Montana Viewpoint


May 10, 2004

It was dueling philosophies at a recent conference on importing Canadian drugs: The pharmaceutical industry said Canadian drugs are unsafe; a Canadian pharmacist said that was news to him; the Federal Drug Administration (FDA) said that they couldn’t guarantee the safety of Canadian drugs; and the AARP pointed out that, no matter the risk, cheap imports were better than unaffordable drugs.

And I thought it would be dull.

This palaver took place at the Governor’s Health Care Summit a couple of weeks ago, and it sure helped me realize a thing or two. If you don’t know the issue, here’s a primer. Drug prices in America have reached a point where people of modest means have turned to other sources for cheaper drugs. One of the major sources they go to is the internet/mail order marketplace selling Canadian drugs—or at least drugs that are sold through a website with a Canadian flag on it.

There is a danger in this. But, as Ed Dale of the National AARP pointed out, there is a greater danger in people skipping doses because they can’t afford to take the full prescribed amount, or people who decide to buy food because they can’t afford both food and medicine.

Kristina Lybecker, who has a Ph.D in economics, seemed to represent the drug industry’s side of things. She is a professor at Drexel University in Philadelphia, and has worked for a major drug manufacturer. Her main contention was that it’s unsafe to buy drugs from Canadian retailers because you don’t know what you’re getting. She presented some very compelling evidence that sometimes drugs claiming to come from Canada are actually made in India or Ghana where, to put it kindly, there is not much government supervision or inspection of drugs.

The FDA was represented by Tom McGinnis, Director of Pharmacy Affairs at the FDA, who voiced the concern that the FDA has enough to do already, and just couldn’t be expected to inspect drug manufacturing outside the U.S., or even when the drugs got here. He, too, had stories about counterfeit drugs that were either impure, diluted, or even just plain aspirin masquerading as the real McCoy.

But to me, the most impressive panelist was Bob Nakagawa, a low key pharmacist from British Columbia who is the Pharmaceutical Manager of a large government Health Care Authority. Nakagawa began his presentation by simply stating, “I think Canadian drugs are safe, we don’t see anybody dying from taking them,” and going on to rebut the arguments to the contrary. And quite well, too.

As the discussion went on, it became apparent to me that the FDA and the drug industry have created a Red Herring—a diversionary tactic—to move the argument from the high cost of drugs in the U. S. to the danger of drugs not made in the U.S. And there is a safety issue, to be sure, but it has nothing to do with drugs manufactured in Canada and bought from reputable pharmaceutical wholesalers. The danger lies in buying from unscrupulous retailers.

The real issue is that Canadian prices for drugs imported from the U.S. or made in Canada are lower—often far lower—than prices in America, and as Nakagawa said, Canadian drug companies aren’t losing any money even with the low prices.

It wasn’t always, but these days, it’s illegal to import drugs from Canada and to paraphrase Will Rogers, the FDA is making criminals out of honest Americans. Americans who can’t afford to buy drugs at current U.S. prices.

The safest way to get cheaper drug prices would be to allow American pharmacists to buy from Canadian drug wholesalers, and pass the savings on to their customers. Nakagawa, Adams, and McGinnis all stressed the importance of a face to face patient-pharmacist visit in any purchase of drugs. The local pharmacist, who actually knows us, often is more aware of our prescription needs and bad side effects than the doctor who prescribed them. The local pharmacy, by the way, is in danger of disappearing because of U.S. prescription drug policies, but that’s another story.

The single most important lesson I took away from the conference is this: the only way Americans will get lower drug prices is by bringing more political pressure on Congress than the pharmaceutical industry, and that’s a tough thing to do.


Jim Elliott
Phone: 406-444-1556
Mail: State Senate Helena, MT 59620