Toronto Star

U.S. move to allow drug imports raises fears of shortages

Groups call on Ottawa to protect supplies of critical medication­s

- MICHAEL LEWIS BUSINESS REPORTER

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 on Wednesday it has contacted American 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 Health Minister 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 Canadaappr­oved 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 presidenti­al 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 because U.S. residents are 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 cooperate with Florida Governor Ron DeSantis on a new law that sets up a formal, government­run 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, chair of the panel that oversees Medicare. Grassley, a Republican, 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 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.

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