Yesterday's warning from acting FDA director Lester Crawford about the possibility of terrorists using contaminated pharmaceuticals as a weapon against us should cause everyone to reflect on the real risks associated with our nation's latest obsession: importing less expensive prescription drugs from Canada.
Specifically, Dr. Crawford noted that "cues from chatter" gathered around the world are raising concerns that terrorists might use the drug supply, particularly illegally imported prescription drugs, to hurt and kill Americans.
In recent weeks, when I have raised the question of safety in my public discussions of the drug importation issue, I am frequently greeted with derision and remarks like, "Oh, that is just propaganda from Big Pharma. There are no safety issues. The drugs from Canada are the same as our drugs. They are safe. The only difference is they are cheaper."
But that complacency today seems totally unjustified. Consider two points:
First, given the enormous increase in the volume of U.S. purchases from Canada, pharmaceutical companies are wising up. Many American companies are limiting the supplies they send to Canada to a level appropriate for the needs only of Canadians. This move leaves very little left to "import" back to the U.S. -- but the demand from Americans is growing steadily. The Canadians now find they have a supply problem: a huge demand for pharmaceuticals but no products to offer. The logical thing for Canadian suppliers to do is find a new source of supply, and they turn to countries around the world who will agree to sell them drugs. But how would the Canadian vendors or the American purchasers know exactly what they are getting? This is a perfect opportunity for terrorists or mere counterfeiters to step in to meet the demand.
Second, and related, while it is true that we have no hard data that contaminated or fake drugs from Canada to date have caused injury or death, the reality is that when you purchase on the Internet, you really have no idea whether or not the drug you are getting is coming from Canada or somewhere else.
The FDA recently ordered three medicines from "Canada." According to facts presented in a GlaxoSmithKline ad (see below) on the FDA investigation (the source for which was a U.S. Senate Hearing before the Committee on Health Education, Labor, and Pensions on "Importation of Prescription Drugs," May 20, 2004), after receiving a spam e-mail from a website offering to sell cheaper drugs from Canada, the FDA ordered Ambien, Lipitor, and Viagra.
The medicines arrived with a postmark from Dallas, Texas and a return address in Miami. The FDA then called the website company twice to find out where they were based. First they were told the United States. Next they said they were based in Belize. The FDA then checked the computer server for the website -- and discovered it was in China. Finally, the FDA checked with the credit card company it had used to purchase the drugs and found that the company that received their payments was in St. Kitts.
This left the FDA wondering: where did these medicines really come from? What exactly was in them?
As FDA's Dr. Crawford suggested yesterday, this is an ideal environment for terrorism and counterfeiting. The bottom line: Do not buy pharmaceuticals on the Internet -- unless you have a prescription from your doctor and you are certain you are dealing with a legitimate vendor site. If, in your eagerness to save money, you violate this rule, you are putting yourself at risk. Even if you receive an inert, harmless pill rather than something poisonous, you could be putting your life and health in jeopardy by skipping appropriate medication.
Instead of clamoring for more freedom to import drugs from "Canada," advocates (including presidential candidate John Kerry and many House and Senate members on both sides of the aisle) should be devising legislation and regulations that will protect Americans from drug tampering and counterfeiting.
Elizabeth Whelan, Sc.D., M.P.H., is president of the American Council on Science and Health.
Here is the GSK ad described in the article above:
