Are online pharmacies affecting drug supply?

Many experts are apprehensive but no one really knows if Web-based pharmacies are affecting Canada's drug supply by shipping to customers in the US.

As Internet pharmacies experience unprecedented growth by offering lower prices to American customers, some pharmacists here are complaining about delays and shortages in supply for Canadian patients. “It makes sense,” says Murray Elston, president of Rx&D. “I think logically that there would be some supply issues at hand.”

But the BC Pharmacy Association thinks the assumption is “hypothetical,” says Susan Ogilvie, because “ebbs and flows” are a feature of the drug supply. “But to come out and flatly blame the Internet pharmacies? We don't have hard facts to support that.”

Dr. David Collins, dean of pharmacy at the University of Manitoba, says data are hard to gather because online cross-border drug dispensing runs counter to US law. He says only anecdotal evidence currently exists but “it's not anecdotal in the field. It's actually happening.”

Manitoba is the hub of the Canadian Web pharmacy industry, with more than 45 online pharmacies collecting about $400 million annually. Pharmacists have told Ron Guse, their registrar, that current shortages are “unlike those they've ever experienced. There's a general feeling of uneasiness. Before, they wouldn't have given a second thought to giving their last bottle of medicine to a patient. I don't think that confidence exists now.”

Barry Power, director of practice development at the Canadian Pharmacists Association, says the association intends to examine the Internet industry's impact on supply. “The industry can assess where its sales are spiking,” he says, and this data can be used to determine if Internet sales are affecting Canadian supplies.

Guse says that regardless of whether the new industry is causing shortages, it is placing new stresses on the supply chain. After Sept. 11, for instance, demand for ciprofloxacin soared and Bayer couldn't handle the surge. “I'm hoping [that shortage] wasn't a sign of what's to come,” says Guse. — Brian Whitwham, Ottawa