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Toronto Star

Drug supply 'crisis' feared;


Coalition warns against letting U.S. buy medications here, but federal health minister says there's no risk of shortages

by NICOLAAS VAN RIJN & ELAINE CAREY
Oct 17, 2004

New battle lines are being drawn in the cross-border battle over prescription drugs, with federal Health Minister Ujjal Dosanjh assuring Canadians that our drug supply is safe even as a coalition representing 10 million Canadian patients, seniors and pharmacists warns of "a potential crisis" fuelled by price-conscious Americans shopping for their drugs here.

Dosanjh, speaking in Vancouver yesterday, dismissed any threat from American consumers, describing it as "a domestic U.S. issue."

Conceding the issue "has an impact on us as a country and as provinces, and we are concerned about that," Dosanjh insisted the two primary Canadian concerns have been satisfied.

"One is the safety of Canadians, one is the supply of the drugs," Dosanjh said. "Both are safe at this point."

Not so, insists Louise Binder, chair of the Canadian Treatment Action Council, one member of the coalition of 14 Canadian organizations which is warning that continued American access to cheap Canadian drugs will cause shortages here.

"We strongly disagree," Binder said, rejecting Dosanjh's assurances. "We've seen plenty of warning signs in the system that point to a potential crisis."

The coalition has called a news conference for tomorrow to discuss its concerns.

"This is a very serious issue that has definite potential for involving our whole health-care system," said Denis Morrice, president of the Arthritis Society, a coalition member.

Other members include the Canadian Pharmacists Association, CARP--the Canadian Association for the Fifty-Plus, the Canadian Breast Cancer Network and the Canadian Hepatitis C Network.

The disagreement over prescription drugs comes amid new concerns that Canada keep an adequate supply of flu vaccine while the United States grapples with a massive shortage resulting from quality-control problems at a British manufacturing plant.

The twin issues of cheap Canadian prescription drugs and an inadequate U.S. domestic flu vaccine supply have taken on "hot button" status in the U.S. presidential race, with President George Bush suggesting in a televised election debate last Wednesday that a Vancouver-based vaccine manufacturer might be called in to help fill the American shortage. That suggestion was quickly shot down as being impractical by U.S. Health Secretary Tommy Thompson.

Senator John Kerry, the Democratic presidential candidate, has already pledged to help cut Americans' prescription drug costs by allowing them to import drugs from Canada; Bush opposes such a move until it is proven "safe."

Tens of thousands of Americans aren't waiting for their government's permission. Dozens arrived by train -- dubbed the Rx Express -- in Toronto last week, travelling from as far away as Miami in their quest for affordably priced prescription drugs.

Tens of thousands more are ordering drugs over the Internet, and now many Americans are beginning to flood the offices of border-area Canadian physicians with requests for flu vaccine.

Dr. Albert Schumacher, president of the Canadian Medical Association, said the American vaccine problem is just that -- an American problem.

"The vaccine shortage problem that they now have in the States or elsewhere in the world is not for us here to fix or sort out," Schumacher said.

And, he warned, Americans shouldn't look to Canada for a vaccine solution.

"The stuff that's sitting in my fridge isn't for them," he said flatly.

Because most of the vaccine available in Canada is purchased by provincial governments, authorities say it's not for sale, noting that government-purchased vaccine cannot be bought by non-residents.

The Ontario government bought 5.5 million flu shots for the coming season and is providing them free to any provincial resident -- including healthy adults -- who wants one. Ontario's universal program began in 2000-01 and is used annually by about 43 per cent of the population.

"The purpose of our program is to protect eligible Ontarians," said Dan Strasbourg, a spokesperson for the Ontario Ministry of Health.

To make sure it does, he added, photo identification and proof of address will be required from people seeking flu shots here.

Canadians spent $16 billion on prescription drugs last year -- one-sixth of all health-care spending -- and almost half of it was paid for by the public purse, according to the Canadian Institute for Health Information. Provincial health ministers have been trying to cut those costs by calling for a national pharmacare plan, but Dosanjh signalled in Vancouver that it isn't going to happen quickly.

Morrice, the Arthritis Society president, said Canada's health care system can't take the stress imposed by U.S. demands for cheap Canadian prescription drugs.

"Americans are cherry-picking on one item -- drugs -- but we have a whole health-care system," he said in an interview. "The implications are very, very serious. Everyone is starting to see just how serious this is except our own government," Morrice said.

It is the first time the groups have joined in a coalition to demand a halt to prescription drug export, he said.

"We're blowing a whistle here. It's got to stop."