In September 2019, the Canada Institute at the Woodrow Wilson Center published a new report detailing the risks for both Canada and the United States if the United States were to move forward with plans to legalize bulk imports of Canadian pharmaceutical medicines.

The issue is gaining media attention and is one of the few where President Donald Trump and Senator Bernie Sanders share the same outlook. One of the main drivers for the U.S. proposals is the price difference between common medicines between the two markets; common medicines are generally more expensive in the United States.

While it is appealing to U.S. politicians to quickly solve the issue by allowing medicine to flood in from Canada, this would do nothing to address the underlying issues and would come with a host of risks. From the Canadian perspective, there would be a serious impact on supply that could leave Canadian consumers facing empty shelves. Large scale exports to the United States would almost certainly impact the price of medicines in Canada too. There are also intellectual property implications that Canada would need to grapple with.

From the United States perspective, bulk imports from Canada would greatly challenge the U.S. Food and Drug Administrations (FDA) role of regulating medicines for the U.S. market. Third party countries could use Canada as a launching pad into the United States, increasing the risk of illegitimate or counterfeit medicines entering the system. Moreover, a blast of Canadian imported medicines would do nothing to address the underlying price gap between the two markets.

Canadian decision-makers are taking the threats posed by the various proposals at both federal and state levels in the United States seriously. National health care systems develop in a particular context to meet the unique needs of that populace. The proposals to get Canadian medicines into the U.S. market are all risk and no reward.

By Jeffrey Phillips
Managing Director, Dawson Strategic