Friday, December 05, 2008

Americans: Corporate victims or pharmaceutical leeches?

Over at AmericaBlog, John Aravosis blogs about his previously-discussed respiratory condition:

I want your input. Are drugs from Canada safe or not?

... I'm writing this post to find out if online Canadian pharmacies, where the drugs are a LOT cheaper than in US online pharmacies, are safe. Some examples in US dollars of US drugs and Canadian generics (I'm not necessarily taking any of these, these are just examples of popular drugs):

Vytorin 10/20, 30 pills (US): $108.62 (90 pills, $308.81) $67.34 (90 pills, $184.02)

Advair 60 500-50 $271.97 $117.60

Lipitor, 20 mg, 30 pills $119.99 $47.08

Nexium, 40mg, 30 pi
lls $154.99 $73.31

Which inspires me to ask -- is anyone else getting tired of Americans (who, as a country, can't get their shit together regarding decent, affordable health care) using us as a source of cheap pharmaceuticals? Perhaps I'm out of line here, but it gets a little tedious to be slagged perpetually and relentlessly as "socialist" by numerous (right-wing) Americans who, as soon as the medical emergency hits, are the first ones Googling for "Canada cheap drugs mail-order."

Am I just being overly persnickety? Or is it really time for Americans to stop leeching off of us for cheap drugs and get their shit together?

P.S. I'm going to email John and point him here, so if you plan on commenting, let's be informative for our American readers.

P.P.S. Just to be clear, I am in no way accusing John of being one of those hypocritical whiners. Regular readers here will be well aware that we at CC HQ are avid readers of John's blog. The point here is a more general one -- should Canada continue acting as a source of cheap drugs for Americans?


CanuckRover said...

I don't care what they say about us as long as they keep sending their money.

Cameron Campbell said...

1) Whole sale sales of drugs to the US could overwhelm the capacity of our local manufactures to keep up which could, in theory, lead to shortages/price increases here.

2) I agree the bitching and moaning and then buying drugs from us is annoying.

3) Generics companies, while they do employe people here, don't employe much in the way of researchers. Those are the high paying jobs that then trickle down and create the need for more manufacturing jobs than just the generics. C22 was supposed to spur this on. I note that many of these research jobs have moved south or have dried up as the US parent companies screwed up their product pipeline.

All of this to say, as much as I'm a big fan of taking money from people who can't get their house in order, I don't want to screw up ours to get that money.

wv: "fessive".. a french word meaning "of the ass"

Ti-Guy said...

You know, the last time this flared up, there was one argument that was sensible from a public health care perspective, but damned if I can remember it. It might have been because this practise undermines the provinces' ability to negotiate the deals that give us the cheaper medication to begin with, but I'm not sure.

I don't think there's anything particularly admirable about Canadian pharmacies doing volume business because Americans are getting fleeced, but I've got compassion fatigue.

The only thing I am tired of is the implication that the drugs here wouldn't be safe. What do they think this is, Mexico?

Noni Mausa said...

Considering many (most?) of the drugs we sell south are made by the same factories that make them for sale in US pharmacies, this fear of Canadian drugs being unsafe always annoys me.


Southern Quebec said...

I think it's the US legislators that are using the fear tactic. The same legislators that receive money from the US drug lobby. If the drugs here were bad, we'd all be dropping like flys...

liberal supporter said...

Of course it's FUD.

"some of the brown acid is bad, man"

KEvron said...

back in the day, these were ubiquitous in the south.


Shannon said...

It's hypocritical, no doubt, but so is it if I want to jump a queue here and go get some immediate surgery in the US (at considerable cost of course). On principle, I'd say, let 'em.

However, practically speaking, can our pharmacies keep up with their demand and ours too? I want our pharmacies giving us first dibs! I don't want to find out there's a Ritalin shortage here because the US is gobbling it all up.

The implication that it's not safe is fair, ridiculous as it sounds, because how can any of those numbnuts know they're ordering from a legitimate pharmacy, and not some asswipe selling knockoffs on the cheap? Now, if they're coming across the border and ordering them at a pharmacy personally, no, it's stupid to whine and bitch about the possibility of unsafe drugs.

Also, I think we should bump up the cost for out of country orders. Fleece 'em a bit. But that's just me being mean. :)

Chimera said...

Strictly from the viewpoint of the safety issue, the only real differnce between American-made drugs and Canadian-made drugs is the inert ingredients. Which may or may not cause problems for someone with a sensitivity to those ingredients. But that's the only difference. The active ingredients are the same in both countries.

Why the difference in price? I'm not sure, but Canada has laws (at least, we used to; I haven't checked lately) that prohibit a profit on prescription drugs. Pharmacies have to sell the drugs to the consumer at the same price they pay for them from the manufacturer. It's only in the dispensing fee that pharmacies are allowed to make money on them.

roblaw said...

Ok.. well, firstly, here's something to chew on. In Canada, we pay perhaps 70% more for the same drugs than most countries in the world. We happen to pay less than the U.S... so that makes us smug.. but government price fixing and restriction on generic drug access to Canada creates a situation where we actually are paying quite a bit.

The U.S. pays more - partly becuase they can.. the average standard of living in the U.S. is about 20 - 30% higher than in Canada.. so they can pay more.

Further - there is much more extensive advertising and more expensive litigation in the U.S. - both of which contribute to higher costs..

Should we care? I don't see why.. unless the government is actually paying for production, why should they at one time a) limit the price you can charge for your product, and b) also limit WHO you can sell it to.. seems slightly..uh.. socialist.. to me.

Besides which.. are we really looking to i.d. people to determine their country of origin before they can buy drugs?

Noni Mausa said...

I'm not sure, but Canada has laws (at least, we used to; I haven't checked lately) that prohibit a profit on prescription drugs.

Not quite. Health Canada sets the prices of prescription drugs in Canada, but a profit element is present -- otherwise we wouldn't be much of a market, would we?

Since the difference in price can be 2 or 3x, that sort of shows you how much profit they are raking in from Americans. Did you know Medicare Part D was forbidden to negotiate for lower drug prices? Some interesting details on how that happened, here:


Noni Mausa said...

Further - there is much more extensive advertising and more expensive litigation in the U.S. - both of which contribute to higher costs.

"The United States and New Zealand are the only developed countries that permit direct-to-consumer advertising (DTCA) of prescription drugs. Average American television viewers see as many as 16 hours of prescription drug advertisements (ads) per year, far exceeding the average time spent with a primary care physician.[1] Since the Food and Drug Administration (FDA) relaxed DTCA regulations in 1997, a polarized debate around the practice has ensued...

...We found that DTCA often attempts to persuade viewers on grounds other than rational consideration of medical costs and benefits. Our findings suggest the need to reconsider the distinction between selling soap or other consumer products and selling prescription drugs..."

Remainder of this long 2007 study here:

However, seeing that only two developed countries in the world allow DTCA might make us think twice about why that is.


liberal supporter said...

At least if it's considered illegal in the States, NAFTA can't force us to keep selling them generics if we run short...

The other way to avoid shortages is to make them all illegal. Seems the illegal drugs are always available for whoever wants them

Of course, wv=tabbles

liberal supporter said...

I think it is an urban legend, but supposedly in the old days in China you only paid the doctor when you are well, and didn't pay when you are sick.

I think DTCA is wrong for prescription drugs. They also saturation bomb physicians so they know what you are talking about when you burst into the office demanding a scrip for whatever the ad said to ask for. If they can advertise them, they should be able to sell them from behind the counter. Then you will find that despite half the ad being about side effects, they will not be protected from lawsuits by that. The current system lets them drum up demand from patients, frogmarch doctors into prescribing, then the doc and his insurance company are on the hook for the problems. That means the doc costs a lot more for the normal doctoring.

Wayne said...

I thought in 2006 prescription drug coverage was added to Medicare in the US, so fewer Americans had to look to Canada for drugs.

Also: Americans are worried about drugs and food from/made in other countries. We are painted with the same brush.

As long as there are no shortages of the drugs in Canada and it creates jobs in Canada, I have no problem with selling these drugs to the US.

Anne-Marie said...

There are shortages. That’s why you can find a public consultation paper from 2007 on Health Canada’s website, titled “Developing a Drug Supply Network and an Export Restriction Scheme”.

Back when Canadian Internet pharmacies were hot news, GlaxoSmithKline, AstraZeneca and Pfizer, speaking for the industry, vowed to squeeze the Canadian drug supply in order to preserve U.S. pricing. They did, and a St. John pharmacist told the L.A. Times in 2004 that his wholesaler reported difficulties sourcing 132 drugs, including insulin.

He wasn’t alone. A poll conducted for the Coalition for Manitoba Pharmacy in 2004, found 83% of non-Internet pharmacists reporting increasing drug shortages.

We came within a hair’s breadth in 2007 of seeing matching Senate (Bill S.242) and Congressional bills passed that would have legalized the bulk importation of Canadian pharmaceuticals into the U.S. The federal Health Minister was silent throughout. What saved us was the awesome influence of the U.S. pharmaceutical cartel.

The Fraser Institute weighed in that same year with the creative solution of raising Canadian drug prices high enough to remove the incentive to buy here.

Chimera said...

"Health Canada sets the prices of prescription drugs in Canada, but a profit element is present -- otherwise we wouldn't be much of a market, would we?"

I knew about HC's setting the price, but I'm not so sure it allows for a profit. Socialized medicine isn't supposed to be a commercial enterprise, after all.

Dispensing fees, though, are unregulated as far as I know. That's where the pharmacies make their money. And the manufacturer charges whatever it can get, too. It's just that if you were able to buy your drug directly from the manufacturer instead of going to the pharmacist, the actual price of the drugs would not change because the pharmacist is not allowed a markup on his drug costs.

But as I said, I know it used to be that way. It may have changed.

the rev. paperboy said...

Roblaw said "The U.S. pays more - partly becuase they can.. the average standard of living in the U.S. is about 20 - 30% higher than in Canada.. so they can pay more."

Yeah, i suppose a few Paris Hiltons balance out a lot of those poor bastards working two jobs and living in their cars. Sorry, but I have to call Total Bullshit on this one. On what possible basis could you make this claim? In comparision to Canada, the US has more crime, less available health care, poorer public education, an inferior public welfare system, far more poverty. Why do you think Vancouver always rates so highly in the Best Cities to Live In surveys? Why do you think Canada is regularly ahead of the United States in the UN's Best Countries to Live In index. Spit out the Kool Aid, Roblaw and quit making up statistics.

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