Northern ℞posure

ANN ARBOR, MICH—Mounting concerns that US consumers’ appetite for low-cost prescription medications from Canadian Internet pharmacies will erode their northern neighbors’ public health could extinguish such cross-border distribution schemes, say some experts from north of the border. Recently, Canadians have faced reports of medication shortages and notices of price increases, despite their country’s system of price controls on patented medications. Experts say the monetary lure of Internet pharmacies entices pharmacists to trade face-toface patient contact for a desk and a fax machine. Some even speculate that the growing cross-border trade could lead to the dismantling of Canada’s pricesetting regulatory agency. During a mid-November meeting in Ottawa, Ontario, US and Canadian health officials agreed to share information on prescription drugs and collaborate on safety measures, even though US Food and Drug Adminstration Commissioner Mark McClellan, MD, PhD, had sought a stronger stance from Canada to restrict Internet medication exports to the United States. But just a few weeks earlier, during a conference here on pharmaceutical reimportation, experts from north of the border said that Canada eventually may step in to halt the practice. “Ultimately, I think . . . you are going to see legislative initiatives coming out of Canada that will close the doors to this kind of practice, if not at the provincial level, then certainly at the national level,” said Chris Ward, a former Ontario legislator who now heads Ward Health Strategies Inc, a health care consulting firm with offices in Ontario and New Jersey. “To date, [government policy] has been rather reserved, and now there’s definitely a change in climate in Canada,” added Jillian Clare Cohen, PhD, assistant professor in the Leslie