Potential impact of U.S. demand on the Canadian supply of 46 prescription drugs.

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Summary

Brett J Skinner, Ph.D. Founder and CEO of Canadian Health Policy Institute (CHPI); Editor Canadian Health Policy.

Canadian Health Policy, September 2019. ISSN 2562-9492

Abstract

Canadian prices for patented medicines are regulated and are lower than American market prices on average, creating an incentive for Americans to import prescription drugs that were intended to be sold to Canadians. Importation on a commercial scale has not been allowed due to concerns of the U.S. FDA about the safety and effectiveness of products sold through foreign resale channels.  Recent policy changes in the U.S. have introduced legal pathways allowing commercial scale importation of prescription drugs. This study estimates the impact that U.S. importation will have on the Canadian supply of a sample of medicines that are likely to be targets for purchase by American states, wholesalers and pharmacists. The purpose is to gauge the urgency of the threat that U.S. importation poses for the Canadian drug supply and to examine how this may affect specific patient populations differently. The analysis shows that the Canadian drug supply cannot sustain increased demand from full-scale U.S. importation.  Most of the drugs studied would have their total Canadian supply exhausted in less than 3 months. Half the molecules would have been exhausted in just over 1 month and many would have lasted less than 2 weeks. The potentially rapid depletion of the Canadian drug supply from U.S. importation puts the onus on Canada’s federal government to act pre-emptively to prevent events from moving faster than the legislative or regulatory process can respond.

References 

1. Patented Medicine Prices Review Board (PMPRB). 2017 Annual Report.

2. U.S. Food and Drug administration (FDA). Importations of Drugs. United States Federal Food, Drug, and Cosmetic Act (Act) (21 U.S.C. section 331). https://www.fda.gov/industry/import-program-food-and-drug-administrationfda/importations-drugs.

3. U.S. Department of Health and Human Services (HHS). Media release: HHS Announces New Action Plan to Lay Foundation for Safe Importation of Certain Prescription Drugs. July 31, 2019. https://www.hhs.gov/about/news/2019/07/31/hhs-new-action-plan-foundation-safe-importation-certain-prescriptiondrugs.html.

4. U.S. Department of Health and Human Services (HHS) and the U.S. Food and Drug Administration (FDA). Safe Importation Action Plan. https://www.hhs.gov/sites/default/files/safe-importation-action-plan.pdf.

5. Improving Access to Affordable Prescription Drugs Act, H 1776, 115th Cong, 1st Sess (2017-1018). Affordable and Safe Prescription Drug Importation Act, H 1245, 115th Cong, 1st Sess (2017-1018). Affordable and Safe Prescription Drug Importation Act, S 469, 115th Cong, 1st Sess (2017-1018).

6. National Academy for State Health Policy (NASHP). State Legislative Action to Lower Pharmaceutical Costs. Updated Aug. 1, 2019. State Prescription Drug Legislative Tracker 2019. https://nashp.org/rx-legislative-tracker-2019/.

7. Alliance for Safe Online Pharmacies Canada. July 25, 2019. Letter to The Hon. Ginette Petitpas Taylor, Minister of Health.

8. Shepherd M (2018) U.S. Drug Importation: Impact on Canada’s Prescription Drug Supply. Health Econ Outcome Res Open Access 4: 146.

9. Shepherd M. The Effect of U.S. Pharmaceutical Drug Importation on the Canadian Pharmaceutical Supply. Canadian Pharmaceutical Journal, Vol 143, No.5, September/October 2010, 226-232.

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