For the past decade, I’ve written extensively about my view that pharma-funded organizations and initiatives are responsible for misleading Americans about the safety of buying more affordable prescription drugs over the Internet for import from Canada and other countries. Most of that writing was on PharmacyCheckerBlog – but periodically it shows up in national media, including in the New York Times back in 2014, and more recently this past February The Hill. That New York Times piece included the following parenthetical disclaimer: “(My company, PharmacyChecker.com, helps Americans find information on obtaining lower-cost medications from Canada and other countries, so I have a financial stake in making sure the public is informed.)” Is this just my commercially motivated “opinion” or is it an indisputable fact that Big Pharma scares Americans away from affording prescription drugs? Here’s one example and you can be the judge.
NeedyMeds, a non-profit organization known for providing patients with help in finding pharmaceutical company-sponsored prescription assistance programs and other drug savings options, hosted a webinar about drug importation last year called “Drug Importation: The topic everyone’s talking about.” The featured speaker was, Shabbir J. Safdar, the executive director of the Partnership for Safe Medicine (PSM). The webinar’s audience appears to be patients and people that serve them. The NeedyMeds host describes PSM as a “not-for-profit organization focused entirely on researching the danger of counterfeit drugs in America and educating the public about how to stay safe from them.”
That description is at odds with investigative reporting covering PSM. The title of one article in Kaiser Health News about PSM explains a lot: “Nonprofit Linked To PhRMA Rolls Out Campaign To Block Drug Imports.” Another article in Bloomberg News called “Sheriffs’ Ads Slammed Drug Imports, and Big Pharma Helped Pay the Tab,” states, “In reality, the ad blitz was secretly paid for by at least $900,000 in grants from the Partnership for Safe Medicines, a nonprofit that’s been funded and operated by the pharmaceutical industry’s trade association.”
The stated focus of the NeedyMeds’ webinar was on “Canadian drug importation.” PSM’s representative dismissed state importation programs as unworkable and a waste of time. Those programs are based on a handful of state laws that allow for drug importation from Canada, pending approval from the federal government. PSM actively lobbies against them – but this blog post is not about that. It’s about how PSM “educates” patients.
Early in the webinar, the NeedyMeds host interrupts Mr. Safdar to ask why Americans are going to Canada to obtain insulin. He replies “U.S. prices tend to float higher…in some cases…than they do in Canada.” What he failed to say is that a vial of insulin that sells for $300 in the U.S. may be purchased in Canada for as little as $30 in Canada.
The question most people have is if they can get cheaper medicine in Canada. One audience member asks about their loved one who is prescribed the drug Dexilant, a drug that treats gastroesophageal reflux disease. Apparently that person was already getting it from Canada because it’s much less expensive there. The NeedyMeds host then asks Mr.Safdar:
“Are there any pharmacies in Canada that are safe to purchase brand name drugs from…? They have been getting it from Canada and are now wondering with this presentation, if that is dangerous.”
I’m going to partially quote and paraphrase the answer provided by Mr. Safdar’s response.
“The Canadian drug supply is pretty safe…” However, standards for a walk-in pharmacy are not applicable to online pharmacies in Canada, which are unregulated and can sell “unlicensed” medications. “It’s probably not going to get you into a lot of trouble if you walk into a pharmacy in Canada…you’re probably likely to get the right thing…the only way to be assured of safety…is to cross the border and walk into a bricks and mortar pharmacy…any mail-order Canadian pharmacy isn’t safe…and, in fact the only pharmacy you should buy from is a pharmacy that is in the U.S. and licensed by your state board of pharmacy.” (Emphasis added).
Another question comes in from a person who has clients that work with Canadian mail-order pharmacies to obtain the drug Eliquis, a drug often prescribed to reduce the risk of strokes. They are wondering if there’s a way to determine the quality of those mail-order pharmacies. Mr. Safdar replies:
“There’s no regulatory control…counterfeits are so good that you’ll never be able to look [inaudible]…A pharmacist can look at that medicine and not be able to tell if it’s counterfeit…The only way to assure that you’re actually getting what you should get is to get it from a U.S. state-licensed board of pharmacy licensed pharmacy.”
Similar questions came in from people wanting to know how they can safety get lower cost medicine from Canada.
Were the statements from PSM’s Executive Director accurate?
Let’s first look at Canadian drug safety. Mr. Safdar seems to hedge on this topic, saying “The Canadian drug supply is pretty safe…” In contrast, former FDA Commissioner Scott Gottlieb, MD, who is also a current Pfizer board member, has stated:
“Canadians have safe drugs and if you go into a brick and mortar pharmacy and you purchase a drug, you’re getting a safe and effective drug. I have confidence in the Canadian drug regulatory system.”
Pivoting from the initial statements about “pretty safe,” the Mr. Safdar does state that “the only way to be assured of safety [using a Canadian pharmacy] …is to cross the border and walk into a brick-and-mortar pharmacy.” Since that’s true, it’s also true that if an American patient can call that Canadian brick-and-mortar pharmacy, order the drug, submit a prescription and the drug is mailed to them, then they can be assured of safety. That safety would equally be assured if the patient could place a prescription drug order with an online pharmacy that filled orders through a licensed brick-and-mortar Canadian pharmacy that, after receiving a valid prescription, dispensed the drug by mail order. Licensed Canadian retail pharmacies cannot dispense medications in person or through the mail that are not approved for sale in Canada.
Consequently, saying “any mail-order Canadian pharmacy isn’t safe” is not just misleading, it’s lying. It is also a lie to have said “
“The only way to assure that you’re actually getting what you should get is to get it from a U.S. state-licensed board of pharmacy licensed pharmacy.”
How do I know these statements are false? One, because my company, PharmacyChecker, verifies and monitors the licenses of pharmacies in Canada that fill prescription drug orders for Americans by mailing them. Two, the Province of Manitoba in Canada even has a special license for international prescription services that permits the cross-border Canadian mail-order pharmacy trade. Three, there’s just the well-publicized fact that millions of prescription drug orders have been placed online and many of those were filled by regulated licensed Canadian pharmacies to patients in the U.S. over the past 20 years.
These lies are reaching patients who can’t afford their prescribed medicines. Drug companies foot the bill for groups like PSM to “educate” the public about importation and buying prescription drugs from Canada. It’s time for the public to rally against these lies and for news media outlets, including webinar hosts like NeedyMeds, which otherwise do good work, to stop providing a venue for them to be spread.
