Web pharmacies fear net tightening

OTTAWA — Canada's Internet pharmacies warn that they face devastation if Ottawa forces doctors to stop approving mail-order prescriptions for U.S. patients without examining them personally.''It could be very detrimental, if not deadly, for our industry,'' said David MacKay, executive director of the Canadian International Pharmacy Association, whose members do the bulk of cross-border business in this market.

He estimated that 95 per cent of the Canadian industry's business is mail-order sales to U.S.-based customers.

"Job losses would be 5,000-plus, not to mention more in the secondary support industries . . . we're one of Canada Post's biggest clients."

On Wednesday, federal Health Minister Ujjal Dosanjh said the present level of on-line pharmacy sales to Americans poses no immediate threat to domestic supply.

But he targeted another crucial aspect of the cross-border pharmacy business, and signalled that he wants something done about it.

Mr. Dosanjh said it is unethical and unprofessional for Canadian doctors to sign prescriptions for U.S. customers without seeing the patients themselves.

He wants provincial colleges of physicians, which view the practise as unacceptable and have censured doctors for it, to crack down strongly. "He wants to be reassured from the perspective of those disciplinary bodies that are enforcing their own rules," a federal official said.

The minister warned that Ottawa is considering changing the Food and Drug Act to let doctors prescribe drugs only to Canadian residents and visitors to Canada.

Mr. MacKay said that concern is unwarranted because Canadian mail-order pharmacies fill only drug requests that are accompanied by an American doctor's prescription.

"The Canadian doctor is a second pair of professional medical eyes that simply checks what is already an existing prescription from an American physician who has seen the patient. How many Canadians feel they have to see two doctors to get their [cholesterol-fighting drug] Lipitor?" he said.

Mr. MacKay separately cheered the federal government's acceptance of current drug export levels as proof that Ottawa is willing to live with existing pharmaceutical sales to U.S. customers provided shipments do not grow further.

Canada's Internet pharmaceutical business began four years ago after a Manitoba entrepreneur started selling Nicorette gum via on-line auctioneer eBay. The sector has grown to between $800-million to $1-billion in annual sales, depending how transactions are measured, Mr. MacKay says.

A federal government official insisted Mr. Dosanjh is not trying to shut down Internet pharmacy sales to Americans but acknowledged the minister's campaign to end so-called countersigning by Canadian doctors could do just that.

"The current level of sales [to the United States] is not a threat to supply. What is an issue is the conduct of practitioners," the Ottawa source said.

"People expect businesses of any sort to be conducted according to the ethical rules of that business," the source said. "If one of the consequences . . . is that this business can no longer be [conducted] -- I guess the question [Mr. Dosanjh] would ask is 'Should people be in that business in the first place?' "

For its part, the United States appears willing to tolerate the current level of mail-order Canadian drug sales to Americans. "It's okay at this current level. . . ." Paul Cellucci, the U.S. ambassador to Canada, told journalists Oct. 21 while visiting Winnipeg, according to reports.

Kathy Kovacs Burns, chairwoman of the Best Medicines Coalition, which opposes all cross-border Internet sales, said she's still not certain that Ottawa is serious about curbing this home-grown industry. "They have played very coy over the past few months," Ms. Kovacs-Burns said of the federal government.

This move isn't completely unexpected. With more and more talk of getting cheaper perscriptions from Canada, there was bound to be some move by the Canadian government to protect lower prices in Canada. They are not stopping the supply to Americans, just making it a hassle by physically going to a Canadian doctor to get the perscription. If you are American and need to see a Canadian doctor, it's on a cash only basis. They don't take U.S. insurance. I know this from personal experience when I went to visit family and got the flue real bad. $27.00 Cdn for the visit, including lab work that had to be paid in Cdn $ in cash. It's similar to a U.S. copay.

"They are not stopping the supply to Americans, just making it a hassle by physically going to a Canadian doctor to get the perscription."

Yes, between the continuing comments of their politicians, their refusal to help defend this continent, and efforts to hassle us it's time the President put Canada in it's place.

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