Canada issued an interim order on Friday, November 27, preventing drug establishments from exporting products that would risk causing domestic shortages. The press release with quotes from Health Minister Patty Hajdu may be more digestible than the official order.

As I see it, Americans who rely on buying less expensive prescription drugs from Canada should not be too concerned about this new development. The order is directed at companies who distribute drugs via wholesale channels, not pharmacies that dispense drugs directly to patients. Patients in the U.S. with a valid prescription who safely order drugs from pharmacies in Canada do so through licensed retail pharmacies not wholesalers.

The order was issued prior to the final rule in the U.S. allowing wholesale importation of lower cost drugs from Canada under what’s known as Section 804, which became effective November 30. States and other non-federal entities will need approval from the Secretary of Health and Human Services in order for any wholesale drug importation to commence under the new rule. Over the last year or so, Canada has expressed concerns about the Trump administration’s policies, fearing that larger scale wholesale drug importation from the U.S. could cause shortages. Canadian officials site the fact that the U.S. population is far larger. The U.S. has 329 million compared to Canada’s 38 million people. In any case, nothing has changed as of yet because Section 804 imports have not begun.

Drug shortages are a problem in many countries, Canada and the U.S. included. For information about drug shortages in the U.S. see: https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages; in Canada, see: https://www.drugshortagescanada.ca/.

The order states that a drug establishment may only distribute drugs for consumption outside of Canada if it “has reasonable grounds to believe that the distribution will not cause or exacerbate a shortage of the drug.” It also mandates new reporting requirements for those establishments that export drugs.

Canada has the right and obligation to protect its citizens from drug shortages. Its actions are understandable, if not commendable. However, Canada’s efforts do not mean that new initiatives on drug importation to lower prices in the U.S. will fail. It means that when wholesale importation commences through the new Section 804 channels, they must not cause shortages in Canada. It’s unknown at this time which specific products might be affected and the new order by Canada doesn’t mention any.

Licensed pharmacies in Canada that dispense prescription drugs to patients in the U.S. play an important role in helping Americans access treatments that are otherwise unaffordable. For the individual patients, that access is incredibly helpful, if not lifesaving. In the grand scheme of things, the personal drug importation market is too small to cause shortages in Canada. Furthermore, many “Canadian” online pharmacies partner with licensed pharmacies in other countries to fill prescription orders for Americans.

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