This editorial, written by Earl D. Fowlkes Jr., appeared in the Washington Blade on December 4, 2020. Fowlkes is the president and CEO of the Center for Black Equity.
Importing Drugs Endangers Lives
On most issues, Democrats and Republicans remain deeply divided. But there’s one policy that unites both parties — prescription drug importation.
Earlier this year, the Trump administration issued an executive order enabling states and individuals to import cheaper medications from foreign countries. The Biden camp has similarly voiced support for allowing Americans to buy drugs from Canada.
Both parties have good intentions. Making medicines more affordable for patients is a goal nearly everyone shares. But importation isn’t the right solution. It would expose millions of Americans to potentially counterfeit medications while offering few, if any, actual savings.
The FDA’s drug approval process is the gold standard in ensuring that medicines are safe and effective. But imported drugs wouldn’t go through that process — the FDA lacks the resources to subject them to the same rigorous scrutiny. And while there are plenty of legitimate online pharmacies in Canada, there are also plenty of scammers looking to make an easy buck by shipping bottles of fake pills to vulnerable Americans.
That’s why four former FDA commissioners sent a letter to Congress highlighting the dangers of circumventing our nation’s drug supply chain, which is currently the safest in the world. They warned that importing drugs would “harm patients and consumers and compromise the carefully constructed system that guards the safety of our nation’s medical products.”
Canadian health officials agree that importation could endanger American patients. They’ve previously warned that Canada will “not assure that products being sold to U.S. citizens are safe, effective, and of high quality.” The FDA itself openly states that it “cannot ensure the safety and effectiveness of drugs that it has not approved.”
This lack of oversight means that many “Canadian drugs,” which often originate in other countries and are merely shipped through Canada, are adulterated. One FDA study found that 85 percent of confiscated drugs that were supposedly imported from Canada were actually manufactured in 27 other countries. Of those drugs, many didn’t include English instructions, and some were counterfeits.
Counterfeit drugs pose a significant danger to patients here in the United States, especially the most vulnerable populations. Sixty percent of Americans suffer from chronic diseases that require regular adherence to medication. Communities of color, who suffer from chronic illness at higher rates than do white Americans, face even higher risks.
As someone who suffers from hypertension and Type 2 diabetes, I’m keenly aware of the perils of receiving counterfeit medicines. Over the years, some Americans have illegally imported medicines from what they thought were legitimate Canadian pharmacies, but the drugs turned out to have no active ingredients, or worse, contained toxic substances. If patients take ineffective drugs that amount to little more than sugar pills, their chronic conditions could spiral out of control.
Even if importation were completely safe — and it isn’t — it wouldn’t save Americans nearly as much money as proponents believe. That’s because Canada has no interest, and no ability, to act as America’s pharmacy.
There are simply too many American patients. Americans fill 4.5 billion prescriptions annually. Canada’s population is about 90 percent smaller than the U.S. population, so demand from the United States could overwhelm the Canadian drug market in just 38 days, according to one study. More than 1,500 drugs sit on Canada’s drug shortage list — the Canadian healthcare system hardly has the bandwidth to support billions of new requests from Americans.
That’s why Canadian patient groups have urged their leaders not to facilitate any large-scale drugs exports to the United States. And those leaders are listening. According to an internal briefing from the Canadian foreign ministry, Canada would “not support actions that could adversely affect the supply of prescription drugs in Canada.”
Drug importation, though well intentioned, is doomed to fail and could endanger many Americans’ health. It’s up to a Biden administration to reverse course and either rescind the Trump administration’s importation rule, or at the very least, instruct the FDA to not approve any state applications for importation programs.