I recently was discussing the issue of the cost of drugs inside versus outside Canada. One of the side-effects of the strong controls present in the Canadian system is that it forms a fence around Canada further making immigration for someone with a medical condition challenging. This is because of the way the existing law is written.
The cost of certain drugs is much lower outside Canada. While we can discuss the relative merits of this, such as this recent Forbes article or this recent book on the topic, the bottom line is that the cost of drugs in Canada is high – in some cases as much as 10x higher than the same drugs are from a reputable manufacturer (Cipla, Teva, etc.) in a different country, such as India, where patent rights differ. One thing that makes this even more difficult in Canada is the blanket prohibition of the importation of certain drugs, currently on a list known as Schedule F, though this is in the process of being replaced by a similar scheme that makes it easier for Health Canada to manage the list.
The purpose of the list, however, is to prohibit the importation of certain drugs into Canada unless one is a doctor, a pharmacist or a hospital. A patient may bring in a 90 day supply for personal use – but that doesn’t allow the drugs to be shipped.
So, how does one get around this? Well there are a few options:
- You can find a sympathetic doctor willing to receive the medications – essentially to serve as the “importer”. This can be tricky, as some doctors are not willing to accept the potential liability of these non-Canadian approved drugs. Still, some doctors are a bit more sympathetic. It can be difficult to find such a doctor. One good thing about the new regulations is that they would extend the importation ability to anyone with the legal right to prescribe in the province. Here in BC, for example, naturopathic doctors have prescription rights for many things and thus would be allowed to import drugs in some of these cases. That increases the potential pool of doctors willing to assist.
- You can arrange for delivery to the US border and then pick up a 90 day supply every three months. Services like Kinek charge a modest fee for receiving a package for you in the US. The US has an exception to the importation ban when the drugs are for personal use, which makes it easier to import them into the US. Then you can bring them into Canada under the 90 day personal use exception.
- You can try to find a Canadian pharmacy willing to sell the drugs to you. For example, here in BC there’s a pharmacy in Surrey (Blue Sky Drugs) that indicates they will ship to Canadian addresses; whether this constitutes importation by a Canadian pharmacy or not is something that I will admit is definitely not clear.
- You can “take your chances”. This is what people who don’t have to worry about immigration do. In my experience these services will reship anything that doesn’t arrive. This is definitely a grey area, as they are exploiting the fact that CBSA cannot police every package and thus only a small fraction are actually seized.
For someone trying to convince CIC that they have a credible plan this situation can be problematic: some officers at CIC know about Schedule F and can use it as a means to refuse someone from being granted permission to immigrate. In that case the best thing is to find a sympathetic doctor willing to allow shipments of the meds to them. The doctor might be more willing if they know the drugs are coming from a foreign charity (NGO) rather than an internet pharmacy; the patient may need to sign a written release indemnifying the doctor in case the drugs provided are ineffective or contaminated – after all, the doctor has no way of being able to verify the veracity of the drugs any more than the patient. Were I trying to come to Canada and had a foreign NGO willing to provide me with expensive (or overpriced – depends upon your perspective) drugs, I’d be happy to indemnify a doctor willing to help me get into Canada in the first place!
Of course some types of drugs are worse than others. In January 2013, Gilead reported they had a 76% profit margin. AIDS Healthcare Foundation has been calling for moderation of their prices, but at the present time that’s the way the system works – the laws protect the companies’ profits not the health and well being of the actual patients. For those wishing to immigrate to Canada this creates a real barrier to entry.
Canada in turn only looks at a few diseases very closely. I personally know of people with heart conditions (requiring multiple surgeries and hospital stays after coming to Canada) who disclosed their conditions but were not subjected to the “excessive demand” fire drill. But this is what the Canadian public has decided to do. Immigration is always fraught with this sort of problem – a deep-seated xenophobia. That’s hardly unique to Canada, sadly.
- Baby born at migrant workers’ cramped Vancouver apartment to stay under the radar (vancouversun.com)
- CIC refuses to fast-track trapped trucker’s application to return to Canada (vancouverdesi.com)
- Will Canada’s Price-Cutting Plan for Generics Affect You? (medmeme.com)