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Canada deals blow to cheap US drug imports...............


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Looks like one of Kerry's campaign promises might have hit a wall:

http://news.ft.com/cms/s/1138adf6-2076-11d9-af19-00000e2511c8.html

Canada deals blow to cheap US drug imports

By Bernard Simon in Toronto

Published: October 17 2004 21:47 | Last updated: October 17 2004 21:47

More than 30 Canadian internet pharmacies have decided not to accept bulk orders of prescription drugs from US states and municipalities.

The move delivers a potentially serious setback to US politicians most notably Democratic presidential candidate John Kerry campaigning to give Americans easier access to cheap drugs from Canada.

Mr Kerry has argued that opening the US to Canadian imports could help lower the costs of prescription drugs for elderly Americans. Such reimportation has become one of the points of difference between him and President George W. Bush during the election campaign.

But growing concern in Canada that growing exports to the US could lead to rising prices and shortages north of the border has prompted the Canadian International Pharmacy Association (Cipa), whose members include several of the biggest internet and mail-order drugstores, to act. “We don't want to give Americans the impression that we have unlimited supply for them to tap into on a commercial basis,” said David Mackay, the association's executive director. Americans, he added, “can't get everything from Canada. We can't be your complete drugstore”.

Prescription drug prices are significantly lower in Canada than the US, because of price controls and bulk buying by the 10 provinces. Individual Americans have crossed the border for years to buy cheap medicines, but the internet and spiralling healthcare costs in the US have led to a wider movement for states and cities to sourcethe drugs they need from Canada. Several states, such as Minnesota and New Hampshire, have set up websites directing residents to approved pharmacies in Canada. Cipa members would continue to service these customers, Mr Mackay said, but would not deal with states such as Illinois and Wisconsin that have proposed turning over their entire supply system to a Canadian internet pharmacy.

Cipa members make up about a quarter of the roughly 150 internet pharmacies operating in Canada, raising the question whether others will follow its lead. Mr Mackay said discussion had been heated at an all-day meeting of Cipa last month at which the new policy was approved. With pharmaceutical manufacturers seeking to restrict supplies and the US Congressional Budget Office recently saying that reimportation from Canada would have a “negligible” impact on US drugs spending, the internet pharmacies have already had difficulty meeting demand from south of the border.

Several have set up alliances with pharmacies in other countries. A sharp rise in the Canadian dollar has also squeezed profits.

Ujjal Dosanjh, Canada's health minister, said over the weekend that he was not concerned “at this point” either about domestic shortages or the safety of Canadian medicines.

Still, public opinion appears to be gradually turning against the online operators. Canadian Treatment Action Council, a lobby group representing pharmacists and patients, is due to speak out today against drug exports to the US.

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This whole thing is just incredible. Canada is the one importing the drugs... FROM US. We would be simply REimporting them. All we have to do, to reduce the price of prescription drugs, is to institute our own socialist price controls. Do we want to do that?

If we did so, the drug companies would be forced to withdraw their drugs from foreign markets because they could no longer count on the US market subsidizing the industry.

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Originally posted by chiefhogskin48

This whole thing is just incredible. Canada is the one importing the drugs... FROM US. We would be simply REimporting them. All we have to do, to reduce the price of prescription drugs, is to institute our own socialist price controls. Do we want to do that?

If we did so, the drug companies would be forced to withdraw their drugs from foreign markets because they could no longer count on the US market subsidizing the industry.

That's what we should do....

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Importing from Canada is not going to solve the cost problem. As a matter of fact, it will most likely aggravate it. It is a short sighted and pathetic approach.

Moreover, the approach the Canadians and many European countries take to paying for their pharmaceuticals is morally reprehensible.

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Originally posted by terpskins

Importing from Canada is not going to solve the cost problem. As a matter of fact, it will most likely aggravate it. It is a short sighted and pathetic approach.

Moreover, the approach the Canadians and many European countries take to paying for their pharmaceuticals is morally reprehensible.

http://www.cbc.ca/news/background/drugs/

Why so cheap?

There are several factors that make drug prices lower in Canada than in the U.S.

Perhaps the most obvious is the exchange rate. For the last few years the Canadian dollar has hovered between 60 and 70 cents, giving Americans more bang for their greenback.

Another reason is the fact that Canadian drug companies are not allowed to market their products directly to consumers. That's a substantial savings not realized south of the border, where so-called direct-to-consumer marketing has been allowed since 1997. According to the Pharmaceutical Research and Manufacturers of America, drug companies spent almost $3 billion on direct-to-consumer advertising – a price that gets passed on to the consumer.

But the biggest reason for the price disparity is the existence of drug price controls in Canada. The Patented Medicine Prices Review Board, a quasi-judicial body of the government created in 1987, reviews pharmaceutical prices and enacts caps for patented drugs and medicines prices.

http://www.chiroweb.com/archives/21/25/12.html

Why Are U.S. Drug Prices So High?

--------------------------------------------------------------------------------

It's no secret that average costs of prescription drugs have risen dramatically in the past decade. According to the Kaiser Family Foundation, average retail prices for brand-name drugs in the United States more than doubled between 1990 and 2000, from $27 in 1990 to $65 in 2000. The obvious question is: Why?

In August 1997, the Food and Drug Administration (FDA) changed its policy on radio and television advertising with regard to pharmaceuticals. Previously, while drug makers were allowed to advertise their products, they were required to include a long list of side-effects and potential problems associated with each drug. The new revisions allowed companies to explain their products' explicit purposes on commercials and tout their benefits, and required them to include information only on the drugs' main risks, not all known side-effects. If a consumer wanted to know more about a particular drug, the manufacturer simply had to include a toll-free phone number or Internet address in the ad.

The amount of money that has been spent promoting drugs since the new FDA regulations went into effect is staggering. In 1996, the drug industry spent $791 million on mass media advertising. Four years later, that number more than tripled to $2.5 billion. All told, the U.S. drug industry spent $15.7 billion on advertising in 2000, from running ads in trade journals, to airing commercials on the radio and television, to handing out free samples of new products to doctors.

A report released by the National Institute for Health Care Management in 2001 highlighted the effect drug advertising has had on the way U.S. health care providers and patients choose which drugs to take or prescribe. Between 1999 and 2000, retail spending on prescription drugs increased almost $21 billion. Of the approximately 9,000 drugs on the market at that time, the 50 most heavily advertised drugs accounted for 47.8 percent of the spending increase. A similar report published by the Kaiser Family Foundation found that while average drug prices in the U.S. increased every year throughout the 1990s, they increased at a higher rate once the FDA relaxed its rules on advertising. From 1990 to 1996, the average retail prescription price rose 8.1 percent per year. From 1997 to 2000, however, prices increased by an average of 9.7 percent, and the biggest single-year increase (13.3 percent) occurred between 1998 and 1999, when the U.S. drug industry implemented a series of large-scale marketing campaigns for new drugs.

Drug Prices, United States vs. Canada

(Figures converted to U.S. dollars)

Drug (condition) U.S. Canada

Mirapex (Parkinson's disease) $ 263 $ 157

Celexa (depression) $ 253 $ 149

Diovan (high blood pressure) $ 253 $ 149

Oxazepam (insomnia) $ 70 $ 13

Seroquel (insomnia) $ 124 $ 33

Campath (cancer) $ 2,400 $ 660

The most heavily advertised drug in the U.S. in 2000 was Vioxx, used to treat arthritis. Merck, Vioxx's manufacturer, spent $161 million promoting the drug; not surprisingly, the sales of Vioxx quadrupled, reaching a record $1.52 billion in 2000 alone. Retail sales of all prescription drugs in 2000 totaled more than $131 billion, making pharmaceuticals the most profitable U.S. industry that year.

While drug costs in the United States continue to spiral out of control, other countries have adopted policies to keep prices in check. One nation leading the way in price regulation is Canada, which had the second-highest average price for pharmaceuticals until 1987. Passage of the Patent Act that year established an organization known as the Patented Medicine Prices Review Board (PMPRB), which was charged with overseeing the prices of all patent drugs sold in the country. Since then, average prices for patented medicine have risen less than 1 percent per year - far less than the increases seen in the U.S. over the same time.

The PMPRB ensures that the prices of patented drugs are not excessive by controlling introductory drug prices. Specifically, it sets guidelines and reviews drug prices; tracks the price trends of patented drugs and the research and development investments made by pharmaceutical companies; and helps to inform and educate the general public about drug prices. Prices of non-patented drugs (such as generics) are not regulated by the PMPRB.

Before a patent drug can be sold in Canada, a pharmaceutical company submits the price of the drug to the board for review. The board uses several tests to determine whether the cost is excessive, including the Reasonable Relationship Test, which considers the association between the strength and price of a medicine in the same or comparable dosages; the Therapeutic Class Comparison Test, which compares the prices of drugs with those that are clinically equivalent and are sold in the same markets at prices the PMPRB considers not excessive; the International Price Comparison Test, which compares the average transaction price with the publicly available transaction prices of the same medicine sold in seven other countries (France, Germany, Italy, Sweden, Switzerland, the United Kingdom and the United States); and the measurement in change of the consumer price index (CPI) over a specific period of time, which compares the average price of a drug with the CPI-adjusted price.

If the price of a drug is found to be too high, a public hearing is held. After the public hearing, if the board finds that the price of the drug is indeed excessive, it may order the company that produces the drug to lower the price, or take other action. Usually, however, drug companies will lower the price of their product on a voluntary basis.

According to Dr. Allen Detsky, a pharmacoeconomist at the University of Toronto, the PMPRB has saved Canadians untold millions in drug costs over the years: "They look at the price of the drug, and they say, 'You know what? We have no idea what the long-run costs of development are, but they can't possibly be that high,'" Detsky said. And since American drug companies continue to sell their products in Canada despite the board's limitations, "It tells you that the true long-run cost of production must be way lower than the American price."

So, isn't it about time for caps on what pharmaceutical companies can charge U.S. consumers for drugs? How is it that chiropractic is being blamed for the high cost of health care, when it should be obvious that the price of drugs in the U.S. is the real culprit? And more importantly, isn't it time for more serious consideration of chiropractic and other nonpharmaceutical options for ensuring patients' wellness, particularly considering the high costs of some of these drugs?

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That's reprehensible to you?

You need to take a good long hard look in the mirror.

You're being raped by American companies given your free market capitalistic approach.

I'd think with all the homeristic patriotism I see around here.... you'd be praising the opportunistic businessmen.

Why control a market in the best interest of society? That'd be like socialism or something. Certainly nothing good can come of any example of anything outside of your border.

And since when is healthcare a god given right in the U.S.?

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Originally posted by Die Hard

That's reprehensible to you?

You need to take a good long hard look in the mirror.

You're being raped by American companies given your free market capitalistic approach.

I'd think with all the homeristic patriotism I see around here.... you'd be praising the opportunistic businessmen.

Why control a market in the best interest of society? That'd be like socialism or something. Certainly nothing good can come of any example of anything outside of your border.

And since when is healthcare a god given right in the U.S.?

Yes it is reprehensible. And not because I'm some homeristic patriot. Nor because I'm free market capitalistic freak. Of course, you might want to know me a little better before throwing around adjectives and presumptions. But, of course, to each his own.

The fact of the matter is that their is a real reason drugs cost as much as they do. It's called research and development. Companies invest billions of dollars to produce better drugs and need to make that money back and then some.

Yes. It is morally reprehensible for other developed nations to reap the benefit of drugs that we, as Americans, pay for development of. It is one thing, to provide health care nations that cannot afford any better. That humanitarianism and I'm for it. It is completely another thing for developed nations with a relatively high standard of living to mooch off of us.

As to your point about direct marketing...penny wise, pound foolish. I agree with you that it is a poor practice. But, in the grand scheme of things, it is a minor part of the contributing costs.

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Originally posted by terpskins

Yes. It is morally reprehensible for other developed nations to reap the benefit of drugs that we, as Americans, pay for development of. It is one thing, to provide health care nations that cannot afford any better. That humanitarianism and I'm for it.

It's awfully nice of you to empathize with drug companies for selling drugs to foreign nations at a loss.

That's awfully humanitarian of those companies.

The next time you don't pay full market value or an overpriced consumer product.... I hope someone tells you what a morally reprehensible character you are.

In fact, I happen to see a MAKE A DONATION button right under your username.

Who's paying that the bandwidth bud? Who's putting the effort into building, running and maintaining, upgrading and paying the day-to-day expenses to keep this site up so you can express your opinion to begin with?

You want to talk about mooching? Look in the friggin mirror.

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Originally posted by Die Hard

That's reprehensible to you?

You need to take a good long hard look in the mirror.

You're being raped by American companies given your free market capitalistic approach.

I'd think with all the homeristic patriotism I see around here.... you'd be praising the opportunistic businessmen.

Why control a market in the best interest of society? That'd be like socialism or something. Certainly nothing good can come of any example of anything outside of your border.

And since when is healthcare a god given right in the U.S.?

:cheers:

The Research and Development is second to none due to the amount of money poured into it at our expense. We spend more on it than most other countries combined.

People come from all over the world for some of our hospitals...

But this drug problem is kinda crazy:

Would you stand for it if you had to buy your PT Cruiser for 22k from Canada or 50k from Cleveland if it was made in Ohio?

(Thats basically all you need to know)...

I don't have all the answers but I can sure smell something fishy if you can buy something from Canada at 40% of the cost when the plant that makes it is within sight from your bedroom window.

Cut back on the erectile disfunction advertising in the buh-illions and fix the mess...

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Well you have the opportunity to move to a country of your choice if low cost drugs are an absolute necessity for you. Socialized medicine, gov't mandated and dicticated price controls and very weak, if at all, patent protection for US drug manufacturers outside the US are really all one needs to know about this specific issue.

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Canada, among others, have "price controls" over drug prices. IE The gov't madates the price(s) at which a drug manufacturers can sell their product(s). Additionally, there is very weak patent protection for US drug manufacturers in many countries. So,typically what happens is the US companies R & D the drugs and then other "drug companies" just copy it or make a simple modification to it and sell it for what they want. Of course it's not as simple as that but for the sake of an explanation it's pretty close. So the US manufactures are left with the choice of selling their product in markets with controls or just letting "other" drug manufactures rip them off and steal their products and the R & D investments. Not a good position to be in IMO.

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DH,

At this point, I'm starting to wonder if you are reading my posts or you are arguing for arguments sakes. Let me address your points:

Originally posted by Die Hard

It's awfully nice of you to empathize with drug companies for selling drugs to foreign nations at a loss.

That's awfully humanitarian of those companies.

When attributing things to others, it would behoove you to prove it. I'm sure you are familar with the quote function. I'd be glad for you to point out where I say that. My humanitarian comment was geared towards our government, not pharmaceutical companies. But, to clear up the issue, if pharmceutical companies are selling durgs to disadvantaged foreign nations at a loss, I would be all for it.

Originally posted by Die Hard

The next time you don't pay full market value or an overpriced consumer product.... I hope someone tells you what a morally reprehensible character you are.

In fact, I happen to see a MAKE A DONATION button right under your username.

Who's paying that the bandwidth bud? Who's putting the effort into building, running and maintaining, upgrading and paying the day-to-day expenses to keep this site up so you can express your opinion to begin with?

You want to talk about mooching? Look in the friggin mirror.

Not even close. Your argument continues to be illogical and now is bordering on absurd. Your analogy compares apples to oranges, which incidentally, makes for a false analogy. (Btw, you may want to read thiebear's post. His analogy is a lot more apropos for this discussion.) You, as an owner of www.extremeskins.com, made this a free community. I didn't ask you to nor does the economics of the situation dictate it. As a matter of fact, every single member has a price that they would be willing to pay to continue to frequent this site. But, that is immaterial.

If the owners of this site, after paying for the bandwidth, "putting the effort into building, running and maintaining, upgrading, and paying the day-to-day expenses to keep this site up" decided they wanted to make this site free, then they ought to know better than to go around calling people who frequent this site moochers. At least, as an invective.

Debates unravel when things get personal. In both your posts you tell me to look in the "mirror." And of course, by doing this, I'm supposed to learn two new things: I'm morally reprehensible and a mooch. I take issues with this for two reasons. One, of course, is that its character assasination. You really don't know me. But, the more important reason for the purposes of a debate, is that your statements muddy up the issues. We are talking about countries (at least I was) and the policies they make. You took that original premise and made it about me. You can't compare me to a country. When I say, "morally reprehensible." I'm not talking about Norm MacDonald of Canada, I'm talking about the Canadian policies towards purchase of pharmaceuticals.

Lastly, if I'm mininterpreting, my apologies. But, your tone seems to be increasingly hostile. If intentional, that's fine. If not, you may want to tone it down a little.

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Originally posted by Thiebear

What are you saying: That the drugs are being undersold outside of the U.S. like CD's in China?

aRedskin's explanation is as simple and clear as it gets. And his point about patent infringement is also very true.

Btw, I really liked your analogy about PT Cruiser's because that is sort of what's happening.

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Canada is a tiny market compared to the US, and drug companies are not as subject to runaway lawsuits as they are in the U.S. Consequently, a drug company may consider it to be in its best interests to accept price controls and sell in limited quantities to Canada for slightly above contribution margins for a drug in order to achieve economies of sale.

Kerry's plan is ludicrous because if US pharmacies tried to buy drugs from Canada en masse, the industry would simply stop selling their drugs there. They've undoubtedly warned of such consequences to our Northern neighbors, which is why Canada is halting drug sales back to the US.

Put Canadian style price controls here in the US, and companies would slash their R&D budgets to compensate. Hence, there's the choice of either accepting the current crop of drugs available at lower prices with minimal future advancements in drug therapies, or paying higher prices with the promise of better drugs on the horizon. As someone with diabetes who has been able to avoid hypoglycemic drugs or insulin thus far, I most certainly prefer the latter.

Of course, the cost of drugs could also be significantly reduced if legislation could be passed that might limit in some way product liability, but don't hold your breath for a Kerry/Edwards administration to champion the virtues of tort reform... especially since Edwards grew rich by suing Doctors who delivered babies with cerebral palsy by making scientifically bogus claims that such complications could have been avoided by C-section births.

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Originally posted by Riggotoni

Canada is a tiny market compared to the US, and drug companies are not as subject to runaway lawsuits as they are in the U.S. Consequently, a drug company may consider it to be in its best interests to accept price controls and sell in limited quantities to Canada for slightly above contribution margins for a drug in order to achieve economies of sale.

Kerry's plan is ludicrous because if US pharmacies tried to buy drugs from Canada en masse, the industry would simply stop selling their drugs there. They've undoubtedly warned of such consequences to our Northern neighbors, which is why Canada is halting drug sales back to the US.

Put Canadian style price controls here in the US, and companies would slash their R&D budgets to compensate. Hence, there's the choice of either accepting the current crop of drugs available at lower prices with minimal future advancements in drug therapies, or paying higher prices with the promise of better drugs on the horizon. As someone with diabetes who has been able to avoid hypoglycemic drugs or insulin thus far, I most certainly prefer the latter.

Of course, the cost of drugs could also be significantly reduced if legislation could be passed that might limit in some way product liability, but don't hold your breath for a Kerry/Edwards administration to champion the virtues of tort reform... especially since Edwards grew rich by suing Doctors who delivered babies with cerebral palsy by making scientifically bogus claims that such complications could have been avoided by C-section births.

A good understanding of the problem.

This is nothing to do with Canada or foreign nations. It has everything with the way Americans want to run their own country.

Putting blame elsewhere is misguided.

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Something does need to be done about drug pricing.....durg companies have been increasing their profits for years by raising the price of drugs in the US.........oh and for all those that b*tch and moan about lawyers suing drug companies over faulty medication....grow up.....pharmeceutical companies don't need to turn over research that show their drugs are bad....they just need to keep funding studies until one shows that their drugs are good....additionally they jack up prices to pay for all the politicians whose votes they buy.....

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Originally posted by Riggotoni

Canada is a tiny market compared to the US, and drug companies are not as subject to runaway lawsuits as they are in the U.S. Consequently, a drug company may consider it to be in its best interests to accept price controls and sell in limited quantities to Canada for slightly above contribution margins for a drug in order to achieve economies of sale.

Not trying to be clever, but I would really like to see information on market share by country. I'm sure Canada is a smaller market. But, in truth, Canada is not the only country using price fixing and by far not the worst. There are a number of European countries, the worst of which is France, that are much worse than Canada. I'm sure, the sum market share of these countries rivals the US.

Originally posted by Riggotoni

Kerry's plan is ludicrous because if US pharmacies tried to buy drugs from Canada en masse, the industry would simply stop selling their drugs there. They've undoubtedly warned of such consequences to our Northern neighbors, which is why Canada is halting drug sales back to the US.

Put Canadian style price controls here in the US, and companies would slash their R&D budgets to compensate. Hence, there's the choice of either accepting the current crop of drugs available at lower prices with minimal future advancements in drug therapies, or paying higher prices with the promise of better drugs on the horizon. As someone with diabetes who has been able to avoid hypoglycemic drugs or insulin thus far, I most certainly prefer the latter.

[/b]

Completely agree. I really don't know too much about Kerry's plan, but the importation (reimportation?) of drugs from Canada is incredibly short sighted. Stupid even.

Originally posted by Riggotoni

Of course, the cost of drugs could also be significantly reduced if legislation could be passed that might limit in some way product liability, but don't hold your breath for a Kerry/Edwards administration to champion the virtues of tort reform... especially since Edwards grew rich by suing Doctors who delivered babies with cerebral palsy by making scientifically bogus claims that such complications could have been avoided by C-section births. [/b]

This is an interesting aside. Would you say that it would be impossible for the Bush/Cheney administration to facilitate corporate reform because they both were executives? As to your other claim about Edwards get rich quick scheme, it is a gross misrepresentation of the facts. I read a similar article on CNSnews.com and was sufficiently underwhelmed by the same claims. You might actually want to look at the specific cases Edwards has trialed over, they are more varied than the one instance that you cite.

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Die Hard,

Would you agree that the US should impose its own price controls like the other Western nations in order to make everything "fair"? That way no one company would be subsidizing the others, right? We could have drugs "at cost", because who really cares about new research and development anyways? We can just stick with the drugs we have.

As it is now, the United States market completely subsidizes the rest of the worlds' pharmaceuticals. We make up the difference from the losses and at cost transactions that the companies make in foreign markets. And you're right, it IS our doing. We tolerate this nonsense, and we shouldn't. It's time to force the issue, and if the world decides that it does indeed want new drug development, we can all pony up an equal share of cost.

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