Canadians are increasingly worried they will run out of medicines as more American consumers and local governments look across the northern border for cheaper prescription drugs.
One Canadian pharmacy group has said it will stop bulk prescription drug sales to U.S. states and municipalities, and a coalition of patients and pharmacy groups this week asked their government to ban prescription drug exports.
“The issue for Canada is a growing concern that if we do continue to supply your market … there will not be adequate drugs for Canadians,” said Louise Binder, chairwoman of the Canadian Treatment Action Council (CTAC), an advocacy group for people with HIV and AIDS.
Pharmaceutical manufacturers are beginning to delay drug sales in Canada until they can guarantee a price that will not undercut sales in the United States, said Mrs. Binder, whose group teamed up with the Canadian Pharmacists Association and other organizations to recommend an end to drug exports.
Re-importation has grown increasingly popular in the United States — and has become an election issue — as health insurance costs have jumped by almost 60 percent in the past four years. Individual consumers often can find prescription drugs cheaper in Canada than in the United States.
The Bush administration has supported the concept of re-importation but resisted implementation because of safety issues.
Sen. John Kerry, Massachusetts Democrat and presidential nominee, backed Senate legislation, which has not passed Congress, that would allow easier access to Canadian imports.
Many of the drugs are made in the United States, but Canada relies on a federal review board to cap prices. Provinces buy in bulk, using purchasing power to help control costs.
Major U.S. buyers, such as the Department of Veterans Affairs and some health maintenance organizations (HMOs), pay about the same prices as Canadian provinces for drugs, but smaller players are unable to bargain for discounts, said Aidan Hollis, a University of Calgary professor in Alberta who has studied pharmaceutical pricing in North America.
“So [U.S. residents] trying to buy drugs in Canada, they are the under- or uninsured,” Mr. Hollis said.
Some states are making it easier to buy Canadian drugs.
Michigan and Wisconsin, for example, started a program this month called I-SaveRx to help residents fill prescriptions with drugs from Canada, Ireland and Britain.
“We are doing what we should be doing to help our residents have access to affordable prescription drugs,” said Rebecca Rausch, a spokeswoman for Illinois Democratic Gov. Rod R. Blagojevich.
Mrs. Rausch acknowledged that amount of supplies was an issue, so the state decided to buy drugs from Europe as well as Canada. Many countries in Europe also have price controls.
Wisconsin also signed on to I-SaveRx to supplement an existing program with three Canadian pharmacies.
“We know that this is not the entire solution [to high prescription drug costs], but we think it is a step in the right direction,” said Melanie Fonder, spokeswoman for Wisconsin Gov. James E. Doyle, a Democrat.
But the new Illinois and Wisconsin program set off alarm bells for the Canadian International Pharmacy Association (CIPA), which represents pharmacies engaged in about 80 percent of the country’s cross-border trade with the United States.
CIPA supports individuals’ purchases of Canadian drugs, but not government purchases.
“We can’t be the drugstore for every American; we can probably help the most needy,” said David MacKay, executive director of CIPA.
He said that many concerns of the CTAC and its allies are “bogus,” but warned that Canada alone could not be the wholesale supplier for the United States. He suggested governments look to European Union states, especially Britain.
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