moved that Bill C-282, an act to amend the Food and Drugs Act (export permits), be read the second time and referred to a committee.
Madam Speaker,I take this opportunity to acquaint my hon. colleagues further on Bill C-282, a bill designed to safeguard Canadians and their prescription drug supplies by extending the export permit requirement in place in the Food and Drugs Act.
Let me set the stage. In 2003 the sales of prescription medicines to U.S. residents, through the medium of Canadian Internet pharmacies, reached a figure of $566 million to $605 million, more than doubling the 2002 estimates of $251 million. Early indicators for 2004 are predicting further growth and volume sales, some estimates putting the figure up to a billion dollars.
Some Canadian pharmacies have been quick to exploit this market. We have seen a growth from only four Canadian pharmacies with an active Internet export business in 1999 to 120 in 2003.
There are two essential reasons for this exponential growth in the cross-border Internet pharmacy trade. First, prices for some drugs in Canada are lower than those paid by consumers in the U.S., on average 36% below U.S. prices. Second, the Internet has made it cheaper to find low priced drugs in Canada and ship them to the U.S.
What troubles me, and many Canadians, is that continued untrammelled growth in this industry will have negative, long term repercussions for all Canadians, while a few profit from the trade. It is Canadian consumers who will be the losers in the long run. Prescription drugs in Canada are priced for the Canadian market and reflect the regime of the Patent Medicine Prices Review Board, PMPRB, and the lower purchasing power of the Canadian dollar in relative terms.
The supply system is geared toward a system of health insurance that is looking for value for money and a smaller and less well off population base. The prescription drugs sold by Internet pharmacies to U.S. consumers are purchased from the Canadian drug supply and then sold on at a profit. If the growth in this business is allowed to continue unchecked, I and others fear that the Canadian drug supply system will be at risk and Canadian consumers will end up paying more. An increase in volume of prescription drug exports and caps being placed on the quantity of drugs shipped to Canada by the pharmaceutical companies will equal drug shortages and price hikes.
There are growing calls emanating from U.S. legislators and drug manufacturers for prices to increase in Canada. Prescription drugs already account for one of the highest health care costs for provinces. We could expect that even modest price increases would strain resources of governments, health plans and individuals. For the chronically ill and seniors, among others, this would mean more than a mere irritant. Any price increases in drugs would mean that ordinary Canadians would suffer.
Our system of prescription drug supply is designed to meet the needs of Canadian consumers, not U.S. consumers. The U.S. pharmaceutical market size is approximately 13 times larger than that of Canada. In 2002 prescriptions dispensed per day in the United States amounted to 8,590,260 compared with 326,219,000 per year in Canada. If we divide the total number of prescriptions dispensed per year in Canada by the U.S. daily figures, we see that if U.S. residents were to purchase all their prescription drugs in Canada, the annual supply of Canadian drugs would be exhausted in 38 days.
I am not suggesting that it would be the likelihood, but as U.S. demand grows, there is an obvious potential that the Canadian drug supply system would be unable to supply both the domestic and the American markets.
There is already a voracious demand from U.S. seniors 65 or older who number over 30 million. That demand and that from other sources has every potential to grow. Numerous states, including Wisconsin and Illinois, and counties and cities in the U.S., are already actively encouraging their citizens to purchase their prescription drugs online from Canada.
Two bills are before the senate in the United States designed to facilitate the import of drugs. It is very probable that U.S. federal laws could be changed to allow retail drug imports from Canada. There are existing problems associated with the Internet pharmacy business as it stands now. Retail drug imports into the United States are not technically permitted by the Food and Drug Administration. In essence, Canadian Internet drug companies are flouting U.S. law.
A commonly used device for Internet pharmacies is to hire a Canadian physician to countersign or fully prescribe a prescription with a U.S. physician in order for the Internet pharmacist to fill the prescription. Not only is the Canadian doctor in this case often breaching the professional obligations set down by provincial Colleges of Physicians by not personally examining the patient, but the Internet pharmacist is breaching a responsibility in standards of practice for patient care and dispensing.
Finally, the results of the Canadian Pharmacists Association, which was released in the past few weeks, suggest that Canadian pharmacists are already experiencing shortages when filling patient prescriptions. Most felt that these shortages had become more evident over the past year. Although the pharmacists are at the moment finding alternative sources to ensure that patients do not go away empty-handed, there is a limit to how long this can go on before patients cannot have their prescriptions filled. Internet pharmacies are already facing increased challenges in obtaining enough stock to meet the demand of their customers, and are actively lobbying other pharmacies to over order and ship the excess to them.
The bill aims at going some way to addressing some of these problems, both potential and already apparent. I am concerned that we as parliamentarians need to be pre-emptive in this matter and not merely reactive to whatever legislation may come from the U.S. What is at stake is the well-being of our country's most important resource, our citizens.
The bill is designed to develop a Canada-first policy and is based on three principles: first, ensuring that medicines are available to Canadians when they need them; second, protecting the ethics of our health care system; and third, ensuring that we are not infringing laws in another country.
The proposed bill will extend the existing export certificate requirements under section 37 of the Food and Drugs Act to require those wanting to export drugs, as set out as schedule F to those regulations, to obtain an export permit, unless specifically exempted. Those wishing to export prescription drugs will need to justify certain criteria. The export of drugs cannot endanger the supply in Canada. The prescription to be filled and exported must be signed by a Canadian physician and pharmacist in accordance with the rules set down by the appropriate regulatory body in the province in which the prescription is filled. Export of drugs cannot contravene laws of the country to which it is being exported. There will be exemptions, most notably for Canadians temporarily residing abroad, such as snowbirds, and any export made with respect to the Jean Chrétien pledge to Africa.
We have to look at harsh realities and do what is best for Canadians. If the U.S. market becomes open to parallel imports from Canada, or if the Internet pharmacy trade is not curtailed, there is a very real probability that our citizens will be the ones who suffer.
The provinces and this government have committed themselves to the preservation of the health care system that ensures a fair, affordable and accessible service where and when Canadians need it. We cannot put profit or the welfare of another country's citizens ahead of the necessity to protect and care for Canadians.
I hope that among other initiatives this bill will serve as a stimulus to find a solution to a problem that threatens all Canadians.
I would hope that every member of this House would recognize our collective responsibility to protect all Canadians. More particularly, we have a responsibility to those that are most vulnerable: the seniors, the chronically ill, low income families and single parent families, who would be adversely affected if this issue is not resolved.
If we cannot find a solution, we will have failed in our responsibility. To that end, I would welcome any other suggestions or solutions proposed by any member of this House.
We need to ensure that our supplies of prescription drugs are always there when we need them, that a few are not endangering the supply of the many. We need to ensure that we are not a convenience for a country whose health care system is a product of neglect and exclusiveness, that our prescription drug system is for all Canadians.
