Therapeutic Dose: Canada and the Blame Game

GlaxoSmithKline and Pfizer were the first to do it, a year ago. A few weeks ago, Merck joined in, becoming the most recent of seven major pharmaceuticals to stop drug shipments to Canada-based pharmacies that have been selling online, and reimporting, drugs back into the U.S. Pfizer, Merck and the others claim their measures are protecting gullible consumers from risky rip-offs. There is something to that, but protecting profit margins in the U.S. market is the greater motive.There is some evidence that the tactic is paying off, as news reports last year had several Canadian online pharmacies laying workers off. And the Canadian government has made noises about reining in its renegade pharmacies or even stopping shipments to the U.S. altogether.These are Pyrrhic victories, though. The Chicago Tribune recently reported that those websites have taken their mission beyond Canada, setting up cyber shops in the U.K., Australia, Israel and elsewhere in order to circumvent the Big Pharma ban. Canadameds.com is advertising, “You choose the country and you choose the savings.”Besides, chasing rogue pharmacies across the globe is not the way to go. Whatever the reality is in this case, the perception of Big Pharma as bully will again win out. It doesn’t help that conspiracy theories arguing collusion on the part of these seven are taking root, or that people like Minnesota Attorney General Mike Hatch are starting to sue because of it.The whole situation is reminiscent of drug firms’ initial dig-in-their-heels resistance to providing HIV/AIDS medications to third world countries at cost. It was a losing fight to begin with, and the wrong thing to do. Not that a solution has come for HIV in the developing world, but at least major pharmaceuticals have become proactive in the fight against the AIDS pandemic.The reimportation snowball is gaining momentum. And it’s not just voices from the fringe doing the pushing anymore. State governors and attorneys general are behind it. The AMA is, too, if three conditions are met:

• products meet FDA standards
  
  
• the distribution chain is “closed” and verified by legitimate track and trace technology
  
  
• Congress allocates more resources and authority to FDA to ensure supply chain security and drug authenticity.

The first condition goes without saying, the third is out of our control. The second is where drug companies can get proactive. While RFID may not be ready (or cheap enough) for prime time just yet, it is on its way. And it has a host of other technologies to complement it. Track and trace is a clear answer to the reimportation debate. Let’s not get diverted. There is important work to be done.