Canada Must Ensure Stable Drug Supply Following Florida Ruling

Recently, the U.S. Food & Drug Administration authorized Florida’s Agency for Health Care Administration to be allowed to import drugs from Canada as a way to reduce costs and improve accessibility in that state. This move follows the passing of Florida bill CS/HB 19 in 2019, signed by Republican Governor Ron DeSantis. Florida believes it can save $180 million USD annually by purchasing common drugs for diabetes, hepatitis, prostate cancer, and other ailments, from Canada. A Rand Corporation study from 2021 paints a grim picture of the cost of drugs in the U.S. They spend more on drugs than literally any other comparable nation, with American drugs costing an average of 218 percent more than Canadian drugs.

While Canada has a significant number of regulations to safeguard our drug supply, it’s important that we resist exporting them unless we can guarantee a stable stock for our own citizens. There is a legitimate concern about the potential for drug shortages in Canada should we start bulk exporting drugs to the U.S. Drug shortages are not uncommon, and they can have a real impact on the health of Canadians. Many parents will remember the difficulty purchasing children’s pain and fever medication last year. A recent shortage of Lenoltec No. 4, the generic version of Tylenol 4, lasted several months this year. EpiPens have also had challenges with shortages in recent years. The Type 2 diabetes drug Ozempic, which has been used both for its intended purpose, and off-label for weight loss, has been in very short supply for months, to the extent that the B.C. government has had to limit refills to one-month supplies to ensure accessibility.

The cost of drugs in the U.S. has long been a significant problem. The U.S. is an exceptional nation in that they allow drug companies to set the prices for drugs, and those drugs are negotiated to their given price point by insurance companies. Canada limits the price of drugs for its citizens, and like most other developed nations, bulk purchases drugs to keep costs as low as possible.

There will almost certainly be legal challenges to the FDAs ruling in the coming weeks and months in the U.S. The American pharmaceutical lobby is, to put it mildly, massive, and will likely pull out all of the legal stops to prevent cheap drugs imported from Canada to reduce drug costs domestically. However, it’s incumbent on the Government of Canada to continue to limit the sale of drugs to the U.S. if it has any effect on our own people.

Trade groups such as Innovative Medicines Canada have also voiced concerns about selling Canadian drugs to the U.S., noting that the U.S. has a market about 10 times as large as Canada, and allowing our drugs to be purchased by Florida or any other state would have serious implications for our own drug accessibility. It is noted that the Health Minister, in discussing the new import rules in Florida, stated “There is no way we will allow any jurisdiction, be it a state or another foreign jurisdiction, to endanger the Canadian drug supply. That is not an appropriate solution to whatever challenges they may be facing.”

Fortunately, we do have decent regulations that would prevent our drug supply from bulk importations that could worsen drug shortages. However, this is not to say that future governments won’t be tempted to change regulations to allow our drugs to be exported, and this is an area where we need to push back.

As we prepare to look at the details of the upcoming National Pharmacare Program in the coming months, we must keep an eye on the details and push to ensure that the program is set up in such a way to ensure accessibility throughout the country. It’s vital that the plan include measures to protect Canada’s supply of critical drugs. One area where Canada could innovate would be through the public manufacturing of critical medicines and vaccines. This would ensure a reliable supply of medicines, lower drug costs and increase availability of innovative medicines for patients.