Two pharmacies from north of the border obtained Florida licenses. They were suspended, but one is fighting in court.
Prodded by irate pharmacists and drugstores, state regulators in Florida have declared war against the growing number of storefronts that help consumers buy low-priced drugs from Canada.
But their battle plans have encountered a few unexpected hitches. Prosecutors seem reluctant to join a fight that would pit them against satisfied customers, many of them seniors, who are determined to keep their access to cheaper medicines.
And now it turns out that two Canadian pharmacies have licenses to operate in Florida, throwing yet another monkey wrench into the effort to weed out the imports.
This month, the state suspended nonresident pharmacy licenses held by Minit Drugs of Alberta and ADV-Care Pharmacy of Ontario. ADV-Care has appealed the suspension and a judge in Tallahassee is expected to rule on the appeal as soon as today. According to state officials, Minit Drugs has not appealed the suspension order.
The Canadian pharmacies obtained the Florida licenses before the recent surge of interest in importing prescription drugs from their country, and the state says the licenses never should have been granted.
The state's action comes as officials rev up their efforts to discourage Americans from buying medicine from Canada, where drug prices are capped under government price controls. The issue has become particularly heated in the past year as several Canadian pharmacies, including ADV-Care, have become affiliated with storefront operations in the United States that make it easier for consumers to get Canadian drugs. Such retail outlets have proliferated in the last few months, with more than 75 in Florida and additional stores nationwide.
Estimates of cross-border prescription sales vary widely, with some experts saying Canadian sales to U.S. citizens could be as high as $4-billion a year. Pharmaceutical companies and U.S. chain stores have taken notice.
This year, pharmaceutical giant GlaxoSmithKline warned Canadian drug wholesalers that it would limit supply of its products to companies distributing to U.S. customers. There seems to be little evidence Glaxo followed through on its threat.
U.S. drugstores and pharmacies have been equally vocal, though no more effective. In June, the Florida pharmacy board accused the storefronts of acting as unlicensed pharmacies and called for them to be shut down. In response to the board's complaints, the state Health Department has been conducting an investigation of these retail outlets. No action has yet been taken.
The Health Department's lawyer warned regulators, however, that even if the storefronts are illegal, it may be difficult to find a state attorney willing to prosecute the case. A spokesman for Palm Beach State Attorney Barry Krischer told the Palm Beach Post that his investigation has shown that the retail outlets are doing nothing illegal.
A spokesman for Pasco-Pinellas State Attorney Bernie McCabe said there have been no complaints against the operations, so there has been no investigation. A spokeswoman for the Hillsborough State Attorney's Office said it is still researching the issue.
Though prosecutors may be reluctant to act, the pharmacy board is doing what it can. It is expected to spend $750,000 on an ad campaign, warning consumers of the dangers of Canadian drugs. U.S. pharmacists argue that drugs from foreign countries are not regulated by the U.S. Food and Drug Administration and may be outdated, contaminated or counterfeit.
The state board also did some clerical housekeeping this month in suspending the previously issued licenses of ADV-Care and Minit Drugs.
Bill Parizek, Department of Health spokesman, said the licenses had been issued in error and were suspended once the department became aware of the mistake. Amr Bannis, treasurer of ADV-Care, said his company made state officials aware it was based in Canada and even paid in Canadian dollars when it received its Florida license two years ago.
After renewing ADV-Care's status without question this year, the state suddenly asked the company in mid April to voluntarily relinquish its license, saying it had been "inadvertently issued." Minit Drugs, which has had a nonresident license since March 2002, was also asked to surrender its license. Both companies refused. Their licenses were suspended by emergency order July 3.
Bannis, who said his company does about $20-million a year in U.S. sales, said ADV-Care plans to fight the suspension. Minit Drugs did not respond to calls about the issue.
"There have been no complaints, no problems, no evidence of us having dispensed any medication that is not FDA-approved," ADV-Care's Bannis said. "We believe the state acted improperly because there was no emergency situation."
In the meantime, storefront referral centers, like the ones affiliated with ADV-Care, appear to be thriving.
ADV-Care's affiliates include Canadian Drug Discounters Inc. of Clearwater. Incorporated in March by Clearwater businessman John T. Rich, Canadian Drug Discounters has licensees who operate 11 stores, with nine in Florida and one each in Virginia and California. The stores serve as order processors; they carry no drugs and accept no money. The drugs are billed to the customer's credit card and mailed to their homes.
Daryle Whitaker runs Canadian Drug Discounters of South Tampa Inc. A former hospital social worker and a doctor's wife, Whitaker knew there was a market for affordable prescriptions. "As a social worker, I used to beg, borrow and steal to send patients home with enough drugs so they would be compliant" with the doctor's orders, she said, referring to her efforts to secure free drugs from pharmaceutical companies for patients.
Whitaker said her operation, open for two months, has processed orders for more than 200 prescriptions, with each averaging about $100 for a three-month supply. Prices through her storefront are slightly higher than the prices on ADV-Care's Web site, with the difference making up her commission.
Dr. Joe Whitaker, who refers patients to his wife's business, said he has had many patients skimp on or simply forgo prescriptions because of the high price.
"How can I take care of people who aren't taking their medicines?" asked Whitaker, an internist who worked as a licensed pharmacist through medical school. "I have no qualms about my patients using drugs from Canada. Canadian drugs beat no drugs."
Daryle Whitaker invested about $15,000 to open her Tampa storefront and expects to break even by year-end. She said she'll let the bureaucrats and lawyers battle while she processes prescriptions.
"A lot is going to have to happen to shut us down," Whitaker said. "We're not doing anything more than you can do yourself on the Internet."
She's backed by dozens of satisfied customers, like Lonna Strickland of Tampa. Using Whitaker's services, Strickland ordered a three-month supply of drugs from Canada for her mother at the cost of one month's supply from a U.S. drugstore. Her husband, who ordered two drugs from Canada, figured he's saving $700 a year. And once her father comes out of a nursing home, she expects Whitaker can help her pare down his $8,000-a-year drug bill.
"I don't buy anything over the computer, so I never considered going online to order these directly," Strickland said.
She added that she doesn't worry about the safety of Canadian drugs. "I don't think people in Canada would take things that are dangerous, do you?"
- Kris Hundley can be reached at firstname.lastname@example.org or 727 892-2996.