Canada issued an interim order on Friday, November 27, preventing drug establishments from exporting products that would risk causing domestic shortages. The press release with quotes from Health Minister Patty Hajdu may be more digestible than the official order.
As I see it, Americans who rely on buying less expensive prescription drugs from Canada should not be too concerned about this new development. The order is directed at companies who distribute drugs via wholesale channels, not pharmacies that dispense drugs directly to patients. Patients in the U.S. with a valid prescription who safely order drugs from pharmacies in Canada do so through licensed retail pharmacies not wholesalers.
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In Thanksgiving seasons past, I have written posts connecting the problems of high drug prices and hunger in America. Where people and households are struggling to afford food, there’s a greater likelihood that they are forgoing needed medical treatments, including prescription drugs. The problem is far worse for people with chronic medical conditions. This may seem intuitive and obvious, but for those wanting some academic research to chew on, take a look at this from The American Journal of Medicine:
Forgetting about the potential dangers to competition from corporate Leviathan Amazon, that it launched a new online pharmacy this week will certainly appeal to tens of millions of Americans. Prescription drugs are yet another thing you can get when you go to Amazon.com. And if you’re an Amazon Prime member (aren’t we all?), then there are discounts and whip-fast delivery to be had. But, unlike in many other industries where Amazon can crush the competition on prices, its online pharmacy launch does not accomplish that. Brand name drugs, ones without and even with generic competition, are similarly priced to other American pharmacies. PharmacyChecker checked this out and has some good advice for consumers about Amazon’s pharmacy at Ask PharmacyChecker this week.
Overall, brand name drugs do not appear to be any cheaper using Amazon Pharmacy than what you can get using a discount card found on GoodRx or PharmacyChecker. How can they when the pharmaceutical industry has monopolistic pricing power over patented drugs? Amazon is subject to the same average wholesale acquisition costs as Walgreens. Not only do drug manufacturers have patents: they have special international trade protections where companies cannot import these same drugs from foreign wholesalers who charge much lower prices in Canada, not to mention the even lower prices in the UK and European Union countries – unless the drug manufacturers do the importing or authorize it.
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The new federal rule on drug importation from Canada, drafted pursuant to Section 804 of the FDCA, does not allow for the importation of foreign versions of FDA-approved drugs. It only allows for the importation of FDA-approved drugs. I’m writing this in response to a paper written by Thomas J. Bollyky and Aaron S. Kesselheim called “Reputation and Authority FDA and the Fight over U.S. Prescription Drug Importation.” Some people who read their paper may be confused.
Kesselheim and Bollyky assert that there are “three avenues for legal importation of prescription drugs that are not FDA approved.” The first example is personal drug importation, the second is importation from Canada under the new federal rule, and the third is shortages. I will address the second.
By “not FDA approved,” they must mean foreign-versions of FDA-approved drugs. After all, the law only allows for the sale of FDA-approved drugs within the United States. The new importation rule doesn’t change that basic fact.
Importation of prescription drugs to help lower prices for Americans will remain a major issue no matter who is president next year. The more we know about where our meds are made (mostly not here) the less successful drug industry lobbying will be against lower-cost, imported medicines.
In some cases, it’s as simple as a drug sold at a U.S. Walgreens is made in a manufacturing facility in one foreign country. For example, type 2 diabetes drug Jardiance (empagliflozin) is made in Italy. Another drug that treats type 2 diabetes, Januvia, is a little more complicated. Its active pharmaceutical ingredient (API) is made in Italy, but that API is formulated into the finished drug in the UK.
Photo courtesy of WhiteHouse.gov
I’m a Democrat and voting for Joe Biden. It’s good to be honest. Biden supporters may view my blog post more favorably, while Trump supporters might be more skeptical. I can live with that. You can all fact check me. But ask yourselves: “have my prescription drug costs gone down over the past four years”? If you want to respond in the comments, please do so politely. About 25% of Americans, many tens of millions of people, say they have a hard time affording their meds. As I mention below, we should all get along on this issue. It’s not only critical that we end the madness of high drug prices in America, but let’s unify when we agree!!
My quick and dirty position point here is that most of Trump’s efforts to lower drug prices have either failed and/or are simply political window dressing to help him get elected. Before my fellow Democrats turn up your noses, just know that Obama promised to take on Big Pharma, too, but he did not. For a positive spin, Trump’s bashing Big Pharma rhetoric may have future political reverberations on the Republican party in favor of real actions to lower drug prices.
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