A New Kind of Drug Smuggling: How Can We Create a Safe System for Americans to Reimport Cheaper Medicine?

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Introduction:

On a sunny morning in late July, a man hops in his car and starts the 2-hour traffic-ridden drive to the border. After the long ride full of winding roads and heavily clogged highways, he arrives at the manned checkpoint. The line of cars ahead of him is already a quarter of a mile long. Slowly he makes his way to the front of the line, each small stop-and-go a step closer to him reaching his goal. Finally, after close to an hour, he arrives at the front of the queue and is greeted by a tall stern-looking man dressed in green formal military-like garb. Hesitantly, he hands over his American passport and the border guard asks him a very simple question: “What’s your reason for visiting today?” The man could say that he “is just visiting family”, or going “for business,” or even “just for vacation;” really the reason does not matter. He is there for one reason and one reason only: to acquire drugs and illegally smuggle them back home. Sheepishly, he looks up at the guard and replies with a quick laugh, “I’m just here for a short vacation away from the kids.” The guard chuckles and after a final long stare at the man’s picture and back at the man sat before him, he ushers the man past him and into this foreign place. The man breaths a sigh of relief and drives away. After another 30 minutes of driving through streets he has never visited before, he finally arrives at the place he had been told to go to a couple of months back by one of his shadier friends. Turning off the ignition and heading into the small building he ambles over to a woman standing at a counter near the back of the premises. Having phoned in about his arrival earlier, the man just says his name, and the woman heads into the back. After what feels like forever, the woman comes back to the counter and hands the man a small white bag. The man, in turn, hands her a wad of cash and dashes back to his car. He stows the little white baggie full of drugs under a cover in the trunk and turns the ignition back on. He knows what he is doing is illegal, yet he does not have enough money for any alternative. Briskly, he drives back to the border. After an even more nerve-wracking encounter with the border guards a second time around, he makes it back into the United States and begins the two-hour drive back home. Although the deed is now finished, he will be forced to do the same again and again every three months. 

You may think this man is some cartel drug mule, smuggling narcotics into the United States to make ends meet, yet that assumption would be far from the truth. This man is just a lower-middle-class 60-year-old man traveling over the Canadian border every three months to get medications he desperately needs for 50% less than he would pay for at his local pharmacy. He, like many other Americans, finds himself entangled in the web of the vast issue that is drug reimportation.

The Issue:

Drug reimportation, in its most basic terms, is defined as “the exporting of drugs from the United States to another country and then reimporting them back into the United States” (). On a smaller scale, consumer importation of prescription drugs has been a common practice among Americans who find the normal US prices for drugs and medication exorbitantly high when compared to the same medications found in neighboring countries. They head across the border and bring back American-made medications for a fraction of the cost they would pay for them at home. Canada especially has become the largest site of this mass pilgrimage as the Canadian government has regulations that limit the price of many drugs. These regulations can help to make medications anywhere from 35% to 55% cheaper than the same medications south of the border. Meanwhile, in the US, the government cannot regulate drug company’s prices and the companies hold a patent on whatever medication they invent for 20 years, giving the company an essential monopoly over the drug and its price.

A Vast Majority of Americans Support Drug Reimportation

Bioethics:

Drug Reimportation mainly falls into bioethics when it comes to the principle of non-maleficence (i.e. preventing harm). The FDA (Food and Drug Administration), mainly cites that shipping drugs back into the US allows for a large period of gray area where the medicine is unaccounted for and unable to be monitored by the FDA. This allows for the potential tampering of the drugs or contamination in facilities that the FDA cannot surveil. When these drugs are then resold back to the American public, they face risks that they did not face when the drugs were held and made in FDA licensed facilities under the scrutinizing eye of the administration. 

Meanwhile, those who defend drug reimportation and the consumer import of prescription drugs commonly use arguments surrounding the three other principles of bioethics: beneficence, justice, and autonomy. Beneficence centers around acting only in ways that benefit those being treated, and many would argue that allowing people to purchase medicine for far cheaper is a way of benefiting the patient. For lower-income patients who find themselves unable to afford the US prices for medication, drug reimportation could be the only way for them to afford medication and keep themselves healthy. Beneficence argues that as drug reimportation benefits patients who can not afford current American prices, it should be legalized. The bioethical principle of justice, which is most likely the most prominent principle argued, believes in the fair allocation of resources. The principle of justice is violated as people in other countries having much easier access to resources like medicine and drugs due to low prices. Resources cannot be correctly allocated if those who need them are not receiving them only because of a hefty price tag. Finally, autonomy, a principle in which rational individuals should be able to make their own informed decisions for themselves, would point out that if the people know the risks involved with potentially tampered medications and still wish to buy medicine internationally, they should be allowed to do so.

Canada has become the number one destination for drug reimportation to the U.S. thanks to its low prices and relative safety

“For Now” Response:

In my opinion, a possible way to minimize the safety concerns involved with drug importation is to limit legal drug reimportation just to our neighbor to the north. Canada, with its significantly cheaper medicinal prices, is already the largest location for drug reimportation back to the US and I believe that if we correctly utilize licensed Canadian pharmacies and further fund the FDA, we can create a safe and easy system for accessing cheaper drugs. Licensed Canadian pharmacies follow a rigid set of protocols in order to operate, and therefore pose a minimal risk when it comes to contaminated or illegally manufactured drugs being distributed by them. If we allow these licensed pharmacies to sell directly into the US, we can use the FDA as a sort of de-facto quality assurance group that could process each Canadian shipment of prescriptions. By further funding of the FDA and allowing them to open up more testing and distribution centers, we could create a system where Canadian filled prescriptions are shipped to facilities watched over by the FDA where quality assurance testing could be carried out before they are sent on to their American destinations all but putting a stop to counterfeit and contaminating drugs reaching the US.

Works Cited

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2 Comments

2 comments

  1. Hi Sam. I think this topic you chose to research is super interesting. I sometimes find it ridiculous that money some Americans have to pay for their meds and it makes sense they would try and find a cheaper option elsewhere. Your suggestion that we should fund the FDA more makes sense as a solution to some of the problems you bring up. I also wonder if created checks of pharmaceutical companies so that medicine is not too expensive in the first place would make sense as well.

  2. Hi Sam, I am glad you chose this topic! Since 3/4 of Americans favor allowing drug re-importation, might not the U.S. government also work on reducing drug prices within the US, rather than focusing on what seems to be an insignificant problem, the contamination of re-imported drugs? In Canada, drug prices are negotiated by the state for all users–that is why prices are lower than they are in the U.S. Why doesn’t the U.S. do this as it seems to be the essential problem? It would hit the target of beneficence (longer-term and for everyone) as well as justice. Thank you for bringing this really important topic to my attention!

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