Big Pharma Won’t Let Us Import Drugs From Canada, But Insists on Sending Carcinogen-Contaminated Pills to the Public

Yves here. I understand the desire of Americans to be able to re-import drugs from Canada. But this is at best an interim strategy, since meaningful orders from Canada could easily cause problems with supplies for Canadians and could thus lead the Canadian government to restrict or bar shipments to the US.

The point would be to pressure the US government to do what every other advanced economy government does: negotiate drug prices. The fact that we don’t when the US provides so much R&D support to Big Pharma is, as Lambert would say, wonderfully clarifying.

By Thom Hartmann, a talk-show host and the author of The Hidden History of the War on Voting and more than 25 other books in print. His most recent project is a science podcast called The Science Revolution. He is a writing fellow at the Independent Media Institute Produced by Economy for All, a project of the Independent Media Institute.

Big Pharma spends a small fortune every year buying politicians to make sure we can’t import prescription drugs from Canada, but they’re more than happy to sell us contaminated medications from countries with weak manufacturing controls and exploitable labor that ensure high profit margins.

A toxic compound that doesn’t belong anywhere near medicine known as NDMA was first discovered in some blood pressure medications in 2018, and the FDA issued an alert and wrote a complaint letter to the raw materials supplier to Big Pharma companies. It turns out the meds follow the very common pattern of being made in India with raw ingredients coming from China. And they are sold by big companies for obscenely high prices to U.S. consumers.

More recently, NDMA contamination provoked a nationwide recall of the popular anti-heartburn medication Zantac and all its generic versions.

And now the world’s most widely prescribed drug of all, which is used to treat and prevent Type 2 diabetes called metformin, is contaminated with NDMA.

NDMA (N-Nitrosodimethylamine) is, according to the World Health Organization, produced by “the degradation of dimethylhydrazine (a component of rocket fuel) as well as from several other industrial processes. It is also a contaminant of certain pesticides.”

And it’s one of the world’s most potent carcinogens, at least for humans and other mammals. Our livers produce an enzyme that converts it to methyldiazonium that then leads to O6-methylguanine, both of which alter a process at the cellular level called methylation that is a cancer turbocharger.

Because it’s such a potent biological agent, NDMA is also extremely poisonous; a Chinese medical student put a few drops in his roommate’s water and killed him. Ditto for a Canadian grad student, who injected it into a colleague’s apple pie.

It’s so poisonous that the FDA has set the “acceptable” amount for human daily intake at 96 nanograms, or 0.000096 of 1 milligram (a single grain of salt is about a milligram). In some of the generic brands of the blood pressure medication, just one tablet was found to have NDMA levels almost 20 times higher than the “acceptable” 96 nanograms, and nearly all were drugs that are taken daily.

Once it gets into groundwater, NDMA is wicked hard to get out, as citizens of numerous California cities found out in the late 1990s. Its “miscibility” (rapid solubility) with water is extreme, meaning that a few drops of it rapidly spreads through miles of underground aquifers or other water supplies in a matter of hours or days at most. Because of this, it’s nearly impossible to isolate the contamination once it happens, the only solution then being radical and expensive water treatment everywhere in the aquafer, principally using ultraviolet light.

Ever since 1987 when Congress and the Reagan administration cut a corrupt deal with Big Pharma to ban the retail import of pharmaceuticals into the U.S., Democrats have pushed to allow Americans to get their prescription drugs from other countries when they’re too expensive here (which is nearly always the case; we pay about twice as much for drugs as any other country in the world).

In 2000, Congress passed a law to allow imported retail drugs, but the Clinton administration, heavily funded by the health care industry, killed it administratively.

Nonetheless, progressive Democrats have pushed for years for the elimination of the ban. I first met Bernie Sanders when I lived in Montpelier, Vermont, around the turn of the century and he was organizing busloads of Vermont seniors to travel the two hours to Montreal to fill their prescriptions.

And now, in another popular policy position “borrowed” from progressive Democrats (who have also opposed neoliberal trade deals for decades), the Trump administration is talking about letting American consumers buy drugs from Canada or overseas.

The downside of this is that generic drugs sold in Canada are just as likely to be made in India and China, and thus just as contaminated, as drugs sold here. The upside is that because Canadian drugs will be cheaper, some of us can afford to buy the name-brand versions made in Germany, Switzerland or Ireland and sold in Canada, and not worry about getting cancer from NDMA in our generic drugs. (Yes, I mean this sarcastically.)

There was a time when virtually all drugs sold in the U.S. were manufactured here, including generics, or in Switzerland and Germany. Congress passed a special tax break for American drug manufacturers who’d move their factories to Puerto Rico, and for decades that was the hub of U.S. drug manufacturing. But in past decades neoliberalism has won out, and only a fraction of the pharma facilities in and around San Juan remain in operation.

Trump ran on the traditionally Democratic and progressive position of bringing manufacturing back to the U.S., a project that progressive senators including Sherrod Brown and Bernie Sanders have worked on their entire modern political careers.

It’s time to apply it to manufacturing pharmaceuticals or at least insist on global regulations that can protect everyone.

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  1. carl

    Soooo, the FDA’s rationale against USians buying their own drugs from overseas has finally been revealed to be the fake warning that we always knew it was? Words to describe this scam in appropriate language fail…

  2. Bob

    Finally someone gets it –

    We are forced to buy drugs manufactured overseas.
    Drugs that contain known carcinogens.

    Looks as if this is a win, win, win all the way around.

    Big Pharma makes more money.
    The national politicians get more “donations”.
    To be clear the donations are bribes.

    We get cancer

    We spent more on pharmacuticals.

    Rinse and repeat.

      1. JBird4049

        When I was told I could not buy my prescriptions from that supposed dystopian hell know as Canada I knew that the FDA was less honest than the National Inquirer.

        At least we know that the United States government’s Go Die America Plan is going strong.

        1. YankeeFrank

          This is almost completely due to people stopping smoking. It doesn’t mean we should ignore the corruption of, and inability to manufacture our own, medicine supply. The trend we are seeing with medicines, as with so much else in our neoliberal wonderland, is a two-tiered world where most of us only have access to toxic food, medicine and insufficient healthcare while the rich get the best of everything.

          1. m sam

            Certainly we shouldn’t ignore the corruption of, and inability to manufacture our own, medicine supply, or anything else you said. Why would I ever? I would not want my disagreement with the statement You forgot to include the doctors and their “war against cancer” get in the way of that.

          2. rd

            Reduction in smoking plays a huge role, but we also have auto and industrial emissions controls reducing air pollution in cities, pollution control and wastewater treatment, and increased percentage of people on public water supplies that all contribute. These all started in the 1970s.

            I view the anti-vaccine movement and the push for deregulation of environmental rules to be similar. Many of the historical problems have been greatly reduced so they are receding from the public consciousness and the secondary aspects start to drive decision-making. So people and communities are shocked when measles makes a comeback. They will be similarly shocked at what is coming in land use, water quality etc. especially in rural communities near industrial areas. The goal of the current US leadership is to turn the country into Houston with no zoning regulations, few design requirements etc. We saw how well that worked out in Tropical Storm Harvey and some other events over the past few years. It will ultimately be dumped on the courts to deal with the most egregious impacts.

  3. xkeyscored

    The article appears to be saying that NDMA can be eliminated from aquafers: “it’s nearly impossible to isolate the contamination once it happens, the only solution then being radical and expensive water treatment everywhere in the aquafer, principally using ultraviolet light.”
    This sounds highly unlikely to me. How would you get UV to thoroughly penetrate aquafers? I suspect that once there, it’s there to stay, near enough, though UV can be used, often in combination with hydrogen peroxide, to destroy more accessible NDMA.

    1. Bob

      UV treatment is commonplace, whether it is used for air streams (think hospitals) Or as a water treatment.
      Generally these systems use a UV light source to send the UV light through the air stream or through the water stream.

      Now of course there are limitations but think of the common Steripen as an example often used for treating drinking water in the back country.

      Probably not suitable to treat underground aquifers but once it is brought to the surface it can be an effective means of water treatment.

    2. Leroy

      I think the UV treatment they’re talking about is at the individual user level. I have a triple treatment water filter system , the final stage of which, after a ten micron followed by a five micron filter, is a UV light , then off to the house. We live on a well and in our area, it’s pretty routine to filter the water. Not all have a UV filter but this system was just a few dollars more and who knows what the neighbor is dumping into the ground ?

  4. oaf

    *Big Tech* will solve this with CRISPR, editing the genes of luminous bacteria so they emit UV? Frack the product where needed. Tech creates the problem, Tech will fix it. Magic!, Tech!!!

    These will be expensive little buggers; buy in to the IPO!

  5. Zachary Smith

    I’ve sworn off this site because of the flaky moderation, but on this topic I’m going to try to make a modest contribution.

    This company says they test the prescription drugs they sell. I pay approximately double the Big Box store price for mine. It’s like buying “organic” stuff at the grocery – maybe you’re getting what they claim and maybe you’re not. It’s no fun at all to get a form letter telling you your meds have been contaminated with dangerous chemicals.

    Given the stakes with the Cancer Pills Big Pharma is so happy to sell us, I figure it’s worth the extra charge. Every Republican and Libertarian knows it’s a sin for Big Government to protect citizens from contaminated food or medicine.

  6. E Williams

    Study this “smoking-gun sentence” from the Food, Drug and Cosmetic Act, which reads, at 21 USC 374 (a) (1):

    “No inspection authorized by the preceding sentence or by paragraph (3) shall extend to financial data, sales data other than shipment data, pricing data, personnel data (other than data as to qualification of technical and professional personnel performing functions subject to this chapter), and research data (other than data relating to new drugs, antibiotic drugs, devices, and tobacco products and subject to reporting and inspection under regulations lawfully issued pursuant to section 355(i) or (k) of this title, section 360i of this title, section 360j(g) of this title, or subchapter IX and data relating to other drugs, devices, or tobacco products which in the case of a new drug would be subject to reporting or inspection under lawful regulations issued pursuant to section 355(j) of this title).”

    The sentence says, essentially, that the FDA cannot inspect a drug company’s financial, sales, pricing, personnel or research records.

    This section of the FDCA makes drug companies invisible to regulation. No government will ever have the power effectively to regulate — or negotiate with — a drug company until we take that cloak of invisibility away.

    1. Oh

      In the book “Bottle of Lies”, the author states that whenever the FDA wants to inspect foreign drug manufacturers, they inform them of the proposed inspection dates.

  7. rd

    I don’t think US consumers will be getting many drugs from Canada. If Trump sets up that policy, I suspect Canada will simply require that a Canadian health care card be provided in order to buy prescription medicine there. Each province negotiates drug prices with the distributors and pharmaceutical companies. I don’t think they want the US to piggy-back on those negotiations because that will likely increase the pricing they would otherwise be able to get. If the US wants cheaper drugs for its populations, it has the option of negotiating those prices – that is not Canada’s problem to solve.

    1. JBird4049

      Americans have been able to buy drugs from Canada for decades. Or at least they were. Back when I had no health insurance, I could go online and have it shipped from Canada to my desk or front door. Of course, the FDA, in its benevolence decided to crack down on the importation of possibly “dangerous” Canadian drugs. As far as I know, you still can have them shipped from Canada, it is just a greater risk that it will be intercepted is all. So far, no Americans have been arrested for using such illegal drugs. (I think. The world is getting more unreal everyday.)

      Next, Operation Go Die, the FDA’s plan to save Americans from those dangerous foreign prescription drugs.

      1. Yves Smith Post author

        Ahem, are you sending a US Rx to Canada or getting a Canadian doctor to issue an Rx without ever having examined your or seen your medical history?

        1. fajensen

          All that bureaucracy would just be standing in the way of Progress :).

          Here in the EU one can indeed get prescriptions done over the Internet. Which is used in *exactly* the way one would imagine it would be – to get hold of quality-checked medication that ones real doctor is reluctant to sign for.

          Medication classified as drugs are hard to get because these are ‘noisy’ – the customs *will* find them *and* trace the prescription back to the origins. Anabolic steroids and similar ‘chemical enhancers’ are apparently much easier to import ‘legally’: There are always some middle-class amateur sports people, with no obvious criminal connections, that are getting nailed over doping themselves!

  8. JohnM

    while not meaning to dispute the narrative that pharma companies have little concern about consumer safety when it comes to imported drugs, here is a wired story that discusses storage/handling as the root cause of NDMA contamination. so if this is to be believed, at least in this case, questionable manufacturing practices in china/india isn’t to blame.

  9. Susan the other

    I’d like to know what the primary source of NDMA contamination is in India’s pharma factories. And China and other manufacturers. I’d guess, along with everyone else, that the main reason is productivity and efficiency that externalizes the cost of remediating, i.e. cleaning up their labs and facilities and monitoring their raw materials (all too expensive if you want to make a bottom-feeder profit), is the reason. If the contamination has gone on for a long time it’s possible that you’d have to tear down the facility to the studs and start over. If we are talking nano pollution. So who got off scot free with all the profit? Clawbacks are in order as well.

  10. He's just this guy

    Hey kids don’t do drugs.

    Especially when big pharma is riskier than street drugs, and the most dangerous drug, ethanol is freely available and mostly legal.

    1. Charger01

      This is the primary method for most Americans to avoid providers, due to the high costs of insurance and actual care.

  11. RBHoughton

    If the West is going to survive on the modern world it will have to eject the merchants from control of government policy and restore the administration of liberally-educated bureaucrats.

  12. Carla

    Some drugs sold to Americans by Canadian online pharmacies are made in India. Not sure if the ingredients come from China, or if the same drugs the Canadians sell Americans are actually consumed by Canadians as well.

    1. Yves Smith Post author

      Let us put it another way: aside from the big generic company Apotex, can you name another Canadian drug company? Now admittedly the US drug companies often have Canadian operations, but I suspect they are mainly sales/distribution arms.

      In other words, those “Canadian” drugs are mainly re-imported US or EU drugs. So then the question is whether the Canadian regulators are doing a better job on safety inspections than the US. To that I have no answer.

  13. jackiebass

    I read an article that in effect we couldn’t fill all of our drug needs from Canada. Canada being smaller in population doesn’t have the capacity to supply the US needs. It would probably be a negative for Canadian citizens because it would probably result in higher prices for Canadians. A possible solution might come from legislation that more closely regulates drug companies. They could cap prices and shorten the time before a drug becomes generic. Also don’t allow minor tweaks in a drug to extend its patten protection. Also don’t allow a company to buy out a generic producer to get rid of the competition. Another would be to limit the money spent on advertising on TV and other media. This is a huge cost that adds to the price of a drug. There are others things but these wold be a start in the right direction. Probably the biggest one thing that prevents any action is the drug companies buying of our politicians.

  14. DHG

    Proving they will make you sick just to drain your pockets till you drop dead from your disease or their poisons.

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