Robert Parada

The Canadian government is expected to crack down on the cross-border trade in lower-cost prescription drugs—a move widely thought to be in response to pressure from the Bush administration. But officials of the provincial government in Manitoba, where most of Canada's online pharmacies are based, say they will resist such action.

An estimated 2 million U.S. consumers buy prescription drugs by mail order from Canada. The Bush administration and the pharmaceutical industry have long opposed the practice, but until now there have been no threats from Canada to close the pipeline. In December Health Minister Ujjal Dosanjh proposed regulations that, if adopted by Prime Minister Paul Martin's cabinet, would create a list of drugs that could not be exported and would bar Canadian doctors from co-signing prescriptions written by U.S. doctors.

Jim Rondeau, Manitoba's minister of industry and economic development, says that the attitude of Canadian government officials toward the country's online pharmacy industry changed after President Bush met with Prime Minister Martin in Ottawa on Nov. 30 for trade talks.

"Within a week of Bush's visit we had a 180-degree turn from accepting the industry, and working with it to make sure that safe standards are adhered to, to—wham—saying we have to eliminate the industry," Rondeau says. "Usually 180-degree reversals of government policy don't happen in seven days."

Then came the U.S. government's announcement in December that it would lift a 19-month ban on importing Canadian beef. "There is some suspicion that we were trade bait for the beef industry," says Dave MacKay, executive director of the Canadian International Pharmacy Association, which represents the online pharmacies.

Spokesmen have confirmed that Bush and Martin discussed drug importation but denied that the president made any demands on the prime minister.

Dosanjh said he is concerned about "250 million Americans" buying drugs from Canada and causing shortages there. "We cannot be the drugstore for the United States," he said on Canadian television.

But, Rondeau says, Canada has never seen a drug shortage, and MacKay estimates the potential U.S. market at no more than 4 million people, adding that members of his association have turned down bulk contracts with states to protect supplies for U.S. consumers.

Manitoba, which is home to about 60 percent of the cross-border trade, opposes the proposed regulations. Gary Doer, Manitoba's premier, has pointed out that the provinces have constitutional authority for regulating pharmacies. "These companies are very good citizens of the province," Doer told reporters, "and we plan on standing with them."

Manitoba aims "to end the game in the first inning," Rondeau says, by persuading Martin's cabinet that online pharmacies pose no threat to the drug supply or to medical ethics.