FRIDAY, Jan. 14, 2005 (HealthDayNews) -- Americans who stretch their budgets by purchasing lower-cost prescriptions from Canada could see those savings vanish.

Canadian health officials are considering measures to restrict that country's Internet pharmacy trade in the United States, a move that would force 1.8 million Americans to look elsewhere for lower-priced medications.

Several states and municipalities have established programs to help citizens gain access to lower-cost prescriptions from Canada. One program, I-SaveRx -- a four-state program initiated by Illinois -- also includes pharmacies in Great Britain and Ireland. Some believe a Canadian import ban would foster similar agreements with western European nations to supply U.S. consumers.

Canadian Health Minister Ujjal Dosanjh is expected to present a proposal to Prime Minister Paul Martin's cabinet in the coming weeks that may recommend prohibiting Canadian physicians from co-signing prescriptions for U.S. patients. It also may seek to forbid them from writing prescriptions for foreigners. Another option would be to ban specified drugs from being exported.

"All of those three proposals are going to be a nail in our coffin," said David MacKay, executive director of the Canadian International Pharmacy Association (CIPA), whose 36 pharmacy members engage in cross-border trade. "Each of those is a blatant attempt to kill the industry."

That imminent threat is compounded by the Bush administration's resistance to changing U.S. law to allow cheaper drug imports. A U.S. Health and Human Services (HHS) task force led by Surgeon General Richard Carmona recently concluded that it would be extraordinarily difficult and costly to create a legalized system of importing drugs for personal use that ensures the safety and effectiveness of those drugs.

Legalized importation would only save 1 percent to 2 percent of total drug spending, or roughly $2 billion to $4 billion a year, the report noted.

A separate report from the Department of Commerce concluded that government price controls used in other countries effectively squelch pharmaceutical research and development and inhibit generic competition.

The cross-border drug trade has become a sizable business in recent years, particularly as older Americans squeezed by prescription drug costs seek out for cheaper medicines. In 2003, almost 5 million shipments comprising 12 million prescription products worth about $700 million entered the United States from Canada via Internet sales, according to the HHS report.

So far, the U.S. government has allowed individuals to import drugs from foreign countries, even though it is technically illegal.

While relatively few Americans buy drugs from Canada, 73 percent of U.S. adults favor changing the law to allow individual imports, according to a post-election survey released this week by the Kaiser Family Foundation. Sixty-nine percent agree that the change would make medicines more affordable without sacrificing safety or quality, and 70 percent do not believe it would stymie research and development by U.S. drug companies. Drug firms have argued that price controls would cripple the research needed to bring new medicines to market.

Some politicians argue that importing drugs from Canada is unsafe, but the American public isn't buying it, explained Mollyann Brodie, a Kaiser Foundation vice president and director of public opinion and media research. "Those (arguments) aren't resonating with people."

If Canada were to halt drug exports to the United States, it could create an immediate crisis for the nearly 2 million individuals who cannot afford the medications they need in this country, some importation proponents speculate.

On the other hand, it could also put pressure on Congress to require Medicare to negotiate with pharmaceutical companies for discounts on medications -- something the current law, which takes effect next year, specifically forbids.

"Perhaps if the border is shut down, it's really going to force the question," said Sharon Treat, executive director of the National Legislative Association on Prescription Drug Prices, a bipartisan coalition of state lawmakers.

For now, U.S. officials and other importation critics urge Americans to try potential cost-saving opportunities in their own backyard. They include:

  • Find out whether your state offers a program to help cover or provide discounts on prescription medicines. These programs typically are geared to help people with low incomes who do not quality for Medicaid.
  • Many pharmaceutical manufacturers provide free or discounted medications to people who meet strict income requirements. The Pharmaceutical Research and Manufacturers of America and its member companies offer a Web site -- -- to help patients identify programs that best serve their needs.
  • Medicare beneficiaries who don't have drug coverage under Medicaid may quality for discounts under a program launched last June. For details, go to or call 1-800-Medicare.
  • People not eligible for Medicare may qualify for discounts under "Together Rx Access," a new program launched this week by 10 pharmaceutical companies.
  • Have your physician prescribe a generic equivalent to the brand-name product you are taking. Consumers could save $17 billion by switching to generics whenever possible, the HHS report indicated.

More information

Seniors and caregivers can search for drug discounts by visiting the National Council on the Aging.

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