Editorial by Former Canadian Health Minister: “Dear Bernie Sanders: Canada is not the United States’ drugstore”

This editorial by Leona Aglukkaq appeared in the Washington Post on May 12, 2017. Leona Aglukkaq was a member of Canadian House of Commons representing the riding of Nunavut until 2015. She previously served as Canada’s minister of health from 2008-2013.

Canada has long been a stalwart friend and neighbor to the United States. But there’s one thing Canada must not become: America’s pharmacy.

Sen. Bernie Sanders (I-Vt.) has proposed a bill to let Americans import prescription medicines from Canada. He hopes to this will give Americans access to lower Canadian prices. It’s not just Democrats who like the idea; several prominent Republicans voted in favor of similar legislation that was defeated in January.

As someone who spent several years as Canada’s health minister, I know that allowing Americans to purchase prescription drugs from Canada could have terrible consequences for the citizens of both countries.

Under Sanders’s plan, Canada would simply serve as an intermediate transshipment point for unapproved drugs heading to the United States. Canadian authorities do not inspect every shipment of products headed for the U.S. marketplace to ensure that packages don’t contain adulterated, counterfeit or illegal drugs. Canada does not have the resources to undertake such comprehensive searches, and the Canadian and U.S. governments are not currently set up to facilitate such a program. Canada’s health-inspection regime is designed to ensure the safety of medications for Canadians, not for other countries.

Absent a major policy shift here in Canada, if bulk Canada-U.S. drug shipments were to become a reality, Americans could receive uncertified, uninspected, third-party drugs. Canada inspects drugs for its own citizens; Canadian authorities wouldn’t have the ability or resources to inspect medicines destined for the United States.

What’s more, there’s an opioid epidemic in the United States, and the situation isn’t much better in Canada; British Columbia recently declared a public health emergency to combat the opioid crisis. Because Canada isn’t inspecting all trans-shipped goods bound for the United States, there are dire concerns that international opioid smugglers could disguise their narcotics as prescription drug packages. The amount of fentanyl, much of it from China, reaching Canadian ports has skyrocketed recently. Canadian officials have seized fentanyl packages fraudulently labeled as containing zero grams of the deadly synthetic opioid. This is but one example of a problem that could be exacerbated by Sanders’s proposed legislation.

Aside from the fear of counterfeit products being transshipped through Canada to the United States, proponents of importation proposals have overlooked the dangers associated with criminal organizations posing as legitimate online pharmacies. One such victim was Ali Schroer, a family therapist from Denver, who opposes Sanders’s bill after falling victim to counterfeit anti-allergy pills she bought from a Canadian online pharmacy. The drug gave her severe migraines and stomach problems.

Schroer points out that the U.S. Food and Drug Administration determined that 85 percent of the drugs sold by supposedly Canadian pharmacies come from 27 countries other than Canada. Some online pharmacies that advertise as being Canadian in fact are not, and there’s no real way for consumers to know. The difficulty in dealing with online pharmacies has confronted us for years and is only becoming more challenging as e-commerce becomes a larger part of our economy.

And that’s not all. Canada’s pharmaceutical industry is already strained trying to serve the relatively small Canadian market, never mind serving more than 300 million American consumers. As the former minister of health for Canada for almost five years, as well as a former minister of health in the Nunavut territorial government before entering federal politics, I am greatly concerned that excess demand from American consumers would siphon off Canada’s domestic supply of essential drugs, particularly for Canadians in remote communities in the north.

Canada’s federal health department has introduced regulations requiring drugmakers to report on drug shortages and launched a website called Drug Shortages Canada. These regulations were initiated in response to our own domestic supply challenges to ensure the health and safety of Canadians in terms of their access to important medications. If overnight the Canadian system was stretched to supply the U.S. market, the shortages in Canada could skyrocket.

There will clearly be more demand in the years to come for innovative prescription drugs that prolong life, ease suffering and cure disease as the populations of Canada and the United States age. Consequently, there are opportunities for Canada and the United States to cooperate to bring new drugs to market faster, share data and outcomes, and invest in research, development and innovation on both sides of the border. That’s what American legislators should be focusing on — not bulk-buying Canadian medicines.

Sanders’s bill threatens Americans’ health and Canada-U.S. relations at a time when there are already trade tensions. Worse, it would reduce the supply of safe and affordable drugs for the Canadian marketplace. American legislators must find another way to address drug prices.