Pharmacist, educator and PSM board member speaks out against drug importation in Florida

Dr. Kenneth McCall

This editorial by Kenneth "Mac" McCall was published in the Tallahassee Democrat on March 19, 2019. Dr. McCall is associate professor and director of residency programs at the University of New England College of Pharmacy. He has served as president of the Maine Pharmacy Association, and is a current PSM board member.

Florida should steer clear of drug importation

As someone who has worked as a pharmacist and trained others in the field for many years, I have a great deal of concern for my colleagues and the patients that they serve throughout Florida.

I see the Florida Legislature working to legalize the importation of prescription drugs from foreign sources, and I worry there is not enough discussion or understanding of the dangers a step like this would bring.

We have had this battle already in my home state of Maine, where a judge struck down attempts to legalize drug importation. In fact, it’s a debate we’ve seen nationally with secretaries of Health and Human Services and Food and Drug Administration commissioners, from both Democratic and Republican administrations, deeming drug importation to be unsafe.

We are currently facing a global counterfeit drug epidemic and it’s already affecting too many Americans. In more than 40 states, law enforcement officials have identified counterfeit pills containing highly lethal fentanyl, a few grams of which can kill someone instantly. In fact, in 29 of those states, there have been fentanyl-related deaths from counterfeit pills.

These aren’t isolated cases. Law enforcement is fighting an uphill battle against a deluge of these dangerous products coming into the country. Just one enterprise claiming to be a Canadian pharmacy made tens of millions of dollars sending unapproved drugs into the United States. This is a legitimate health crisis, one local and national law enforcement are hard pressed to stop, given their limited resources. The sheer volume of counterfeit drugs coming by international mail services from so-called pharmacies peddling these products over the internet is overwhelming..

The FDA has just issued a letter of warning to a company called CanaRx, that lists a Canadian address on its website. CanaRx is contracting with health plans in the United States to provide drugs, and the FDA says these medications are likely coming from sources other than Canada and could well be counterfeit or carry safety risks. 

If the state moves forward with drug importation, pharmacists could find themselves in legal jeopardy. If Florida acquires drugs through a wholesaler, and that wholesaler purchases drugs of unknown origin through a foreign supplier, pharmacists can be held legally liable for dispensing a counterfeit medication to a patient — even though they have no knowledge they are dispensing potentially toxic substances.

The aforementioned CanaRx case underscores this danger. CanaRx is dispensing potentially dangerous drugs to American health insurance customers. A Florida patient would instinctively trust an unlicensed foreign vendor if it is bundled with a legitimate U.S. health plan. The patient would have no way of knowing they are part of a possibly-lethal supply chain.

Several other states have attempted to legalize drug importation, but all have failed to show that it’s safe or saves money. The federal government has determined multiple times that drug importation can’t be done safely. I hope, for the sake of Floridians, that state policymakers come to that same conclusion.