Peter Pitts: Importing drugs is a dangerous prescription

Most Americans take the safety of their prescription drugs for granted. But if the FDA product to enable states to import medicines from Canadathat could change — because the risks of some imported drugs far outweigh the benefits.

The lure of importing drugs is understandable. Patients hear about people in other countries paying less for the same drugs, so they naturally want to take advantage of what looks like a bargain. But what some see as a “cure” for expensive drugs could be worse than the disease.

Counterfeit medicines cause more than a million deaths a year, according to the World Health Organization (WHO). It’s bad enough that a large group of doctors banded together in 2019 to declare the rise of ‘falsified and substandard medicines’ nothing less than a ‘public health emergency’, which is killing 250,000 children per year.

Some counterfeit drugs contain an insufficient amount of the active ingredient needed to fight a particular disease. Many counterfeits come from China and India and contain not only inactive but also toxic ingredients such as printer ink, paint and arsenic. Worse still, without knowing the intimate details of the packaging, it is almost impossible to differentiate the real from the fake.

And, unfortunately, the danger is growing. A study of Pfizer identified 29 fake medicines in 75 countries in 2008. In 2018, there were 95 fake medicines in 113 countries. According to the WHO, one in 10 medicines sold in developing countries are counterfeit or substandard, leading to tens of thousands of unnecessary deaths each year.

But the problem is not just in the developing world. In 2018, as part of a week-long anti-counterfeiting operation, Canadian authorities inspected nearly 3,600 packages and found that 87% contained counterfeit or unlicensed health products. Since 2008, INTERPOL removed more than 105 million counterfeit or counterfeit drugs from circulation and made more than 3,000 arrests.

American patients are protected for now, but we shouldn’t think of ourselves as immune. It is no coincidence that the Drug Supply Chain Security Actwhich guarantees the safety of drugs prescribed here, was enacted shortly after a counterfeit version of the cancer drug Avastin – lacking the active ingredient needed to fight tumors – found its way into the hands of American patients.

Imagine being one of those patients. You take your medicine thinking it gives you a fighting chance against the disease that is ravaging your body. Instead, you ingest the equivalent of a sugar pill. And if the fake medicine you’re taking contains another active ingredient, it could make you even sicker.

Such a scenario is unacceptable. Yet if we give the green light to drug importation, we only make it more likely. We simply cannot guarantee the safety of drugs produced outside of the United States. Even many of those that come from Canada were not made there. The fake Avastin originated in Turkey and made two more stops before coming to the United States. Canadian regulators have even warned against the practice, saying they “do not guarantee that products sold to US citizens are safe…and have no intention of doing so in the future.”

The risk to consumers has increased exponentially with the rise of online shopping. Today’s pharmaceutical Wild West is as close as your laptop or smartphone. If the United States deems certain foreign drugs safe to import, many consumers will take the plunge and try to order them themselves.

How much would all this added risk save US consumers? Virtually nothing. The Congressional Budget Office ran the numbers and found that importing drugs would cut costs by a measly 0.01%. Even if the practice were perfectly safe, which it is not, it wouldn’t be worth it.

If that sounds surprising, it’s probably because proponents of importation exaggerate the savings patients can expect. Apart from a few specialty drugs, most generic drugs approved by the Food and drug administration sold in the United States cost about the same price here as in Canada – and about 90% of the drugs prescribed in the United States are generic.

Import advocates promise ‘cheaper, safer drugs from Canada’, to quote the Biden administration, but the ‘cheaper’ part has been vastly oversold, and the ‘safe’ part is far from it. the truth. With so many lives at stake, we cannot afford to play Prescription Roulette.

Peter J. Pitts, former associate commissioner of the FDA and member of the Senior Executive Service of the United States, is president of the Center for Medicine in the Public Interest and visiting professor at the Faculty of Medicine of the University of Paris. This piece originally aired at RealClearHealth.

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