Should Consumers Be Allowed to Buy Drugs from Canada?

Marianna Day Massey/zuma/Corbis

Surveys released at the launch of the Minnesota Senior Federation's groundbreaking Canadian importation program revealed a dramatic 62 percent savings on a basket of commonly prescribed prescription medications and a 52 percent overall savings on prescriptions for Glaxo-SmithKline drugs.

While the argument against importation is primarily one of safety, we should heed the wisdom of Stephen Schondelmeyer of the University of Minnesota School of Pharmacy: "A drug that is not affordable is neither safe nor effective."

The U.S. Food and Drug Administration (FDA) obviously cannot guarantee the safety of medications purchased in Canada. Rather, consumers rely on the oversight of the Canadian Ministry of Health, which assumes its responsibility as well as the FDA. While we are not aware of contaminated drugs coming from any Canadian regulated pharmacy, we are all too aware of examples of counterfeit, contaminated and impure drugs in the United States (such as adulterated chemotherapy drugs from a Kansas City pharmacy). Drugs manufactured for the Canadian market come from the same FDA-approved facilities as those destined for the American market.

Buying prescription drugs from any mail order source is not the ideal way to purchase medications. But for hundreds of thousands of Americans, buying from licensed Canadian pharmacies is the best way to get affordable, safe and effective medications. Permitting prescription importation needs to remain a viable option for the health, life and safety of thousands of uninsured Americans.

The real debate now before Congress is whether, by joining the rest of the world in negotiating prescription drug prices, we will put the needs of our citizens ahead of the excessive profits of the pharmaceutical industry. "Until that time," one Republican congressman told the Senior Federation, "we need to be able to rely on the power of international free trade to help bring down the cost of prescription drugs."

Peter Wyckoff is the executive director of the nonprofit Minnesota Senior Federation, which runs a mail order service for buying prescription drugs from Canada.

By Carmen Catizone

Patients in the United States are facing a crisis. Lack of access to affordable medications is driving patients outside the U.S. regulatory system to unidentified, unregulated and dangerous drug outlets.

Purchasing medications from pharmacies not regulated by U.S. agencies opens the door for the shipment of expired, contaminated, subpotent, superpotent and counterfeit drugs. These drug outlets may ship contraindicated medications, medications with incorrect strengths or medications without adequate directions for use to patients.

If we allow medications to be shipped illegally from Canada or any other part of the world, we remove the appropriate standards and safeguards in place in the United States to prevent and detect such occurrences. In fact, patients may never know there is a problem. More important, even if there is a problem, the patient has little or no recourse since the dispenser may not be known.

There may be no legal authority to which a complaint may be submitted and resolved in Canada, and, unfortunately, patients may have waived their right to sue through waiver forms supplied by the providing pharmacies.

A survey of products stopped by the U.S. Food and Drug Administration (FDA) at American borders revealed that 8 percent of the packages contained drugs that could not be identified because they lacked labels or labels were in a foreign language.

Most of the drugs were packaged in plastic bags, with one shipment containing drugs taped between magazine pages. Several samples did not appear to correspond with any FDA-approved drugs or contained drugs withdrawn from the market because of safety concerns. One package contained a drug denied FDA approval because it increased cardiac risk and lacked efficacy data.

Purchasing medications through illegal means does not resolve the problem of access but only increases the opportunity that U.S. citizens will be harmed by unregulated entities.

Carmen Catizone is the executive director of the National Association of Boards of Pharmacy, a professional organization setting uniform standards.