After issuing a series of warnings over the last year about the cross-border trade in prescription drugs, the Canadian government yesterday struck a softer tone and said it does not want to completely halt the $1.3 billion in annual sales to US consumers.
In a much-anticipated move, Canada's health minister, Ujjal Dosanjh, revealed two initiatives that could curb sales. But he stopped short of calling for an outright ban on the practice of selling Canadian drugs to American consumers.
''It is not our intent to kill the industry," Dosanjh told reporters during a conference call. Industry and provincial officials say that thousands of people are employed in drug sales, especially in Manitoba and Alberta, breadbasket provinces where Internet pharmacies have cropped up in industrial parks and prairie towns.
Americans can find deep discounts on Canadian Internet sites because Canada's drugs are subject to government price controls. In the United States, some local and state governments seeking to save money have started Canadian purchasing programs for their employees and residents, including a number of Massachusetts communities such as Springfield and Boston.
The US Food and Drug Administration says all of these purchases from foreign sources are illegal, but the practice has spread as the agency has declined to take legal action against consumers or government officials.
Dosanjh said the government of Prime Minister Paul Martin will introduce legislation in Parliament in the fall that would give Canada the authority to suspend bulk sales of drugs outside the country if they threatened domestic supplies.
Such a law would have little or no effect on the current trade, which consists almost entirely of individual retail sales through the mail. But Dosanjh described it as a preemptive strike in case the US Congress passes stalled legislation to permit wholesale shipments into the United States.
''We need to make sure we have the tools in place to protect the supply," Dosanjh said.
On another front, Dosanjh said he would seek new administrative regulations, which would not require parliamentary approval, to prohibit Canadian doctors from writing prescriptions without ''an existing doctor-patient relationship."
If a doctor-patient relationship were defined as requiring an in-person examination, it could signal the end of Canada's importation industry, which relies on faxed prescriptions and e-mail and telephone communications between US and Canadian doctors and patients.
Dosanjh refused to endorse a requirement for a face-to-face examination, but said he shared the concerns of some provincial authorities who contend that ''unethical" Canadian doctors are writing dozens and even hundreds of prescriptions for Americans every day. He said the regulations will be written with input from provinces and other interested parties and could be ready by the end of the year.
The government has no intention of interfering with ''foot traffic" prescription sales in border communities, where Americans visit Canadian doctors and purchase drugs from Canadian pharmacies, he said.
The Canadian International Pharmacy Association, a trade group representing the largest Internet drugstores in Canada, reacted favorably to the government's statement.
''There's nothing there that's detrimental to us," said Andy Troszok, the association's president.
The FDA did not react directly to the Canadian proposals. Thomas McGinniss, the agency's director of pharmacy affairs, said Americans should understand that generic drugs are 50 percent less expensive in the United States than in Canada. He said that many US drug companies have launched programs to offer free and discount drugs to needy patients, and that more seniors will have access to prescription drug coverage in 2006 when the government launches its Medicare prescription drug benefit program.
But former Springfield, Mass., mayor Michael Albano, who drew national media attention two years ago when he launched the first high-profile municipal importation program, said consumer pressure for lower-priced drugs from Canada would continue.
''Nothing has changed but the US prices have gone up," Albano said. ''This is an issue that will not go away."
In Boston, Mayor Thomas M. Menino launched a pilot program a year ago with about 200 city retirees and a few current employees that resulted in savings of less than $50,000, said mayoral aide Mitchell Weiss. The city will evaluate the program to determine whether to expand it, he said. Dosanjh's recommendations will not have an effect on the program, Weiss said.
In addition to Springfield's 7,000 city workers and municipal retirees, importation plans are available to workers in Newton, Fall River, Somerville, Bellingham, and Worcester.
Christopher Rowland can be reached at firstname.lastname@example.org.