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Why the NABP says Canada isn't a safe alternative.
As drug prices increase in the United States, many patients look elsewhere to buy their drugs. Many patients see websites labeled with a maple leaf and assume that Canadian imports will be cheaper and just as safe as ones they might find in their local pharmacy. But are drug imports actually safe?
The National Association of Boards of Pharmacy (NABP) wrote to Congress in February asking Congress not to pass legislation to allow for the importation of drugs-APhA and NACDS also recently wrote similar letters, along with the previous four FDA commissioners. NABP has done considerable research into the topic. Since 2008, the organization has reviewed nearly 11,700 websites claiming to sell Canadian pharmaceuticals-and its most recent report confirms that the situation is not improving.
Of the 11,688 sites NABP reviewed, 11,142 operated outside of recommended safety procedures or state and federal laws. Most of those sites operating outside of the law (88.9%) dispensed medication without a valid prescription.
Drugs claiming to come from Canada-new legislation might allow Canadian imports-have recently been under the spotlight. The FDA has said that “Drugs coming to the United States from Canada may be coming from some other country and simply passing through Canada. The drugs could also be counterfeit, contaminated, or subpotent, among other things.”
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NABP recently reviewed more than 100 websites claiming on some level to provide Canadian medications, such as those that had the word “Canada” in their URL or posted a Canadian address. Of the 108 websites reviewed, 29 dispensed controlled substances, and none required a valid prescription. Most (80) said that they sourced their drugs from outside of Canada. Those medications are not legal to sell in Canada and have not been approved by Health Canada.
Most drugs sold through the sites came from India, Hong Kong, or Singapore. NABP cited a recent report from the U.S. Trade Representative, which stated that up to 20% of the drugs from the Indian market are counterfeit and could pose a safety risk. Canadian regulations ensuring quality and safety do not protect U.S. citizens buying from online pharmacies. “Sourcing medications,” said the report, “from outside of a tightly regulated supply chain also greatly increases the chances of counterfeit medicines finding their way to consumers.”
All this led NABP to conclude that “importing medication from Canada presents a considerable public health threat.”