[Ip-health] Joel Baglole in WSJ: Canadians Express Concerns About Drug Imports by U.S.

[James Love]

Canadians Express Concerns
About Drug Imports by U.S.

By JOEL BAGLOLE
Staff Reporter of THE WALL STREET JOURNAL

While U.S. politicians and drug makers grapple with the issue of cheaper
brand-name pharmaceuticals coming down from Canada, Canadians, too are
trying to figure out just where things are headed. Some government and
industry officials north of the border are expressing increased concern
about legal issues, neighborly relations and sufficient medicine supplies
for Canadians.

The U.S. Food and Drug Administration's position on Americans reimporting
cheap prescription drugs from Canada only complicates the issue for
regulators, pharmacists, consumers and drug companies, says Barbara Wells,
executive director of the National Association of Pharmacy Regulatory
Authorities, the umbrella group representing pharmacy regulatory bodies
across Canada.

"The FDA, by saying it's illegal but we're not enforcing it, has only served
to complicate things on our end. To be honest, we'd prefer for the FDA to
either say it's illegal and enforce it. Or legalize the importation of drugs
from Canada. That would get us out of the gray area we're operating in right
now."

A senior FDA official says the U.S. agency is exercising "enforcement
discretion" when it comes to Canadian medication imports and that the agency
is using its limited resources to crack down on large commercial drug
supplies and narcotics, not prescription-drug shipments for personal
consumption. The official acknowledges the complicated nature concerning
Canadian drug imports, noting that several U.S. politicians actively refer
their constituents to Canada for cheaper prescription medication, and that
the FDA itself would rather see U.S. citizens get medicine from Canada than
other foreign countries.
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"We don't want anyone to get their prescriptions filled in a foreign
country. We urge people not to import foreign drugs. That said, if people
are going to go ahead and order drugs outside the U.S., they're better off
getting them from Canada than from a country like Thailand or Mexico. At
least Canada has drug regulations and testing systems that are comparable to
ours in the U.S., which makes it a little safer," the FDA official says.

The pharmaceutical industry is battling legislative efforts that would
facilitate drug importation from Canada and elsewhere, arguing that such a
practice will open the U.S. drug supply to counterfeit, contaminated or
substandard products. The industry's main trade group, echoing the FDA,
contends that patients are putting themselves at risk when they take
medications that aren't FDA approved.

Jeffrey M. Leiden, president and chief operating officer of the
pharmaceuticals group at Abbott Laboratories, said any efforts to encourage
purchase of drugs in Canada or other foreign countries are misguided. "We
put in place the FDA to protect Americans and be sure they're getting safe
and effect medicines," said Dr. Leiden. "Any idea that we would bypass that
system is unthinkable."

Still, the practice of buying medicines in Canada is growing more widespread
as entities from health insurers to Canadian pharmacies are making it easier
for U.S. citizens to place their orders and get them reimbursed.

To drum up business, some Canadian Internet pharmacies pay doctors licensed
to practice medicine in both Canada and the U.S. to visit the states and
examine American patients. The written prescriptions then are brought back
to Canada and filled by various Internet pharmacies. One Manitoba-based
e-pharmacy each month pays a doctor to visit the Mall of America in
Minneapolis, where dozens of patients -- mostly seniors who line up for
hours at a time -- are seen at a makeshift clinic. The doctor then returns
to Canada with a stack of prescriptions that are filled by the Internet
pharmacy and mailed back to the Minnesotans.

The U.S. pharmacy industry, like drug makers, is critical of larger scale
efforts to aid Canadian importation. Crystal Wright, a spokeswoman from the
National Association of Chain Drug Stores, said, "Now it's not so much mom
and pop trying to find a way on their own. They're being encouraged in
writing ... it's being condoned," she said. "Our government needs to get
serious about what to do for seniors in the long run."

In the past two years, some 50 licensed "e-pharmacies" with names like
CanadaMeds.com, RxNorth.com and PayLessMeds.com have sprung up across
Canada, mostly in the western province of Manitoba, where local governments
actively support them as job-creation vehicles. The low Canadian dollar and
government policies that cap drug prices allow Americans to save as much as
70% filling their prescriptions through Canadian Internet pharmacies.

Efforts to rein in the proliferation of online pharmacies in Canada is
complicated by the fact that Canadian pharmacies are regulated by individual
provinces, with no federal-government oversight.

-- Sarah Lueck and Thomas M. Burton contributed to this article.

Write to Joel Baglole at joel.baglole@wsj.com

Updated October 22, 2002

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James Love, Consumer Project on Technology
http://www.cptech.org, mailto:love@cptech.org
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