Will Internet pharmacies hurt you?

Since Canadian Internet pharmacies first hit the web in 2001, the issue of how cross-border drug buying by Americans will affect us has been a hot topic both here and in the U.S.

Various high-profile organizations in this country, including CARP, have published their positions on the subject. The issue came up as part of the platform in U.S. presidential campaigns by George Bush and John Kerry. And, at the start of the year, pharmaceutical giant GlaxoSmithKline took the unprecedented step of banning the supply of their drugs to online pharmacies in an effort to quell the huge number of drugs earmarked for Canadians leaving this country for the U.S.

Why is it an issue?
Because Canada’s drug prices and quantities are regulated and American drugs are not, Canadians pay less for their drugs. In fact, some drugs prices in Canada are up to 50 per cent cheaper than in the States. Coupled with the low value of our Canadian dollar, buying cheap drugs from Canada has become an attractive option for U.S. seniors who are on fixed incomes and may have no drug plan. And at an estimated $1 billion annually, it’s big money for the more than 200anadian online pharmacy operations.

Will supply dwindle?
But according to the Canadian Pharmacists’ Association, selling our set supply of prescriptions to a foreign pharmaceutical market 20 times our size is going to impact the Canadian health-care system. “Our first concern is that no shortages occur to prevent us from getting our drugs when we need them,” explains Lillian Morgenthau, founder and president of CARP. “Canadians come first.”

Recently, an article in the Canadian Medical Association Journal reported that in Manitoba, which has become the centre of the Canadian Internet pharmacy industry, there are more than 45 online pharmacies in operation, pulling in about $400 million annually. As a result, non-Internet pharmacists in the province have reported shortages in drug quantities for Canadian customers unlike those they’ve ever experienced. “There’s a general feeling of uneasiness,” says Ron Guse, the province’s pharmacy registrar. “Before, pharmacists wouldn’t have given a second thought to giving their last bottle of medicine to a patient. That confidence doesn’t exist now.”

The Canadian Pharmacists Association has also expressed concern that selling drugs online at a reduced price to Americans may lead to pharmaceutical manufacturers placing more caps, as was the case with GlaxoSmithKline, on the amount of drugs being shipped in to Canada and may also delay the marketing of breakthrough drugs in this country.

What about safety?
Among the other issues of concern for CARP and other Canadian associations is the issue of safety for those buying their drugs online.

“Although prescription drugs require a Canadian doctor’s signature on all prescriptions filled in Canada, many doctors may be co-signing U.S. prescriptions,” explains Morgenthau. “It is CARP’s stand that a patient should be examined before a prescription is issued so that the doctor is aware of a patient’s health issues and any possible reactions to any drug.” Not all online pharmacies require a faxed copy of a doctor’s prescription.

When you order a drug online, you are taking a chance not only that it’s safely packaged, legitimate and uncontaminated but also that it won’t interfere with other drugs you may be taking.

There is also growing concern over the issue of a pharmacist shortage in Canada. According to Denis Morrice, president of the Arthritis Society, 200 of the 1,000 pharmacists licensed to practise in the province of Manitoba alone have shifted from serving Canadians to doing U.S. Internet business.

With the lure of big money to be made in the Internet pharmacy game, new pharmacists may also be more apt to join or start their own websites rather than work in hospitals.

Finally, we may end up paying a high price for shipping our supply of drugs south. Increasingly, U.S. legislators and drug manufacturers are requesting increases to the price of drugs in Canada in an effort to stem the flow of money from the U.S. to Canada to buy drugs that were originally sold at a lower cost because of regulations in this country.

It’s an issue that deserves the attention of all Canadians. Many organizations have come out with strong positions against Canadian Internet pharmacy trade to the U.S. including the Arthritis Society, the Canadian Medical Association and the Canadian Pharmacists Association. According to Morgenthau, “CARP is calling for safety standards to ensure the health of anyone who orders drugs from Canada and the need for strict monitoring of our country’s drug supply to ensure we do not face serious shortages of the drugs we need.”