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### Viewing cable 05OTTAWA1989, HEALTH MINISTER ANNOUNCES STRATEGY ON CROSS-BORDER

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
05OTTAWA1989 | 2005-06-30 13:01 | 2011-04-28 00:12 | UNCLASSIFIED//FOR OFFICIAL USE ONLY | Embassy Ottawa

`

    This record is a partial extract of the original cable. The full text of the original cable is not available.

` `

    UNCLAS SECTION 01 OF 02 OTTAWA 001989

    SIPDIS

    SENSITIVE

    E.O. 12958: N/A
    TAGS: ETRD ECON SOCI CA
    SUBJECT: HEALTH MINISTER ANNOUNCES STRATEGY ON CROSS-BORDER
    DRUG TRADE

    REF: OTTAWA 0525 (CANADA SEEKS REGULATORY
         PRESCRIPTION FOR INTERNET PHARMACIES)

    ¶1.  (U) Summary:  Health Minister Dosanjh announced that the
    GOC will take three steps to address the cross-border drug
    trade:  1) create a drug supply monitoring network, including
    input from both public and private stakeholders, to determine
    whether there are drug shortages or threats to the Canadian
    drug supply; 2) seek legal authority to ban bulk exports in
    the event of a drug shortage or "when it is necessary to
    protect the health of Canadians;" and 3) require an
    established doctor-patient relationship for prescriptions.
    Pharmaceutical industry associations are hailing this as a
    good first step, while internet pharmacies are already up in
    arms at the new attack on what Dosanjh deems the "unethical
    conduct" of doctors' cosigning prescriptions.  Dosanjh says
    that it was never his intention to kill the internet pharmacy
    industry and that he is sure that the industry "will adapt."
    End summary.

    Drug Supply Monitoring Network: More than anecdotal evidence
    ------------------------------

    ¶2.  (SBU) Following months of hints and speculation, Health
    Minister Dosanjh received Cabinet go-ahead to announce  three
    new initiatives to stem the flow of prescription drugs from
    Canada to the United States.  The first initiative is the
    establishment of a drug supply monitoring network, to be
    housed in Health Canada, which will work with the provinces,
    territories and other stakeholders to provide Health Canada
    with more comprehensive drug supply data.  This initiative
    should not require any legislative changes, and thus will be
    the easiest for Health Canada to implement.  (Note:  An
    industry contact suggests that Health Canada may encounter
    resistance to monitoring at anything beyond a wholesale level
    because of the commercial confidentiality involved.) In
    declaring a threat to Canada's drug supply from cross-border
    trade, Health Canada has frequently run into the difficulty
    that there is limited empirical evidence of any drug
    shortages.  The formation of a drug supply monitoring network
    will give Minister Dosanjh evidence beyond anecdotal accounts
    from pharmacist associations and patients groups to support
    his contention that the cross-border drug trade poses a
    threat to Canada's drug supply.

    Bulk Export Bans "if and when necessary"
    ----------------------------------------
    ¶3.  (SBU) Second, the GOC also intends to introduce
    legislation to amend the Food and Drug Act to allow Health
    Canada to ban bulk exports in the event of anticipated or
    actual drug shortages (note: GOC is reacting to possible U.S.
    legislation allowing bulk inports of drugs from Canada).
    Despite questioning, Minister Dosanjh did not make it clear
    whether the GOC intends to impose bans as soon as legislation
    is passed or act only when there is a threat of shortage of
    "prescription or other needed" medication.  A pharmaceutical
    company representative called this portion of the
    announcement "ambiguous", and Minister Dosanjh further
    muddied the waters by at first saying that the GOC would
    "possibly introduce legislation" and then, under questioning,
    saying that the GOC will definitely introduce legislation.
    (Note: Local stakeholders inform us that the insistence on
    modifying language rather than an outright ban may have come
    from resistance at the cabinet level, possibly prompted by
    the fact that an outright ban could block legitimate domestic
    drugs produced for export to foreign markets.)

    Unethical Conduct:  Thou shalt not...kill the internet
    pharmacy industry?
    ------------------

    ¶4.  (U) Finally, in keeping with his previous insistence that
    prescription cosigning is "unethical" (ref Ottawa 0525),
    Minster Dosanjh intends to propose measures to "strengthen
    existing federal regulations under the Food and Drugs
    Act...to require an established patient-practitioner
    relationship."  This initiative prompted the most intense
    questioning at the press conference, including repeated
    questions at to whether the requirement of an established
    patient-practitioner relationship would "kill the (internet
    pharmacy) industry."  Minister Dosanjh stated that he
    "...never intended to kill the industry" and said that he was
    "sure the industry would adapt."  When pressed to clarify
    what is meant by an established patient-practitioner
    relationship, Dosanjh answered "A doctor-patient relationship
    means a doctor-patient relationship" and explained that he
    expected foot traffic by Americans traveling to buy drugs in
    Canada to continue and that he would work to ensure that
    Canadian snow-birds would still have access to drugs from
    Canada.  Representatives of the internet pharmacy industry
    say that actions against cosigning would have a major impact
    on their industry.

    Visit Canada's Classified Web Site at
    http://www.state.sgov.gov/p/wha/ottawa

    WILKINS

`