Canadian sites look overseas for drug supply

But during the last year, U.S. customers using Canadian websites have faced increasing difficulty getting top-selling medications such as Celebrex to treat arthritis and the antidepressant Effexor. That’s because several of the world’s biggest pharmaceutical makers are restricting supply to online Canadian pharmacies that ship to the U.S., leading to delays of several weeks for many customers. In severe cases, some sites have stopped accepting new clients looking for the hardest-to-get medications.

Faced with the growing shortages, Canadian Internet pharmacies are looking abroad themselves and increasingly selling U.S. consumers drugs that originate through pharmacies in England, Fiji, Israel and Chile. Depending on the country, that is raising concerns that U.S. consumers — many of them senior citizens — are getting medications from countries with less-stringent safety regulations than those in North America.

“It’s a potentially scary situation” that a significant number of Canada-to-U.S. prescriptions could soon originate from other countries, says Marv Shepherd, a pharmacy professor at the University of Texas, Austin, and an expert in the field of cross-border prescription sales. It’s particularly worrisome if Canadian companies “start to partner up with some of the more shaky countries,” he says.

Shepherd says that most U.S. consumers believe Canadian drugs are safe, but that could change if they start running into problems with drugs from other countries.

Robert Heinlein coined a word in 1966 – TANSTAAFL (there ain’t no such thing as a free lunch). Those who thought that importing drugs from Canada would solve the pharmaceutical cost problem are guilty of level 1 thinking. As demand for drugs from Canada increases, the Canadian pharmacies must develop supply problems. This is simple economics. Certainly the pharmaceutical industry understands this, and will eventually limit supply to Canada. Thus Canadian pharmacies look elsewhere for product.

You should not treat a deep abdominal knife wound with a bandaid. The Canadian “solution” makes for good politics, but bad policy. This “solution” is destined to fail.

We need higher level thinking to better understand pharmaceutical costs and our resultant expenditures. The “wonder drugs” are not created by spontaneous combustion. They result from expensive research.

Physicians need to understand newer drugs very well. We need to understand when an expensive drug is a better alternative, and when a cheaper generic works as well.

We need the NIH (and associated Institutes) to sponsor important drug studies. Relying on the pharmaceutical industry to fund drug studies seems cost effective in the short run, but from a long term perspective, such studies are rarely designed to answer the important cost questions.

We must start considering costs and benefits when prescribing. To do this, we need better data.

But we must treat the disease not the symptom. Importing drugs from Canada is treating a symptom, but not addressing the disease. The disease is intelligent drug prescribing. And we (the US) should take the lead in providing the research needed to develop intelligent prescribing.

Related posts:

1. Canadian drug importation is not the answer
2. Robert Goldberg on Canadian drug importation
3. On Canadian drugs
4. Heroes and villains – why costs accelerate
5. Politics and drug importation

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