The Trump administration said Wednesday that it is looking at setting up a system that makes it legal for Americans to buy prescription drugs from Canada at a lower price than in the United States.
The statement, made by Health and Human Services Secretary Alex Azar on MSNBC, prompted questions about whether this could actually happen — and what it would mean for Canadians.
Azar said the administration’s proposal would allow states, wholesalers and pharmacists to get FDA approval to import certain medications that are also available in the U.S.
The FDA currently permits U.S. residents to bring medication for personal use across the border, but not more than a three-month supply.
“I came up with the idea to import cheaper generic drugs where there had been these price-gouging behaviours in the United States. We have to be open-minded here; we could get something done that really would benefit the American people,” Azar said.
He didn’t offer details on talks between Canada the U.S. or give a timeline on when the possible changes would be in place.
Paul Grootendorst, a University of Toronto associate professor who researches economics of the pharmaceutical industry, explained to Global News that there are several major flaws in the U.S. announcement.
WATCH: Americans flock to Canada for cheaper insulin
He noted that multinational drug companies, such as Pfizer and GSK, would not welcome such a change.
“The stuff that is for sale in Canada at a relatively low price would cannibalize their sales in the United States. The companies will obviously devise ways to ensure that doesn’t happen,” Grootendorst said.
He added that FDA limits on importing drugs exist for important health and safety reasons, mainly to ensure Americans are getting “unadulterated, high quality medicines.”
“If you start importing drugs from Canada, you don’t really know exactly what you’re getting. Suppose that you purchase from the web from a so-called Canadian drug distributor, you don’t really know exactly where in Canada. How do you know exactly what it is that you’re importing?”
There are also concerns about how much dialogue occurred between Canadian and U.S. officials before Azar made the announcement. Grootendorst said he believes it’s unlikely this is something Canadian officials would be open to.
“It would be a headache,” he explained. “We already have shortages and I don’t think they’re going to welcome any move which would exacerbate that.”
In an email to Global News, the federal ministry of health did not offer many details on how much discussion occurred between Canadian and U.S. officials on the topic before Wednesday’s announcement.
WATCH: The rising cost of insulin in the U.S.
“We’re in touch with U.S. officials and look forward to discussing today’s announcement with them,” the statement read.
It added that U.S. interest in Canadian medication is “evidence of our commitment to more affordable prescription drugs,” and that ensuring the country’s drug supply meets the needs of Canadians is one of the government’s top priorities.
“We’re in touch with U.S. officials and look forward to discussing today’s announcement with them.”
Canadian pharmacists react
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The Canadian Pharmacists Association raised several concerns about the U.S. announcement, calling on the federal government to develop a plan so Canadian drug supplies are not compromised.
Joelle Walker, the vice president of public affairs at the association, told Global News that there are no clear answers on where Canada stands on exportation of medication.
“Since we’ve never actually had to face the issue of importation legislation being passed in the states, we really have to assess where our vulnerabilities are,” she said.
“We’re asking the federal government to work with stakeholders, such as ourselves and others, to make sure the legislation and the measures are accurate and going to able us to restrict that demand and not create unnecessary barriers on Canadians inadvertently.”
Walker added there are already several concerns about Canadian drug supplies.
“Canada’s drug supply is not in a position to support a country that is 10 times our size. Our biggest worry here is that this is going to exacerbate drug shortages that exist in Canada already.”
According to the association, one in four Canadians have faced drug shortages, either personally or through a family member.
Last week, the 15 groups representing patients, health professionals, hospitals, and pharmacists warned Health Minister Ginette Petitpas Taylor of the potential for increasing drug shortages in a letter.
“The Canadian medicine supply is not sufficient to support both Canadian and U.S. consumers,” the letter read. “The supply simply does not, and will not, exist within Canada to meet such demands.”
On the Drug Shortages Canada database, there are currently 7,910 shortage reports. Twenty-three per cent of those shortages, or 1,849, are current issues. One per cent of the reports, a total of 51, are anticipated shortages. The remainder have either been avoided or resolved.
Fixing the problems in U.S.
Wednesday’s announcement is a step toward fulfilling a 2016 campaign promise by U.S. President Donald Trump, and it weakens an import ban that has stood as a symbol of the political clout of the pharmaceutical industry.
It also comes as the industry is facing a crescendo of consumer complaints over prices, as well as legislation from both parties in Congress to rein in costs, along with a sheaf of proposals from the Democratic presidential contenders.
The disparity between Canadian and U.S. drug prices is also something that Sen. Bernie Sanders has mentioned repeatedly.
WATCH: Trump complains about the cost of prescription drugs in Canada
That’s why Grootendorst explained that the U.S. looking to Canada for cheaper drugs is a sign of the problems that exist in the country’s own system.
“It’s a little crazy there,” he said. “There’s a lot of different prices being paid by different players, there’s lots of different deals being struck.”
Grootendorst said the U.S. system itself needs reform, which requires government action and possibly start regulating drug prices.
“They have to solve the problem at home. It’s not something Canada can do, we just can’t supply their market.”
— With files from Global National reporter Jackson Proskow, The Associated Press
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