Nov 16 2004
Canadian pharmacies that mail prescription drugs to U.S. patients have been backed into a no-win situation by the Canadian government and the provincial medical and pharmacy associations.
Recently, federal Health Minister Ujjal Dosanjh threatened to modify the Canadian Food and Drug Act to prevent Canadian physicians from authorizing U.S. prescriptions without examining the patient. Currently, Canadian physicians are required by a provision to convert foreign prescriptions into an order that can be legally filled by a Canadian pharmacy.
The consequence of this change would be the complete elimination of the mail order industry, resulting in a loss of more than 5000 jobs primarily in Western Canada, as well as a significant impact on support industries.
"We are damned if we do and damned if we don't. Our pharmacies are required by law to perform this step and now we are being accused of facilitating unethical practices. It is unbelievable, but I would rather debate ethics than break a law, especially if the practice enhances safety rather than detracts from it," says MacKay.
Dosanjh's portrayal of the secondary medical review as "unprofessional" and "unethical" demonstrates a fundamental misunderstanding of the true clinical benefit that the Canadian physician brings to the continuum of care. Their review of an existing prescription by a U.S. primary care physician serves as a "double check" of the patient's medical profile and possible drug interactions. When a problem is discovered the two physicians often consult each other. On many occasions, Canadian physicians catch errors overlooked by the U.S. physician.
"The government and the colleges are condemning a process that actually saves lives, just to avoid liability exposure. It seems they have their priorities mixed up," adds Andy Troszok, president of CIPA.
One solution that CIPA proposes is the elimination of the requirement under the Food and Drug Act for a Canadian conversion of a U.S. prescription.
"It seems absurd to create one law just to counter another. Why not scrap the requirement for the secondary review and make everyone happy?" MacKay suggests. "Are Canadians required to have two doctors write their prescriptions? Do we really believe that American doctors are unqualified?"
Ironically, 29 U.S. states will fill Canadian prescriptions at pharmacies without conversion. Perhaps Canadian pharmacies should offer reciprocity with their U.S. counterparts. Therefore, it would only be necessary to validate the physician's license before filling a prescription. Medical colleges need only include licensed U.S. physicians in their definitions of acceptable prescribers and the ethical issue is solved.
The Canadian International Pharmacy Association is a non-profit trade association that represents 35 of Canada's leading mail-order pharmacies. CIPA's member pharmacies service about two million U.S. patients, primarily seniors and the uninsured. Annual sales of prescription medications are estimated at approximately $1 billion U.S. retail.
http://www.ciparx.ca/
Barney Britton, President Minit Drugs, Pharmacy-Online.ca said:
To suggest that a Canadian Pharmacy cannot accept a prescription from a licensed US physician is to undermine the qualifications of a US primary care Physician. This is the situation that Canadian pharmacies have been faced with for the last few years while trying to help out the US senior citizen. Hopefully the politicians will see the light and try to assist us in our attempt to provide the cheaper Canadian medications so desperately required by the US senior citizens.
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