The U.S. government apparently is stepping up seizures of cheap drugs ordered by Americans -- mainly seniors -- from abroad, Canadian pharmacies say.
The pharmacies, which sell drugs by mail and over the Internet, say their shipments are being intercepted by U.S. Customs officials around the country where foreign mail is handled.
"It's huge -- we've had over 800 seizures in January," up from 15 in a typical month, said Barney Britton, president of Calgary-based MinitDrugs.
Other pharmacies reported four- to five-fold increases. An informal survey of 30 Canadian pharmacies that cater to American customers, conducted by a senior-citizen advocacy website, showed that the rise began in November, doubled in December and doubled again in January.
Health officials in Minnesota, the first of several states to make cheaper Canadian drugs more readily available to its residents, echoed the reports from north of the border. They said seizures increased in late December from less than 1% to about 4% of shipments, said Brian McClung, a spokesman for Minnesota Gov. Tim Pawlenty.
Ordering drugs from abroad is illegal. But U.S. Customs and Food and Drug Administration officials have generally allowed the practice, apart from occasional seizures designed to publicize potential risks.
Federal regulators say that policy hasn't changed -- and there is no crackdown.
"It's not a special effort other than our normal enforcement," said Lynn Hollinger, a spokeswoman for U.S. Customs and Border Protection.
People whose drugs are seized are not cited and generally are able to get them replaced free of charge by the foreign pharmacy. But many customers are infuriated.
"It's despicable," said Samuel Robert Greenberg, a Laguna Niguel retiree who lost a package of anti-cholesterol pills and glaucoma eyedrops late last month. "They are playing with people's lives."
Greenberg, 73, said he and his wife had bought drugs from Canadian pharmacies for years without incident.
But if replacements for his Lipitor pills don't arrive by next week, Greenberg said, he will have to buy from a local pharmacy at a cost of about $3 a pill -- a third more than he pays through the mail.
Greenberg said such seizures were a waste of government resources. "Forget about the heroin," Greenberg said. "They are going to stop the Lipitor."
Although the FDA has never taken enforcement action against an individual for ordering prescription drugs from abroad, it has conducted a handful of what it calls "blitzes" over the last five years in cooperation with the Customs Service at international mail centers.
The FDA analyzed the drugs seized in those cases and publicized their findings in an effort to warn mail-order customers about the risks of getting the wrong medication, poor-quality substitutes or counterfeits.
Some Canadian pharmacy operators believe U.S. authorities timed the latest seizures to coincide with the Jan. 1 launch of Medicare's drug-discount program, which competes for the business of American seniors.
"I think, quite frankly, that [U.S. authorities] see an opportunity," said Britton of MinitDrugs. "They know that this would probably be the most vulnerable time for us."
Canadian pharmacies report declines of 10% to 30% in U.S. orders since the Medicare program began. But many seniors, particularly those whose drug needs are modest, find Canadian pharmacies are cheaper.
According to a Kaiser Family Foundation study published in 2004, 25% of eligible seniors -- as many as 7.4 million people -- could pay less buying drugs on their own. If too few seniors sign up for the Medicare drug plan, experts say, the program could run into financial trouble.
Most Canadian pharmacies accept the cost of replacing seized drugs to preserve an $800-million market that serves about 2 million U.S. customers. Over the last five years, less than 1% of all shipments have been seized, said Andy Troszok, president of the Canadian International Pharmacy Assn.
The association has not yet determined how much that rate has increased. But so far, he said, the seizures do not represent a serious threat.
"We are currently still chalking it up as the cost of doing business," said Troszok, who owns Extended Care Pharmacy in Calgary.
The pharmacies learn of the confiscations from customers who have received seizure notices. A customer also can use a tracking number to find out what happened.
A sudden, unannounced policy of increased enforcement -- after years of looking the other way -- would be irresponsible, Troszok said.
"It's an issue of patient safety," he said. "We're not talking about Viagra and narcotics abuse. We are talking about people with breast cancer, heart disease and diabetes and are established on medication. Who is going to be liable for these people going off medical regimens and suffering or even dying?"
Canadian pharmacies, which are able to purchase brand-name drugs at low wholesale prices negotiated with the purchasing power of the Canadian government, already had been adapting to increasing political and market pressure.
When major drug makers began curbing sales to Canadian pharmacies that shipped to the U.S., many began ordering in bulk from drug factories in Europe, India and Israel.
"The business just gets smarter and adapts," said Bill Pigden, business development manager for CanAmerica Global Health Services, a Winnipeg-based pharmacy.