Maine's proposal to bulk buy drugs from Canada not feasible, pharmacists say

The head of the New Brunswick Pharmacists' Association says Ottawa shouldn't allow a plan by some US states,including Maine, to bulk buy prescription drugs from Canada.

Paul Blanchard said the proposal would overwhelm an already strained system in Canada.

"We're 10 per cent of the American market here, right," Blanchard said.

"We don't have that supply to be able to feed, to supply the American market."

In late July, President Donald Trump told reporters his administration would allow individual states to seek approval to import prescription drugs from Canada.

Since then, Colorado, Florida, Vermont, and now Maine, have taken steps to do just that.

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One of the proponents of the plan in Maine is Trish Riley, the executive director of the National Academy for State Health Policy.

Riley said this is an effort to help reduce drug costs for the most vulnerable people in the state.

"A state would only import certain very high cost drugs, so this is not an effort to import all drugs for all people," she said. "Medicare beneficiaries, for example, already have drug benefits, by and large, Medicaid as well, so it would be for people who have difficulty paying for drugs."

Riley said the general model would see the state contracting with a Canadian wholesaler to buy certain drugs in bulk. That wouldn't include opiates or injectables.

But any plan would have to be approved by the federal government in Washington, including the Food and Drug Administration.

And that's not the only hurdle.

According to Blanchard, it is illegal for a Canadian wholesaler or pharmacy to export drugs to the U.S.

"If they do that, then they're putting at risk their licence to practise in Canada," Blanchard said.

That doesn't mean his organization isn't concerned.

"The country's pharmacists association has been talking to the federal government … to make sure that the federal government and Canada is aware that the Americans are literally knocking on our door."

Shortages already

"One out of four Canadians acknowledged last year that they were affected personally by a drug shortage," Blanchard said.

He cited blood pressure and cholesterol medications as a big issue in New Brunswick, along with important cancer-fighting drugs like tamoxifen.

"If we're allowing Americans to import drugs from Canada, then the shortages here will just increase," Blanchard said.

Blanchard also worries that big American pharmaceutical companies would refuse to ship drugs to Canada, if they knew they were being imported back into the U.S. at lower prices.

Most brand name drugs are cheaper in Canada because of something called the Patented Medicine Prices Review Board.

The independent board compares drug prices in countries around the world, then sets a maximum for Canada.

For Blanchard, the U.S. should import our system, not our drugs.

"If they want lower drug prices, they can just regulate them," he said, "And the problem with that is that the Americans don't like regulation, right?"

Health Canada gave a written response to CBC's request for an interview.

"Health Canada is engaging with a range of partners, including U.S. officials, to better understand the implications for Canadians of the U.S. proposal regarding bulk importation of prescription drugs and the potential impact on Canada's supply chain," it read.

"There have been no exchanges with the U.S. federal government regarding changes to Canadian laws in this area."

In August, Prime Minister Justin Trudeau promised to protect Canada's drug supply.

"We recognize the new situation brought on by American announcements and Health Canada will continue to ensure that our priority is always ensuring that Canadians have access to the medication they need at affordable prices," he said.