To Canada and Back Again, and Again, and Again
By: Bernie Sanders
Tags: Drug Price Stories, Healthcare, Pharmaceutical

John Kramarz’ story of his quest for reasonably priced drugs for his wife and youngest daughter illustrates the benefits of buying Canadian. But it also shows how far Big Pharma will go to stop Americans from getting cheaper medicines.

John and Karen Kramarz’ daughter, Kellie, was about four when, after complaining of constant thirst and some dizziness between meals, she was diagnosed with Type I or juvenile diabetes. Neither her parents nor her older sister Katie had that condition. John realized that his little girl would have that life-threatening disease the rest of her life, and would likely be getting injections for insulin every day forward.

Kellie’s insulin, Humalog, cost about $68 per vial at the time (in 2007). Because Kellie was a little girl, one vial usually lasted a month. Humalog is fast-acting, but Kellie also needed Lantus, insulin that works more slowly.

During a business trip, John found a Canadian pharmacy that sold Humalog for only $28 a vial.

“I felt pretty nervous about buying some, but the price was amazingly low,” he said.

The pharmacy agreed to ship more to his home in New Jersey, which was great because Kellie was growing up, needing more than one vial per month. For a while, the Kramarz girls were covered by the state children’s health insurance program (S-CHIP), and the prices for medicine were so low, John didn’t need to go to Canada. But the S-CHIP plan was scaled back. And the cost of Humalog was pushing $300.

John returned to Canadian online pharmacies, but their website price sheets didn’t offer breaks on brand-name insulin.

“It was all sky-high,” says John. “I didn’t know what to do.”

On a trip to Canada, he went into a drugstore to check out Humalog again, and found it for about $25 a vial. He asked the pharmacist why it was cheaper to buy in person, and was told that the pharmaceutical industry had complained that low prices of insulin in Canada were undercutting drug makers in the U.S. and elsewhere. They were particularly upset about online drugstores advertising shipments to America. So, online, certified Canadian drugstores advertised insulin prices similar to those in the U.S. John increased his trips to Canada.

“I became an insulin ‘mule’ for my daughter,” he said, laughing. “But it was my little girl’s life blood.”

The insulin makers “are treating my daughter like a cash cow,” John said. When insulin was first developed, it won a Canadian scientist a Nobel Prize. That doctor and his partners sold their rights to the University of Toronto for one Canadian dollar each, because they believed access to insulin was critical for humanity. “It’s ironic, isn’t it,” said John.

In November, Sen. Bernie Sanders and Rep. Elijah Cummings asked the U.S. government to investigate potential price collusion called “shadow pricing” in the insulin market. Meantime, a federal class-action lawsuit has just been filed against, among others, the makers of Humalog and Lantus.

The insulin makers “are treating my daughter like a cash cow,” John said.

John’s wife, Karen, also had medicine price problems. Hers involved Advair, a widely-used inhaler to control asthma. It didn’t take John long to learn that across the border, Advair was about 40% cheaper.

But like Kellie’s insulin saga, getting inexpensive Advair had a few twists. In America, there’s no generic Advair for sale — it’s been on patent a while. In Canada, however, drug makers have been churning out what they advertise as a generic copy of Advair. So, Branded Advair diskus can cost over $1,000 in America and only $355 in Canada. But “generic” Advair is even cheaper, and a hot seller for Canadian online drugstores.

“You can pay $300 for 12 disks, practically a year’s supply,” said John.

That did not sit well with Big Pharma. A few years ago, during the Obama Administration, the White House’s office for Intellectual Property Rights began a campaign on behalf of patent holders — i.e., corporations — across many industries. One strategy involved pressuring the credit card industry to help block foreign pharmacies from sending medicine to the U.S., on the grounds of “safety concerns” with other countries’ medicines. In fact, some of that proposal came from the Big Pharma lobby in Washington.

One day, John found out that he could no longer use any of his credit cards to purchase “generic” Advair from Canada.

“We were back to 1984, writing checks. My Canadian pharmacy finally verified my bank account and, and now I can order regular refills.

“But I’ll bet a lot of people don’t understand what this is about, and have given up getting their Advair from Canada,” John said. “Drug companies just don’t want to let us go.”