While the Bush administration has firmly opposed legalizing drug imports, government leaders in various U.S. states and cities have set up programs to help cash-strapped residents buy their pharmaceuticals from Canada.
The U.S. Congress is expected to pass legislation to ease Internet drug sales. But in a new twist, the Ottawa government, concerned that pharmacy sales to the U.S. may cause domestic shortages in Canada, is drafting legislation to restrict bulk exports of Canadian drugs, although the legislation is not likely to be as severe as once feared. Any changes would probably not happen until later this year.
The authors of this study compared prices on 44 common brand-name medications at 12 highly ranked Canadian internet pharmacies and three major online U.S. chain pharmacies: CVS, Rite Aid and Walgreen’s.
The survey, conducted at the end of 2004, found that 41 of 44 medications were less expensive on Internet sites north of the border.
The medications with the largest mean yearly savings were Zyprexa (for schizophrenia and bipolar disorder) with annual savings of $1,159, Actos (for control of diabetes), with savings of $852, and Nexium (for heartburn), with savings of $772.
Only three medications, all of them for erectile dysfunction, were more expensive in Canada. This is because so-called lifestyle drugs do not have the same price controls as drugs that are considered “vital,” Eisenberg explained.
The mean savings at Canadian internet pharmacies was 24 percent per dose.
Canadian price savings apparently extend beyond medications, Eisenberg added.
“The same stent here costs much less than it does 30 or 40 miles away in northern New York State,” Eisenberg said. “I published a paper a few months ago comparing the cost of bypass in Canada and the U.S., and it was half as much here with the same outcomes.”
Why the difference?
“Companies will charge as much as the traffic will bear, and the traffic will bear much more cost in the U.S. than in Canada, and that keeps driving up costs,” Eisenberg stated. In addition, Canada has placed price-control measures on brand-name prescription drugs.
Some thought the findings might spur the U.S. government to modify its stance on imported drugs.
“Maybe this is one way to move the federal government,” Treat said. “It’s a ridiculous way to be addressing the problem to go state by state, receiving threats from the government saying it’s illegal, and yet states are doing it anyway. It just shows how desperate they are to come up with anything to reduce drug prices for their citizens.”
JUNE 30, 2005…
CANADA MAY TIGHTEN RULES ON U.S. DRUG PURCHASES
By Julie Appleby
USA TODAY
June 30, 2005
Saying Canada can’t be America’s drugstore, the Canadian health minister proposed changes Wednesday that could make it harder for Americans to get lower-priced prescription drugs from north of the border. The proposals by Health Minister Ujjal Dosanjh will include a requirement that an “established” doctor-patient relationship exists with a Canadian doctor before prescriptions can be filled.
Dosanjh said the definition of “established” will be worked out in consultation with professional associations that oversee doctors and pharmacists, most of which oppose the practice of co-signing prescriptions by Canadian doctors who don’t actually see the patients.
He stopped short of saying the new rules would require face-to-face consultations between Canadian doctors and U.S. patients. Such a rule, which would not require legislative approval, would severely hamper cross-border sales, which Dosanjh estimated at least about $1.2 billion (U.S.).
Dosanjh also will ask Canada’s legislature to bar bulk shipments of drugs to the USA if shortages occur in Canada. The ban on bulk shipments is aimed at “potential American legislation legalizing the bulk import of Canadian medications,” said Dosanjh, who will introduce legislation on the bulk buying ban this fall.
Congress is considering several bills that would broaden U.S. patients’ ability to buy drugs from Canada. Canadian pharmacists had mixed reactions to Dosanjh’s proposals.
“The message I heard was the medicine cabinet is closed – and we’re happy about it,” says Lothar Dueck of the Coalition for Manitoba Pharmacy, an opponent of drug sales to the USA.
“It’s a poison pill for us,” says Paul Clark, CEO of Hometown Meds, an online pharmacy based in Carman, Manitoba. “While there are a few people right on the border who can travel to Canada, realistically, 99% of the business is done through mail order.”
Andy Troszokys, president of the Canadian International Pharmacy Association, says a doctor-patient relationship already exists between U.S. doctors and their patients, so the Canadian co-sign rule should be dropped altogether, a move Dosanjh’s spokesman says the minister rejected in February.
He says his group supports the bulk ban and hopes to assist the minister in working out details on the doctor-patient rules. Requiring physical exams would damage the industry, he says.
