Ask the Advisor: Canadian Doctors Pressured to Stop Co-signing Prescriptions For U.S. Consumers

We read that the major Canadian malpractice insurance organization was going to stop covering Canadian physicians who re-write prescriptions for U.S. residents buying drugs by mail. The organization was quoted as saying that Americans are so prone to litigation the coverage was too risky. We figured that lack of malpractice coverage would put the cross-border pharmacies out of business. But there's still a bill pending in Congress to regularize drug reimportation from Canada.

From the editor, Mary Johnson
There are some obstacles that would have to be dealt with for the legal �reimportation� of drugs from countries like Canada where governments negotiate lower prices. One of them is malpractice insurance. Earlier this year the Canadian Medical Protective Association (CMPA), a �defense union� that provides about 95% of the doctors in Canada with malpractice insurance, made it clear that Canadian doctors who are sued by U.S. citizens who ordered prescriptions by mail won�t be covered.
Canadian law requires that a Canadian-licensed doctor must write prescriptions filled in Canada. When U.S. consumers purchase medications in Canada they either visit a Canadian medical clinic or, when ordering over the Internet, fax prescriptions from their U.S. doctor for review and the signature of a Canadian doctor.

A spokeswoman for CMPA told me that medical licensing boards in Canada have long held that doctors who don�t have a legitimate, ongoing �doctor-patient� relationship are operating unethically and could be sanctioned. In addition, our nation has gained a rather dubious reputation as the �land of litigation.� CMPA expects Canadian doctors to take a history, perform examinations, diagnose, obtain consent and assure follow-up, as well as keep medical records. Doctors who don�t would be on their own in the event of a lawsuit.

CMPA�s action, however, has not stopped U.S. consumers who are spending an estimated $800 million a year on drugs from Canada from getting their prescriptions filled by Canadian pharmacies. According to the Seattle Times, some Canadian doctors are working their way around the problem by residing in the U.S. and getting their insurance here, while others are covered by the pharmacies that provide the drugs.

TSCL believes that allowing the reimportation of less costly prescription drugs from other nations like Canada remains one method that will allow seniors to quickly cut out-of-pocket health care spending. TSCL continues to support and lobby for strong reimportation legislation.

Sources: Canadian Clinics Cutting Off Drugs For Americans, Carol M. Ostrom, Seattle Times, May 18, 2004. CMPA Assistance In Legal Matters Initiated By Non-Residents of Canada, Canadian Medical Protective Association, July 2003.

September 2004

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