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Canada has nothing to fear from the importation of its drugs in the United States


Denis Méthot

18 September 2019 11:30

Photo : Freepik

Without consulting Ottawa, on the 31st July last, the directors Trump has announced that it would put in place a system that will allow Americans to legally importing prescription drugs from Canada because of their very high prices in the United States.

Donald Trump has made of the reduction in the cost of drugs one of its priorities for his re-election, and he supported a Florida law that would allow its residents to purchase prescription drugs from Canada. Not less than 15 States in total have done the same, or look to do so. Colorado wants to move forward and this is not a bluff, insisted the democrat Sonya Jaquez Lewis, a pharmacist who sits in the House of representatives of Colorado.

In the United States, the same drug can cost up to ten times more expensive than here. A vial of insulin sells for about $ 300 with our neighbours to the south and to Canada is $ 30. It is not surprising that the aspiring democratic presidential candidate, Bernie Sanders, has been chosen as an example and have crossed the border this summer to get them in Ontario, where he denounced the inflated prices in his country and the greed of the pharmaceutical.

A possible shortage in Canada ?

Consumer groups americans see this competition as a way to reduce the price for them. Forty-five million Americans could not afford prescription drugs. It is more than the entire population of Canada. The possibility that Americans buy prescription drugs in Canada was raised at the September 12, during a debate between democratic candidates for the presidency of the United States. It makes us fear to some a shortage in Canada if Americans can buy their drugs here in very large quantities.

In 2005, the minister of Health in the liberal government of Paul Martin, Ujjal Dosanjh, had introduced a bill to prohibit the massive export of canadian medications with a valid prescription to the United States. It died on the order paper when Paul Martin was defeated and no government has risen since. Today, this same Ujial Dosanjh accused the federal government of sleeping on the gas, and asks him to wake up.

For the moment, Justin Trudeau’s reaction was rather lukewarm to the intentions of the Americans and said to monitor the situation. In date of 16 September, this risk had not been raised by any party in the framework of the election campaign.

Dr. Marvin Shepherd, an american scholar in Texas, anticipates itself, the impacts are extremely negative, this gesture could have for patients and canadian insurers. In an interview he gave to Radio-Canada, he said that it would take 118 days for the canadian supply of prescription drugs are exhausted if Americans could eat here and only for certain cardiovascular drugs, and insulin, for example, a shortage could occur in Canada in less than 30 days.

The Canadian pharmacists Association, who is concerned with already existing shortages of certain medications, the canadian medical Association and the canadian Institute for patient safety have urged Ottawa to take measures to prevent the Americans ” dry up the supply of drugs to Canada.”

“The theater “, says the president of the College

Thecanadian Association of insurance companies of persons (CLHIA) has refused to comment on the plans of Donald Trump in the absence of details. The president of theOrdre des pharmaciens du Québec (OPQ), Bertrand Bolduc, is much less restless as it seems to be the case in other provinces. Despite the opinion pessimistic of experts from the us and canada, it is not alarmed. “This is theatre “, he responded about the intentions of president Donald Trump.

In interview to the Newspaper “insurance”, it has indicated that it is not because Donald Trump wants to allow its citizens to import drugs from Canada that Canada can export.

“Pharmaceuticals such as Pfizer, Merck, Novartis and others have channels in canada to sell in Canada, not to ship their stock in the United States,” he says. When these companies sell their products to canadian wholesalers, they have agreements that prevent the re-export. If they do, they do sell more and they are put out of circuit. “

In addition, the pharmacists of canadians and quebecers who buy canadian wholesalers do not have the right to sell at wholesale. “You just have to honor the orders of a prescriber, canadian, adds the president of the College. We do not sell wholesale, this is not possible. If pharmacists do, we will pinch them and bring them to discipline. Therefore, it is not that because [Donald Trump] wants to leave [his compatriots] that we are allowed to do the thing in Canada. “

Bertrand Bolduc added that Canada negotiates the price of his medication and that it is the american president to do the same for him. “It is he who wrote the book Art of the Deal (the art of negotiation), quips he. We, in Canada, we have mechanisms to negotiate the price, but they are more consistent for the whole population, while in the United States, this is the jungle. If you’re not insured or you’re not a member of this or that, you pay the wholesale price. “

Not possible in the short, medium and long term

To his knowledge, said Bertrand Bolduc, the sale of canadian medications by pharmacists canadians or quebecers Americans does not happen in Quebec, or even Ontario. Several barriers the prevent.

“I don’t see how it could be possible in the short, medium and long term, he believes. The pharmacist that would do this would find himself very quickly in the impossibility of obtaining supplies from its suppliers and it would twist the arm [by the Order]. I’m not very worried. In Quebec, where there are no large american cities that are contiguous, it is even less of a concern. The pharmacist Lacolle will not rob tomorrow morning. “

In another aspect, it is not possible for a pharmacist to sell its drugs to a customer outside, ” adds the president of the College. If a passing tourist in Canada loses his medication for a month, he says, ” we will not leave him in misery. We are going to troubleshoot it, but the pharmacist may not not buy drugs from a wholesaler and ship them elsewhere, in addition to border “.

Get prescription drugs in a pharmacy in quebec is not easy, also recalls Bertrand Bolduc : it is necessary to see a local doctor to have an evaluation, get a diagnosis in order to get a prescription quebec in good and due form. The prescriptions from physicians in the us are not accepted. In short, the pitfalls are many-before the Americans could begin to order drugs from Canada via the internet or in person.

The import is not a solution

“The solution to the high prices of medicines in the United States is not to import pharmaceutical products from another country, and to threaten their stocks of drugs,” wrote Marv Shepherd in the study U. S. Drug Importation : the Impact on Canada’s Prescription Drug Supply, published last year. “Drug supply in Canada is not a long-term solution to the problem of pricing of medicines of american origin. “

The solutions, he said, are to solve the problems among them in the United States. He listed several : open up competition, eliminate government regulations excessive, shorten the approval process for drugs, especially generics, to enhance the transparency of the insurance providers, and prosecute those involved in farm prices of medicines.

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