Imported Canada drugs illegal, but often allowed

Jan. 19--He may have been defeated for the Democratic presidential nomination last year, but Sen. Bernie Sanders, I-Vermont, got back into the health care headlines a few days ago, offering the U.S. Senate a spectacular opportunity to disappoint Americans of all political stripes.

Jointly with Amy Klobuchar, D-Minn., Sanders introduced an amendment to the Republicans' budget resolution to begin pulling planks out of the Affordable Care Act, or "Obamacare." The amendment called for the legal importation of drugs from Canada by American patients and pharmacies.

The amendment went to a vote Jan. 11, and a dozen Republicans senators -- including Ted Cruz, John McCain and Rand Paul -- voted in favor. But the measure still died because 13 Democrats broke ranks and voted against it. The vote was 52-46 to kill the amendment.

Among the Democrats saying nay was Sen. Cory Booker, D-N.J. His vote immediately dissolved the capital he built among the left with his unvarnished words toward Sen. Jeff Sessions, R-Ala., during Sessions' confirmation hearing for attorney general. It was revealed that Booker and several others voting against the amendment received significant campaign support from pharmaceutical companies.

Booker's defense of his vote was identical to all arguments against importing prescription medications: It is unsafe. He said the Sanders-Klobuchar amendment contained no language to ensure "consumer protections that ensure foreign drugs meet American safety standards."

"We are all under the guidelines of the Food and Drug Administration," said Dr. James Myers, pharmacist for the NeoHealth Pharmacy in Hulbert. "The FDA can't approve drugs outside the U.S. -- only within. That's where the problem lies."

Though the Sanders-Klobuchar measure called for legal import for pharmacies, Myers said he believes legality might not be enough.

"As a licensed agency, we would not be able to do that," he said. "There is a reason for FDA approval in that it protects the consumer of final user of the medication. They guarantee the drug is what it says. If individuals want to buy drugs from Canada, there is probably no way to stop them, but buyer beware."

Dr. Shanon Gower, pharmacist for Cox Pharmacy, was not optimistic that a drug import measure would pass anytime soon.

"There would need to be oversight on both sides of the border that agreed on the same safety standards," Gower said. "There is no easy fix. There would still be people who can't afford their prescriptions."

Most developed western countries have socialized their health care to some degree. A Harvard Medical School report gathering data between 2005-'16 noted that, normally, pharmaceutical companies must negotiate drug prices with a government agency. If the agency believes the price is too high, coverage will not be offered for the drug in the respective nation. Nothing of the sort happens in the U.S., resulting in a captive, comparatively wealthy public that can be made to lay golden eggs for life-saving drugs.

The study also pointed to drug patents that sometimes last 20 years, tricks such as changing pill coatings to extend patents, and "pay for delay" settlements to generic drug companies to defuse lawsuits. The study said brand-name drug prices drop 55 percent when two generics are available, and drop by two-thirds when five generics are on the market, but the FDA can take up to four years to approve generics once patents expire.

Pharmaceutical companies often cite research and development expenses as a factor in drug costs, but the Harvard report expressed some skepticism. It stated that most new drugs arise from R&D funded by federal grants from the National Institutes of Health, or from private investment. Many new drugs are discovered in the laboratories of the nation's university medical schools. The Harvard authors suggested the true prescription drug price factor was the highest cost patients -- and their insurance companies -- would tolerate.

Thousands of Americans already buy their medications from Canadian pharmacies, which is illegal, but the U.S. focuses its resources on the interception of large shipments of legal or illegal drugs rather than a senior citizen trying to save money on a few prescriptions.

Under the Prescription Drug Marketing Act of 1987, only the original manufacturer can bring prescription drugs into the U.S. However, the policy of enforcement is discretion when prescriptions are filled in Canada. When border enforcement catches an American returning with no more than three months worth of pills prescribed in his name, usually nothing is done.

Gower was not surprised by the tolerance of federal authorities for small amounts of prescription drugs entering the U.S. from Canada.

"They are watching for terrorism and large shipments of illegal narcotics," she said. "I also think federal agencies and customs understand there is a problem with people being able to afford their medications. If someone is driving to Canada to buy their blood pressure and heart medications, who are they to deny those people the right to live?"

Online, ordering prescriptions from Canada is also illegal, technically. However, if customs inspectors find a 90-day supply of legitimate prescriptions entering the U.S., they generally let them through.

But ordering drugs online has inherent risks, and Myers' warning carries weight. The National Association of Boards of Pharmacy, which accredits online drugstores, reviewed 8,300 online pharmacies in July 2011 and found just 3 percent to be fully licensed and legitimate. Furthermore, it found some sites claiming to represent Canadian drugstores were housed far from North America.

Buying prescriptions online requires diligent research. The FDA warns that online pharmacies might not be in the U.S. or Canada, or pharmacies at all. They may fail to protect personal information or give improper diagnoses. Common complaints of online medications are that they are of improper strength, counterfeit, expired, or wrongly labeled or stored.

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