites between July 1, 2016 and June 30, 2017 that included “Canada” or “Canadian” as part of their advertised name or website address found 80 websites, about 75 percent, “included language” indicating “that their medications were not from Canada, they had not been approved by Health Canada nor were they legally sold within the country itself.” The remaining 25 percent of websites “omitted information regarding origin of the medication used to fill the prescriptions.”


POLITICO has warned an importation program would not work for other reasons. As this report explained, “Canadian pharmacists can’t accept American prescriptions, meaning patients would need to line up a Canadian doctor to co-sign their prescriptions — which is not an accepted practice up north.” Joelle Walker, director of public affairs for the Canadian Pharmacists Association, pointed out “it’s not inexpensive to get a Canadian physician to see you and sign a prescription.”


There are many reasons drug importation is not a “silver bullet” for U.S. consumers. Which one, though, will be enough to slay this bad idea?