The Trump administration said Wednesday it will set up a system allowing Americans to legally import bulk quantities of lower-cost prescription drugs from Canada for the first time, raising concerns about whether the move could result in drug shortages and higher prices for Canadians.
More than a dozen organizations, including Diabetes Canada and the Best Medicines Coalition, say they are worried about the much larger American market depleting stocks at Canadian pharmacies and they would welcome a public statement from the Canadian government confirming that it will take action to help protect Canadian supplies.
Health Canada told the Star it has contacted U.S. officials to “ensure there are no adverse effects” to the supply or cost of prescription drugs.
“Ensuring that Canadians have access to the medicines they need is one of our top priorities: we constantly monitor Canada’s drug supply and will be working closely with health experts to better understand the implications for Canadians,” said Mathieu Filion, a spokesperson for federal Minister of Health Ginette Petitpas Taylor. “We’re in touch with U.S. officials and look forward to discussing today’s announcement with them.”
Asked if Canada would consider legislation to prevent the bulk import of Health Canada-approved medicines for U.S. patients, Filion said in an email: “We will first need to see what their pilot projects are before we can speculate on the next steps.”
While the main concern is shortages, Filion noted Canadians are protected from drug price spikes because prices in Canada are monitored by the Patented Medicines Review Board.
The Trump administration has promised to lower American drug prices and U.S. interest in Canadian medication has become a key issue in the American election campaign, prompting Canadian groups to urge Petitpas Taylor to act.
Kimberley Hanson, executive director of federal affairs at Diabetes Canada, said the group is reaching out to the minister seeking assurance of “decisive action.” She added that Diabetes Canada has already noted a temporary and localized shortage of insulin from a Canadian pharmacy due to Americans buying up supplies.
She called the Trump move to allow bulk drug imports a game-changer that demands assurance from Ottawa that supplies of drugs including critical insulin medication will be safeguarded.
John Adams, chair of national patient alliance the Best Medicines Coalition, said he believes bulk importation could be a reality within months given political pressures and Trump’s impatience. “The government needs to pull up its socks and figure out how to protect Canadians from having our supply hoovered by Florida,” he added.
The U.S. administration’s plan to allow lower-cost prescription drug imports from Canada weakens a long-standing ban that has long been a priority for the politically powerful pharmaceutical industry. Previous administrations have sided with the industry on imports, echoing its concerns that it could expose patients to risks from counterfeit or substandard medications.
According to Trump, U.S. patients will be able to import medications safely and effectively, with oversight from the Food and Drug Administration. The administration’s proposal would allow states, wholesalers and pharmacists to get FDA approval to import certain medications.
The administration has also asked the U.S. Health and Human Services Secretary to co-operate with Florida Governor Ron DeSantis on a new law that sets up a formal, government-run system for importing cheaper medicines to the state from Canada.
Most patients take affordable generic drugs to manage conditions such as high blood pressure or elevated blood sugars. But polls show concern about the prices of breakthrough medications for intractable illnesses like cancer or hepatitis C infection, which have costs that can run to $100,000 or more. And long-available drugs like insulin have also seen price increases that have forced some people with diabetes to ration their own doses.
The importation idea won praise from a key lawmaker, Senator Chuck Grassley, R-Iowa, chairman of the panel that oversees Medicare. Grassley said on Twitter that importation would lower prescription drug costs for Americans, and all drugs from abroad must be verified as safe by the FDA. He and Democratic presidential candidate Senator Amy Klobuchar of Minnesota are backing a bill to facilitate importation.
Drug prices are often lower in countries such as Canada because governments take a leading role in setting prices. But in the U.S., Medicare is not permitted to negotiate with drug companies.
Some experts have been skeptical of allowing imports from Canada, partly over concerns about whether Canadian suppliers have the capacity to meet the demands of the much larger U.S. market.
But consumer groups have strongly backed the idea, arguing it will pressure U.S. drugmakers to reduce their prices. They also point out that the pharmaceutical industry is a global business and many of the ingredients in medications sold in the U.S. are manufactured abroad.
AARP had pushed hard for the Florida plan, saying it’s possible to safely import lower-priced, equally effective drugs and it would promote worldwide price competition.
The drug industry lobby, Pharmaceutical Research and Manufacturers of America, has successfully blocked past efforts in Washington to allow importation. It argues that patients would be at risk of receiving counterfeit or adulterated medications.
With a file from the Associated Press
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Michael Lewis is a Toronto-based reporter covering business. Follow him on Twitter: @MLewisStar