Canadian drug importation is "an economic fantasy," former Canadian health minister says.

photo of Ujjal Dosanjh

Ujjal Dosanjh (Source: Dave Chan / CC by https://creativecommons.org/licenses/by/2.0)

This editorial by Ujjal Dosanjh was published in The Globe and Mail on March 2, 2020. Dosanjh served as federal minister of health as well as premier of British Columbia.

The U.S. has a problem with prescription-drug prices. Canada shouldn’t try to fix it

President Donald Trump and the U.S. Congress are scrambling to find ways to make medicines more affordable, particularly with a major national election coming up this year. One of the solutions that is gaining traction is to import comparatively low-cost drugs from Canada to meet the U.S. demand.

Our policy makers should waste no time in nipping this idea in the bud and telling our American friends, sorry, but you can’t have our drugs. End of story.

There has been a great deal of attention paid of late to the fact that many Canadians cannot gain access to a frequently used breast-cancer drug because of manufacturing disruptions and a demand that exceeds supply. But this is far from an isolated case. According to Health Canada, we are experiencing shortages in close to 2,000 drugs right now. It is folly to believe that a country struggling to meet the needs of its own people can help the much larger population in the United States meet theirs.

Here’s the reality: We control prices here through the Patented Medicine Prices Review Board. Under these government price controls, drug manufacturers are going to sell just enough supply to meet the needs of the Canadian population. These companies are not going to make surplus supplies available in Canada just so they can be shipped to the United States at cut-rate prices. That’s an economic fantasy.

If we allow the United States to import drugs from Canada in numbers that could actually impact prices there, our own drug inventories will be depleted, and the pharmaceutical companies will have no financial incentives to restock those shelves.

We have been down this road before. A little more than a decade ago, the notion of drug importation was heating up in the U.S. political system. A bill was introduced in Parliament to amend our Food and Drugs Act to provide the minister of health the authority to ban bulk drug exports.

This made logical sense in order to protect the health and well-being of Canadian citizens. In fact, our nation’s pharmacists, patient advocates and participants in the supply chain issued a statement at that time saying, in part, "allowing Canadian price-controlled medicines to be exported to the United States will damage the Canadian drug supply and could very well lead to increased drug prices for Canadians.”

Parliament didn’t pass that measure, even though Canadian-based internet pharmacies were selling hundreds of millions of dollars worth of drugs across the border. Perhaps members of Parliament thought at the time that the American push for drug importation was just a passing political fad. As we see now, it was not. U.S. government leaders still want our drugs so that they don’t have to do the hard work of fixing their own health-care system.

There is another danger that accompanies the U.S. push for our cheaper drugs. With a demand vacuum that the Canadian drug supply can’t possibly fill, counterfeit drug traffickers will try to make up some of that gap.

Drug counterfeiting is a very real, pervasive and growing problem, and Canada is at risk of becoming a major junction point for traffickers to move their product into the U.S. We don’t have the capacity to secure our borders against illegal drug shipments going out to our southerly neighbours, and U.S. authorities don’t have a plan to track and trace potentially dangerous substances entering their country under a drug-importation program.

The U.S. Drug Enforcement Administration has, in fact, issued a recent warning about counterfeit pills containing potentially lethal levels of fentanyl making their way into communities. We don’t want to see our American counterparts harmed by this worsening counterfeit-drug phenomenon and we also don’t want those fake pills coming through Canada on their way to the U.S.

Parliament should revisit what it didn’t do in the past decade: enact a law that will ban any bulk shipment of pharmaceuticals to other countries. American policy makers have the misguided notion that we can magically fix their drug price problem. We need to do our friends the favour of providing some tough love and tell them they need to look elsewhere for answers.