In Agendas: hidden and not-so, Allen Coukell asks: “If you were an uninsured patient unable to afford medication in the US, would you rather get your prescription filled in a Canadian pharmacy or go without?”

If those are the only choices, you should go without.  Primum non nocere. (“First, do no harm.”)

Judging by his biography, Allen appears to be a Canadian pharmacist by training.  So he should know that many so-called Canadian pharmacies are not actually in Canada, many drugs sold by “online pharmacies” are counterfeit, and we really don’t know where Canadian pharmacies are going to source enough products to meet U.S. demand. 

Still not convinced of the danger?  Read this Drug Channels post about a father-son duo who supplied counterfeits to online spammers.  How about the guilty plea of pharmaceutical distributor that sold counterfeit drugs to U.S. pharmacies?  Or this 2005 report from Giuliani Partners about the loopholes that could endanger us?  

I could go on and on.

People will buy drugs online from unscrupulous sellers to “save money.”  Organized criminals, drug traffickers and terrorists could (and probably do) exploit gaps in our drug distribution system.  I wish it were only fear-mongering, but unfortunately we are talking about legitimate issues. 

McKesson (MCK) announced a settlement with the Drug Enforcement Administration (DEA) that temporarily suspends distribution of two controlled substances from two of its distribution centers. This latest settlement reflects the DEA’s aggressive strategy for controlling diversion by pursuing actions against wholesalers. However, I presume that McKesson has learned some lessons from Cardinal Health’s (CAH) troubles so the marketplace impact should be less severe.

A DEA press release describes McKesson’s alleged interactions with online pharmacies:

“Three McKesson distribution centers received and filled hundreds of suspicious orders placed by pharmacies participating in illicit Internet schemes, but failed to report the orders to DEA. They did so even after a Sept.1, 2005, meeting at which DEA officials met with and warned McKesson officials about excessive sales of their products to pharmacies filling illegal online prescriptions…As a result, millions of dosage units of controlled substances were diverted from legitimate channels of distribution.”

McKesson resolved its claim with the DEA for $13.25 million, an expected outcome given the company’s previous disclosures. For the record, I will remind you that “the settlement agreement is neither an admission of liability by McKesson nor a concession by the United States that its claims are not well founded.” Florida got $7.5 million of the $13.25 million in civil penalties, ensuring that the state retains its infamous reputation.

This Reuters story notes that McKesson must also temporarily suspend distribution of two drugs from two of its distribution centers. Competitor Cardinal Health (CAH) has struggled with the customer service issues associated with similar suspensions, but the impact should be smaller for McKesson. (See Cardinal Health’s Customer Problems Deepen from my Drug Channels blog).