IPABC - Questions & Answers

We are the International Pharmacy Association of British Columbia (IPABC), a coalition of distance-based health care providers located in the province of BC. We advocate on behalf of our members so they can serve patients with the medications they need through a distance-based delivery model.

Although the internet is one way a patient can get in touch with us, we require the same protocols and procedures to be followed as the local pharmacy in your neighbourhood, including checks and balances to ensure patient safety. We have physical addresses, and employ pharmacists, pharmacy technicians, managers and support staff – no artificial intelligence or chatbots here. Our patients simply require their prescriptions to be shipped to them and live in a variety of locations, including outside of Canada.

The practice of international pharmacy in Canada pre-dates the internet when U.S. patients physically travelled into Canada to buy their medications at prices they could afford. As Internet usage and e-commerce began to grow rapidly in the early 2000s, providing service to patients beyond border communities or for vacationing Americans became a reality., and we’ve been developing our businesses and contributing to the British Columbia economy ever since.

IPABC serves patients in British Columbia, across Canada, the US and other countries around the world who can’t afford, access or trust the medications where they live.

Our members significantly contribute to the BC economy. We directly employ a wide range of full time staff, including pharmacists, pharmacy technicians, call centre representatives, software programmers, IT technicians, shipping clerks, administrative personnel and more.

The U.S. Food and Drug Adminisration’s guidance on personal importation of prescription drugs provides, in part, that FDA personnel have the discretion to allow entry of shipments of pharmaceutial products from foreign pharmacies when “the quantity and purpose are clearly for personal use, and the product does not present an unreasonable risk to the user.”

Numerous Bills have been introduced over the years in the United States House and Senate relating to personal drug importation and the issue has had many U.S. Congressional champions, including the late Senator John McCain (R-Arizona). Along with Senator Amy Klobuchar (D-Minn), McCain introduced the Safe and Affordable Drugs from Canada Act in 2015 which has more recently been re-introduced with Senator Chuck Grassley (R-IA- Iowa) as co-sponsor.

One unfailing champion of personal drug importation to the U.S. from Canada and other countries is Senator Bernie Sanders (D-Vt). The Senator is well noted for joining patients in travelling to Canada to purchase their maintenanxe medications dating back to the 1990s.

Those patient excursions are just part of an enormous grassroots pressure in support of personal importation. Americans who have benefited from improved health outcomes by purchasing affordable drugs from Canada would be in dire straits if their right to access these medicines was was curtailed.

IPABC members dispense Health Canada approved medications from their licensed pharmacies. Where there are business relationships with regulated pharmacies and fulfillment centres in other countries, these operations are regularly inspected by the Canadian International Pharmacy Association to ensure adherence with the stringent Standards and polices of CIPA.

We are confident these controls are as strict as any regional pharmacy regulator’s, including those based in the United States.

IPABC members do not supply narcotics and controlled substances.

Most of drugs that are shipped to the United States are "maintenance medications" designed to treat chronic conditions such as high cholesterol, diabetes and heart disease. IPABC members supply medications designed to keep an existing and ongoing condition under control.

The U.S. is the only Western country that allows a completely unregulated approach to drug pricing, meaning there are no price controls on pharmaceuticals. The result of this approach means medications in the U.S. are routinely 50-80% more expensive than in Canada.

In Canada, the system operates much differently. In 1987, the Canadian government created the Patented Medicine Prices Review Board, which is mandated to ensure the price of patented drugs in Canada is fair and accessible for patients.. In exchange for increased patent protection, pharmaceutical manufacturers agreed that (among other things) drugs which are new to the market would not be priced significantly above the cost of its closest related treatment, and that any increases would be tied to the Consumer Price Index. Furthermore, provincial governments, including BC, have been diligent in regulating pricing and driving down the costs of pharmaceuticals for patients.

Evidence shows that the development of new pharmaceuticals in the U.S is largely funded by the National Institutes of Health, a federal government organization. Biotechnology firms usually lead the way in R&D, with U.S. pharmaceutical companies then purchasing the rights for drugs that look promising after clinical trials.

The amount of money drug manufacturers spend on R&D is dwarfed by other expenditures, such as marketing and lobbying government. With profit margins at all-time highs, the costs are passed on to the patient. The work that IPABC does is patient-focused and has little to no impact on the ability for the U.S. to fund future research and development.

The drug companies are certainly part of the process ut many of the drugs manufacturers deelp are often not new at all.. This is what industry calls ‘Evergreening’.

Often, when a drug patent is about to expire and the drug becomes a candidate for generic manufacturing, the manufacturer dramatically reduces marketing efforts to slow demand for their product. As the demand for the old drug fades, a new drug - with a full-length patent - is positioned in market as a replacement, often with only minor variations from the older version. In some cases, the dosage of the ‘new’ drug is increased, declaring it more efficacious - not surprisingly, since the patient is now taking more of it.

Evergreening has two purposes:

• One, to undercut generic drug suppliers, who now have the right to reproduce a previously patented drug, often at a much cheaper price.
• Two, to ensure that the brand manufacturer continues to dominate a market using sophisticated marketing skills and expertise. While that may be good business for drug companies, it's not necessarily good for patients and the medical systems that support them.

CIPA and IPABC maintain a ‘Canada First’ policy whereby our members agree not to sell products to patients in other countries in the event of a drug shortage in Canada. This policy was first activated in 2005 when there was a potential Tamiflu shortage during the Avian Flu outbreak. It was again activated in 2009 during the H1N1 epidemic. More recently, when we were notified by Health Canada of an Epipen shortage in 2018, CIPA and IPABC members ceased sales of that product.

In addition to notifications from Health Canada, Canadian pharmacies are notified by their suppliers of any potential shortages. The website www.drugshortagescanada.ca is a resource used by drug companies to report shortages. There is no evidence that international pharmacy practices have ever resulted in a shortage of Canadian drugs.

Our pharmacies have a perfect safety record.

Our pharmacies:

• Require a valid prescription before dispensing medications;
• Obtain demographic and medical information from the patient and maintain a health profile with medication history to avoid adverse drug interactions;
• Have a licensed pharmacist on staff to supervise dispensing of medications and to be available for consultation; and
• Have procedures to ensure patient privacy and confidentiality of personal records and contact information.

IPABC pharmacies are thoroughly vetted and certified by the Canadian International Pharmacy Association (CIPA).

All our pharmacies display the CIPA red oval seal that denotes integrity, quality, and trust. CIPA is aggressive in pursuing fraudulent online pharmacies.

Our members significantly contribute to the BC economy through thousands of direct and indirect jobs and tax revenue. We directly employ a wide range of full time staff, including pharmacists, pharmacy technicians, call centre staff, software programmers, IT technicians, shipping clerks, administrative staff and more.

We are distance-based health care professionals. We are knowledgeable, ethical and experienced. We believe we represent the future of distance-based health care.