Canadian Drug Prescription Websites

1
Canadian Drug Prescription Websites

• James Blankenship
• Richard King
• Adrienne Semann

2
Overview

• Ethical issue ? different treatment
• Complexity
• Many players
• Same player could have opposing interests.
• Unfold the situation
• Focus on 2 basic options, analyze each player
  individually

3
Situation A
Canada
Pharmacies
Citizens
Low
United States
High
Only Src
Mfrs
Citizens
Pharmacies
4
Situation B
Canada
Pharmacies
Citizens
Low
United States
Cheap Src
High
Conv. Src
Mfrs
Citizens
Pharmacies
5
Situation C
Canada
Pharmacies
Citizens
Low
FDA/Customs
United States
?
Unapproved
High
Mfrs
Citizens
Pharmacies
6
Situation D
Canada
Pharmacies
Citizens
Low
FDA
FDA/Customs
United States
?
Club
High
Mfrs
Citizens
Pharmacies
7
Situation E
Canada
Pharmacies
Citizens
Low
FDA
FDA/Customs
United States
?
Club
States
High
Mfrs
Citizens
Pharmacies
8
Situation F
Canada
Pharmacies
Citizens
Low
FDA
FDA/Customs
United States
?
Club
States
High
Mfrs
Citizens
Pharmacies
9
Summary

• US Mfrs sell at different prices
• US Consumers and States pursue lower prices,
  buying Canadian via websites and standard
  shipping.
• US Mfrs try to maintain disparate pricing

10
Issue Pricing Model

• Disparity in Pricing
• vs.
• Customer Competition

11
Sub-Issues

• Shipping to US consumers (hidden)
• How to prevent target groups from buying outside
  their group/sphere/domain/locale OR
• How to attain the lowest possible price
  regardless of locale

12
Players Involved

• American Consumer
• US Government agencies ? FDA
• Pharmaceutical Companies
• American Pharmacies
• Canadian Consumer
• Canadian Pharmacies

13
Critical Questions of Players

• IMPLICATIONS
• Disparate pricing
• Customer competition
• STRATEGY
• What is the players goal what are they trying
  to achieve?
• Should the player pursue disparate pricing or
  customer competition?
• ETHICS
• Is the action legal?
• How would it make the player feel if it was on
  the front page of the Wall Street Journal, good
  or bad?
• What is the players point of view
  self-interested, or stakeholder interested?
• TECHNOLOGY
• How can the player use technology to achieve
  their goal?

14
American Consumers
15
American Consumer

• IMPLICATIONS
• Disparate Pricing
• Low Safety Risk
• Trade-off Higher Prices
• Customer Competition
• Lower prices available to everyone
• Trade-off Higher risk
• No legal recourse
• GOAL
• ETHICS
• TECHNOLOGY

?
16
American Consumer

• IMPLICATIONS
• GOAL
• Affordable Health anyone can get drugs needed,
  when needed, at non-discriminatory low prices
• ETHICS
• TECHNOLOGY

?
17
American Consumer

• IMPLICATIONS
• GOAL
• ETHICS
• Legal Not anymore
• Public Wise financial decision feel good/not
  embarrassed
• Point of View Highly self-interested
• TECHNOLOGY

?
18
American Consumer

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• Internet Use of web and email to order
  prescriptions from Canadian companies

?
19
U.S. Government
20
U.S. Government - FDA

• IMPLICATIONS
• Disparate Pricing Easier to execute mission
• Customer Competition
• Costs rise
• Legal Issues
• GOAL
• ETHICS
• TECHNOLOGY

?
21
U.S. Government - FDA

• IMPLICATIONS
• GOAL
• Protect U.S. Consumer Health
• ETHICS
• TECHNOLOGY

?
22
U.S. Government - FDA

• IMPLICATIONS
• GOAL
• ETHICS
• Legal Yes
• Public Feel good about stance however, could
  backfire
• Point of View Stakeholder interest
• TECHNOLOGY

?
23
U.S. Government - FDA

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• Chemical sniffing to detect
• Shipment data mining
• Internet web-taps and email-taps

?
24
Pharmaceutical Companies
25
Pharmaceutical Companies

• IMPLICATIONS
• Disparate Pricing Better able to cover economic
  costs FC, VC, RD, ROI
• Customer Competition Slower payback period
  slower development of new meds, loss of
  shareholder value, possible shutdown
• GOAL
• ETHICS
• TECHNOLOGY

?
26
Pharmaceutical Companies

• IMPLICATIONS
• GOAL
• Maximize Shareholder Value covering economic
  costs
• ETHICS
• TECHNOLOGY

?
27
Pharmaceutical Companies

• IMPLICATIONS
• GOAL
• ETHICS
• Legal As much as they can make it so
• Public Even with justification, would be
  embarrassing
• Point of View self-interested
• TECHNOLOGY

?
28
Pharmaceutical Companies

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• RFID Tags affixed to containers
• Marker Chemicals Govt can detect
• Data Mining Isolate suspect patterns

?
29
American Pharmacies
30
American Pharmacies

• IMPLICATIONS
• Disparate Pricing
• Guaranteed cost base
• Keep same margin
• Customer Competition
• Undercut by unfair price competition
• Loss leader offsets fixed cost
• GOAL
• ETHICS
• TECHNOLOGY

?
31
American Pharmacies

• IMPLICATIONS
• GOAL
• Market Stability keep market share, protect
  revenue stream
• ETHICS
• TECHNOLOGY

?
32
American Pharmacies

• IMPLICATIONS
• GOAL
• ETHICS
• Legal Yes
• Public Less publicity of alternative sources
• Point of View Self-Interest
• TECHNOLOGY

?
33
American Pharmacies

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• Offer Convenience keep up-to-date with changing
  technology

?
34
Canadian Consumers
35
Canadian Consumer

• IMPLICATIONS
• Disparate Pricing Reliable supply, no rationing
• Customer Competition Risk shortage and possible
  black market
• GOAL
• ETHICS
• TECHNOLOGY

?
36
Canadian Consumer

• IMPLICATIONS
• GOAL
• Assure Low-Cost Supply continues indefinitely
• ETHICS
• TECHNOLOGY

?
37
Canadian Consumer

• IMPLICATIONS
• GOAL
• ETHICS
• Legal Yes
• Public No problem, nothing to hide
• Point of View self-interest
• TECHNOLOGY

?
38
Canadian Consumer

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• email to voice opinions

?
39
Canadian Pharmacies
40
Canadian Pharmacies

• IMPLICATIONS
• Disparate Pricing No downside sell same amount
  to Canadians as before
• Customer Competition Opportunity to sell more
  volume and increase profits
• GOAL
• ETHICS
• TECHNOLOGY

?
41
Canadian Pharmacies

• IMPLICATIONS
• GOAL
• Grow by increasing sales volume, and possibly
  profit margins
• ETHICS
• TECHNOLOGY

?
42
Canadian Pharmacies

• IMPLICATIONS
• GOAL
• ETHICS
• Legal Not really
• Public Feel good about supply meds to more
• More publicity is good
• Reputation tarnished is bad
• Point of View Self-interest
• TECHNOLOGY

?
43
Canadian Pharmacies

• IMPLICATIONS
• GOAL
• ETHICS
• TECHNOLOGY
• Website for customer/order mgmt

?
44
What Did Happen?

• Canada had capped prices, forcing U.S. Mfrs to
  sell at disparate prices
• GlaxoSmithKline banned online sales of its meds
• It has become more difficult to import meds to
  U.S.

45
What to do now?