Canada May Alter Its Policy on Sale of Drugs

Canada might soon prohibit pharmacies from selling prescription drugs to mail-order customers -- a move that would cut off a market that is increasingly popular with U.S. seniors eager to take advantage of Canadian price controls that make drugs there far cheaper than at home.

The proposal by the Canadian government could preempt a politically explosive battle brewing in the United States over whether to crack down on consumers who buy their drugs through Canadian pharmacies.

According to spokesmen for both governments, President Bush discussed the issue privately with Canadian Prime Minister Paul Martin during a visit to Ottawa in late November -- sparking accusations from one trade group and a Democratic U.S. senator that Bush engineered the plan to stave off a debate in Washington about which he holds an unpopular view.

White House spokesman Trent Duffy said late Tuesday that Bush “made no such request of the Canadian government.” But with the debate expected to begin in Canada as early as next week, Bush’s critics here say they are poised to continue raising questions about the president’s role.

Bush has been reluctant to allow the purchase of drugs through Canada, arguing that the practice could result in consumers buying unsafe, untested pharmaceuticals. That position was backed up last month by an administration task force, which said legalized drug imports should be allowed only under strict federal supervision.

The practice is opposed by the politically influential pharmaceutical industry, a major financial backer of Bush and other candidates from both parties, which in the recent election cycle gave almost twice as much to Republicans as to Democrats, according to the Center for Responsive Politics.

It is supported by consumer advocates and Democratic and Republican lawmakers who view Canadian pharmacies as a viable alternative for older Americans who are on fixed incomes.

“When is the president going to stand up for the health of American patients and stop protecting drug company profits?” Sen. Edward M. Kennedy (D-Mass.) said in a statement Tuesday.

One Democratic aide said administration critics would argue that cutting off Canadian drugs in the name of safety would make matters worse, sparking a “public health disaster” by forcing cash-strapped U.S. consumers to turn to pharmacies in places such as Bangkok.

The trade group that represents many of Canada’s mail-order pharmacies says Bush engineered the proposal by enticing Martin with potential trade concessions, such as loosening restrictions on Canadian beef. “President Bush delivered somewhat of an ultimatum,” said David MacKay, executive director of the Canadian International Pharmacy Assn.

MacKay attributed his allegation to a “high-level government source” in Canada but declined to offer further details.

It is technically illegal for Americans to import drugs from abroad, but they do so anyhow in big quantities -- about 10 million shipments a year, valued at $1.5 billion. Half of that business is from Canada.

Residents of other industrialized countries pay less for pharmaceuticals because those governments enact price controls, limiting what drug makers can charge.

Drugs from Canada, for instance, cost about 40% of their price in the United States.

Under pressure from consumers outraged by escalating U.S. drug prices, some local and state governments have started programs and websites designed to help people find Canadian pharmacies. One such website is sponsored by Minnesota Gov. Tim Pawlenty, a Republican who campaigned on his support of easing drug imports. He said this week that he would help seniors in his state find drugs elsewhere if Canada shuts the door.

“The proposed change in Canada’s prescription drug policy would have serious effects on the pocketbooks and well-being of the more than 2 million Americans who buy their prescription medicines from Canada,” Pawlenty said. “In the unfortunate event that Canada changes its policy, we will seek a way to keep our MinnesotaRxConnect.com website operating by facilitating purchases from European countries with safe pharmacy systems.”

Calls to Martin’s office were referred to the health ministry. A spokeswoman for the health minister, Ujjal Dosanjh, said Tuesday that she could not say whether Bush pressed for the limits on Canadian pharmacies.

“I am not at liberty to discuss that,” said the spokeswoman, who spoke on condition of anonymity.

Dosanjh has been criticizing the growing industry of mail-order pharmacies for months. Addressing a Harvard Medical School audience Nov. 10, he said that the growing practice of U.S. consumers purchasing drugs through Canadian pharmacies could jeopardize the supply of low-cost drugs.

“It is a matter of common sense that Canada cannot be the drugstore of the United States,” he said, according to a speech transcript. “Neither American consumers nor Canadian suppliers should have any illusions otherwise.”

But in that speech, about three weeks before Bush’s visit to Ottawa, Dosanjh made no mention of a potential change in policy -- saying only that the Internet pharmacy sales had “plateaued” at about $600 million a year and that his government would “continue to keep a very close eye on this phenomenon.”

But in a Dec. 12 interview on the Canadian television network CTV, after Bush’s visit, Dosanjh laid out the two potential changes. He suggested forbidding doctors and pharmacies to fill prescriptions for patients not present or for any patients who were not residents of Canada.

“President Bush did speak to Prime Minister Martin with respect to this issue, and we’re taking all the steps we can to ensure that affordable prices and adequate supply of drugs remain uppermost as our concern, and they remain protected for Canadians,” he told CTV.