Canada Cannot Be America's Drugstore
The drug importation debate, sparked by Sen. Bernie Sanders’ introduction of legislation that would allow Americans and pharmacies to import medicines not approved by the FDA from foreign countries through and including Canada, is largely focused on one key question: Are medications imported from outside the FDA’s jurisdiction safe for consumers?
Clear and compelling evidence tells us the answer is no. Beyond that, though, we haven’t even begun to address concerns from the Canadian side of this issue.
Stated simply, Canada does not have the drug supply nor the drug distribution system to meet even a small level of U.S. demand. Additionally, it is highly unlikely that the pharmaceutical industry will increase the supply necessary for Canada to become a major exporter.
The raw numbers speak for themselves. Pharmaceutical manufacturers provide drugs to meet a country’s indigenous needs, often allocating just enough in reserve in the event of an unexpected national emergency or a health care crisis. Canada’s population is approximately one-ninth the size of the United States (34.8 million versus 318.9 million). More importantly, among the 65-and-up population that relies the most on pharmaceutical drugs, Canada has just 6.1 million senior citizens as compared to 45.8 million in the United States.
So, let’s do the math. If just 10 percent of U.S. seniors were to reach out to Canada to purchase their pharmaceuticals it would nearly double the size of the senior citizen population demanding Canadian drugs. With 64.8 percent of American seniors taking three or more different medications per day and another 30.9 percent taking more than five or more medications, the supply simply isn’t there.
This begs the question: Wouldn’t U.S.-based pharmaceutical companies simply increase their supply to Canada in order to meet this increased demand? The answer is likely “no,” as it’s not a practical market-based response.
If drug importation is legalized, the U.S. and Canadian pharmaceutical markets essentially become one. It would not be in the fiduciary or long-term interests of any pharmaceutical company to increase its supply to Canada at artificially low prices set by government fiat, which would only reduce demand for medications sold in the United States at market-based prices. Why would any company reduce the amount of dollars available for research and development of new, innovative products by boosting sales to a country that is now exporting price controls?
That leads to the inevitable next step that Sen. Sanders and other importation advocates aren’t taking into consideration. If Canadian pharmacies can’t get the drugs from U.S. manufacturers to meet both domestic needs and export demands, they will turn to other countries to secure these supplies. That presents a heightened danger to both Canadian and American patients. It increases the likelihood that drugs will instead flow from countries like Russia and India, where counterfeiting is ubiquitous.
Yes, allowing importation of cheap drugs from Canada sounds like an enticing idea. It ignores, however, crucial economic and safety realities. The supply simply isn’t there, and any effort to increase that drug supply will put Canadian and American lives at greater risk.
For more than two decades, Dr. Marvin D. Shepherd served as Director of the Center for Pharmacoeconomic Studies and Chairman of the Pharmacy Administration Division at the University of Texas at Austin’s College of Pharmacy. He is currently president of the Partnership for Safe Medicines.