The Current

Canada has 'no reason' to support U.S. plan to import prescription drugs, expert says

Canada has "no reason" to support the U.S. government's plan to allow imports of cheaper prescription drugs from north of the border, says Andre Picard.

Andre Picard claims 'there's a thousand practical reasons this won't happen'

A pharmacist reaches to shelves with prescription medication.
The prospect of Americans soon being able to legally access Canadian pharmacies in order to obtain cheaper drugs is drawing criticism from health-care advocates who warn of the spectre of drug shortages north of the border. (Regis Duvignau/Reuters)

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Canada has "no reason" to support the U.S. government's plan to allow imports of cheaper prescription drugs from north of the border, says Andre Picard.

"It's the equivalent of Trump saying, 'We're going to build a wall and Mexico is going to pay for it,'" said Picard, health reporter and columnist for the Globe and Mail.

"It's exactly the same thing. It's, 'We're going to have cheaper drugs and Canada's going to pay for that.'"

The prospect of Americans soon being able to legally access Canadian pharmacies in order to obtain dramatically cheaper drugs is drawing criticism from health-care advocates who warn of the spectre of drug shortages north of the border.

"This definitely raises the risk," said Kim Hanson, executive director of federal affairs for Diabetes Canada, told The Current's guest host Laura Lynch.

The U.S. has the world's highest drug prices. Faced with voter anger over the steep and rising costs of drugs, President Donald Trump's administration announced Wednesday it will set up a system to allow Americans to legally import lower-cost prescription drugs from Canada. 

The policy change, if passed, would reverse previous decisions by past administrations and weaken a longstanding ban that had stood as a top priority for the politically powerful pharmaceutical industry. So far, Washington lawmakers have offered no estimate for when this new legislation might take effect.

U.S. President Donald Trump delivers a speech about lowering prescription drug prices at the White House in May 2018. The world's highest drug prices ahead are seen as an important campaign issue in the 2020 election, and Trump is looking to deliver on his promise to bring costs down. (Jonathan Ernst/Reuters)

The news sparked a swift response from Canada's Health Minister Ginette Petitpas Taylor.

"[We] will be working closely with health experts to better understand the implications for Canadians and will ensure there are no adverse effects on the supply or cost of prescription drugs in Canada," the minister said in a statement. 

Canada is not structured to produce an amount of medications required for a population that size.- Kim Hanson, Diabetes Canada

Trying to head off the U.S. government's upcoming move, more than a dozen organizations signed a letter urging the Canadian government to safeguard the country's drug supply.

Diabetes Canada was one of the signatories to that letter, and following Wednesday's announcement Hanson says her organization is now looking to Ottawa "to take decisive and proactive action."

"It's clear to us that whatever measures need to be put in place to prevent, for example, large-scale importation by online pharmacies or large-scale importation by large U.S. states, has to be put in place because Canada is not structured to produce an amount of medications required for a population that size," she told Lynch.

'A thousand practical reasons why this won't happen'

With major American and Canadian drugmakers united in their condemnation of Washington's proposal, Picard contends "there's a thousand practical reasons why this won't happen."

"A lot of these laws, I think, will be struck down in the U.S. There will be opposition from the pharma companies there," he said.

"[And] there's no reason that pharma companies in Canada, which tend to be subsidiaries of larger American and European firms, to ship to the U.S."

The largest U.S. pharmaceutical and biotech companies said Wednesday they opposed the idea of importation through their lobbyists PhRMA and BIO, claiming it could have harmful consequences.

"There is no way to guarantee the safety of drugs that come into the country," PhRMA chief executive Stephen Ubl said.

In a statement, BIO's president and chief executive Jim Greenwood called it a "misguided attempt to keep and ill-informed campaign promise."

Canada already facing drug shortages

Insulin has been a flashpoint in the U.S. battle over exorbitant prescription drug prices.

The cost of the life-saving medication can be as much as 10 times more per vial in the U.S., where pharmaceutical companies control the price, than in Canada.

North of the border, a federal regulator, the Patented Medicine Prices Review Board, is responsible for setting ceiling costs for brand-name drugs.

At the end of April, a group of Americans travelled to Canada to buy insulin because the price of the life-saving medication is so much cheaper north of the border. They called it the Caravan to Canada, and launched a social media campaign under the hashtag #Insulin4all. (Submitted by Lija Greenseid)

As a result, more Americans are making the cross-border trek as an alternative to paying thousands of dollars for insulin. The U.S. Food and Drug Administration currently permits cross-border dispensing of up to a three-month supply of the drug, provided it's for personal use.

Picard believes importing drugs from Canada will create a litany of other problems in the process.

"We have drug shortages now for a variety of complex global reasons, and this would probably be exacerbated if it happened," said Picard.

In recent years, Canadian drug makers have reported thousands of shortages — often because of manufacturing issues but also due to increased demand.

According to Picard, the pressure of these companies needing to supply 10 to 15 times the amount they're currently producing "is just not possible."

"The ultimate solution to this if the U.S. wants lower drug prices, [is] they have to introduce price controls like every other Western country has done."

Hanson admits she has "tremendous empathy" for what Americans face, but believes that should not come at the expense of Canadians with Type 1 or Type 2 diabetes.

"We also have to ensure that none of these caravans — or more worryingly, large-scale importation of drugs from Canada — disrupts the supply of this life-giving medication," she told The Current.


Written by Amara McLaughlin, with files from CBC News and Reuters. Produced by Sarah-Joyce Battersby, Max Paris and Imogen Birchard.